Department of Pharmacy, Peking University People's Hospital, Beijing, China.
Faculty of Life Sciences and Biopharmaceuticals, Shenyang Pharmceutical University, Shenyang, China.
BMJ Open. 2023 Mar 17;13(3):e069645. doi: 10.1136/bmjopen-2022-069645.
It is unclear whether the use of antineoplastic drugs for patients with lung cancer in China has changed after the implementation of the national drug price negotiation in 2016 and continual update of clinical guidelines. This study aims to evaluate the trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer in major cities of China.
We conducted a retrospective observational study using data from January 2016 to December 2020.
This study used prescription records based on inpatient and outpatient hospital data from 97 hospitals in 9 major cities of China.
A total of 218 325 antineoplastic drug prescriptions in patients with lung cancer were retrospectively collected from the Hospital Prescription Analysis Cooperative Project during the study period.
Trends in antineoplastic drug use, cost and prescribing patterns among patients with lung cancer.
The yearly antineoplastic prescriptions increased by 85.6% from 28 594 in 2016 to 53 063 in 2020 (Z=1.71, p=0.086). Significant increases were seen in the prescriptions for protein kinase inhibitors (PKIs) and monoclonal antibodies (mAbs), whereas significant decreases were observed in antimetabolites, plant alkaloids and platinum compounds. The yearly cost increased progressively by 145.0% from ¥113.6 million in 2016 to ¥278.3 million in 2020 (Z=2.20, p=0.027). The top three anticancer drug classes in terms of total cost were PKIs, antimetabolites and mAbs. In prescribing patterns of antineoplastic agents for lung cancer, monotherapy, and triple or more drug combinations gradually increased, while dual combinations decreased significantly from 30.8% to 19.6%.
Prescription practices among patients with lung cancer in China underwent major changes during the study period. The observed trends can aid in understanding the present medication use status of patients with lung cancer in China and provide information for future drug management.
尚不清楚 2016 年国家药品价格谈判实施后以及临床指南不断更新后，中国肺癌患者使用抗肿瘤药物的情况是否发生了变化。本研究旨在评估中国主要城市肺癌患者抗肿瘤药物使用、成本和处方模式的趋势。
我们使用 2016 年 1 月至 2020 年 12 月期间的数据进行了回顾性观察研究。
本研究使用了来自中国 9 个主要城市 97 家医院的基于住院和门诊医院数据的处方记录。
从研究期间的医院处方分析合作项目中，共回顾性收集了 218325 例肺癌患者的抗肿瘤药物处方。
肺癌患者抗肿瘤药物使用、成本和处方模式的趋势。
2016 年至 2020 年，每年的抗肿瘤处方量增加了 85.6%，从 28594 增加到 53063（Z=1.71，p=0.086）。蛋白激酶抑制剂（PKIs）和单克隆抗体（mAbs）的处方明显增加，而抗代谢物、植物生物碱和铂化合物的处方明显减少。2016 年至 2020 年，每年的成本以 145.0%的速度递增，从 11360 万增加到 27830 万（Z=2.20，p=0.027）。从总成本来看，排名前三的抗癌药物类别是 PKIs、抗代谢物和 mAbs。在肺癌抗肿瘤药物的处方模式中，单药治疗和三联或更多药物联合治疗逐渐增加，而双联治疗则从 30.8%显著下降到 19.6%。
研究期间，中国肺癌患者的处方实践发生了重大变化。观察到的趋势有助于了解中国肺癌患者目前的用药情况，并为未来的药物管理提供信息。
