Yu Zhenwei, Zhang Jianying, Zheng Ying, Yu Lingyan
Department of Pharmacy, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Outpatient Nursing, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Front Psychiatry. 2020 Jul 16;11:551. doi: 10.3389/fpsyt.2020.00551. eCollection 2020.
The objective of this study was to investigate the current status and trends in antidepressant use and expenditure in China from 2013 to 2018. The study had a retrospective design based on prescribing data on antidepressant drugs, which was sourced from the Hospital Prescription Analysis Cooperative Project. The trends in hospital visits and corresponding expenditure on antidepressant drugs were examined. Subgroup analyses were carried out by sex, age, and drug class. A total of 1,795,230 outpatient prescriptions were collected from 79 hospitals in six major cities in China. Hospital visits with antidepressant prescriptions rose significantly from 244,626 in 2013 to 348,718 in 2018, reflecting a 42.6% increase ( < 0.05). The antidepressant expenditure also rose, increasing from 48.0 million Chinese yuan in 2013 to 64.8 million Chinese yuan in 2018. There were approximately 1.6 times more antidepressant prescriptions written for women than for men. The most frequent age category for antidepressant prescriptions was 45-64 years. The most commonly prescribed antidepressants were selective serotonin reuptake inhibitors (N06AB) and other antidepressants (N06AX), whereas tricyclic antidepressants (N06AA) accounted for only a small part of the total antidepressant prescriptions. Flupentixol/melitracen and escitalopram were the most frequently prescribed antidepressants. Antidepressant prescribing rates continue to increase in China, although the prescribing patterns have changed over the past few years. The wide use of expensive antidepressants and those with weak clinical evidence raises concerns regarding the rational use of antidepressants. This study provides a basis for future stewardship by the government and medical institutions.
本研究的目的是调查2013年至2018年中国抗抑郁药使用情况和支出的现状及趋势。该研究基于抗抑郁药物的处方数据进行回顾性设计，这些数据来源于医院处方分析合作项目。研究考察了医院就诊情况以及抗抑郁药物的相应支出。按性别、年龄和药物类别进行了亚组分析。共从中国六个主要城市的79家医院收集了1,795,230份门诊处方。开具抗抑郁药的医院就诊人次从2013年的244,626人次显著增加到2018年的348,718人次，增长了42.6%（<0.05）。抗抑郁药支出也有所增加，从2013年的4800万元人民币增至2018年的6480万元人民币。开具给女性的抗抑郁药处方数量约为男性的1.6倍。抗抑郁药处方最常见的年龄类别为45 - 64岁。最常开具的抗抑郁药是选择性5-羟色胺再摄取抑制剂（N06AB）和其他抗抑郁药（N06AX），而三环类抗抑郁药（N06AA）仅占抗抑郁药处方总数的一小部分。氟哌噻吨/美利曲辛和艾司西酞普兰是最常开具的抗抑郁药。尽管过去几年处方模式有所变化，但中国抗抑郁药的处方率仍在持续上升。昂贵且临床证据不足的抗抑郁药的广泛使用引发了对抗抑郁药合理使用的担忧。本研究为政府和医疗机构未来的管理提供了依据。
