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法国的药品短缺:一所大学医学中心的 6 年回顾性研究。

Medicine shortages in France: a 6-year retrospective study in a university medical centre.

机构信息

Pharmacy Department - Purchases and supplying section, Lille University Hospital, Lille, France

Pharmacy Department - Purchases and supplying section, Lille University Hospital, Lille, France.

出版信息

Eur J Hosp Pharm. 2023 Sep;30(5):297-301. doi: 10.1136/ejhpharm-2021-002911. Epub 2021 Nov 10.

Abstract

OBJECTIVES

Medicine procurement disorders, commonly referred to as 'shortages', are a health-threatening phenomenon that have been reported by several stakeholders around the world. This study aimed to describe data from a mitigation tool, namely a shortages report implemented within one of the largest university hospitals in France over a 6-year period.

METHODS

For 6 years (from 1 June 2014 to 31 May 2020) the data used were collected from different sources: purchasing groups, distributors, manufacturers and the national health agency. The report included: medicine identification, disorder duration, starting and ending dates, available alternative products, the Anatomical Therapeutic and Chemical (ATC) classification. Different situations were described: medicine shortages, quotas, supply tensions and market withdrawals.

RESULTS

Over the 6-year period, 1780 disorders were registered comprising 0.67% market withdrawals, 16.97% quotas, 79.89% shortages and 2.47% supply tensions. The median duration of a disorder was 56 days and the most affected ATC classes were the nervous system (N), anti-infectives (J) and the cardiovascular system (C). A substitute medicine was registered for one-third of the disorders. In the N class, the most frequent level 4 classes were N01BB (local anaesthetic amids such as lidocaine, levobupivacaine and ropivacaine), N03AX (other antiepileptics) and N05AX (other antipsychotics). In the J class, the most frequent level 4 classes were J01CR (penicillin combinations), J01CA (extended-spectrum penicillins such as piperacillin and amoxicillin) and J01XX (other antibiotics for systematic use).

CONCLUSIONS

Procurement disorders are still spreading. The study results are similar to those of other research teams around the world. Common answers have to be found to deal with the phenomenon, that include standardisation and risk assessment methods.

摘要

目的

药品采购紊乱,通常被称为“短缺”,是一种威胁健康的现象,全球多个利益相关方均有报道。本研究旨在描述一种缓解工具的数据,即在法国最大的大学附属医院之一实施的短缺报告,该报告为期 6 年。

方法

在 6 年期间(2014 年 6 月 1 日至 2020 年 5 月 31 日),数据来自不同来源:采购组、经销商、制造商和国家卫生机构。报告包括:药品识别、紊乱持续时间、起始和结束日期、可用替代产品、解剖治疗学和化学(ATC)分类。描述了不同情况:药品短缺、配额、供应紧张和市场撤回。

结果

在 6 年期间,共登记了 1780 次紊乱,其中 0.67%为市场撤回,16.97%为配额,79.89%为短缺,2.47%为供应紧张。紊乱的中位数持续时间为 56 天,受影响最严重的 ATC 类别为神经系统(N)、抗感染药物(J)和心血管系统(C)。三分之一的紊乱有替代药品登记。在 N 类中,最常见的四级类别为 N01BB(局部麻醉酰胺,如利多卡因、左旋布比卡因和罗哌卡因)、N03AX(其他抗癫痫药)和 N05AX(其他抗精神病药)。在 J 类中,最常见的四级类别为 J01CR(青霉素组合)、J01CA(广谱青霉素,如哌拉西林和阿莫西林)和 J01XX(其他全身用抗生素)。

结论

采购紊乱仍在蔓延。研究结果与全球其他研究团队相似。必须找到共同的应对措施来处理这一现象,包括标准化和风险评估方法。

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