欧洲和北美2010年至2024年间药物使用和利用模式的变化与报告的短缺:一个网络队列研究
Marta Pineda-Moncusí1, Alexandros Rekkas2, Álvaro Martínez Pérez3
1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, UK.
The Lancet. Public health
|September 24, 2025
概括
药物短缺严重影响患者护理,导致欧洲和美国减少药物使用和改变治疗模式. 进一步的研究对于减轻这些全球影响至关重要.
科学领域:
- 药物经济学 药物经济学
- 公共卫生 公共卫生
- 药物使用研究 药物利用研究
背景情况:
- 药物短缺对患者护理质量构成重大威胁.
- 欧洲药物管理局 (EMA) 宣布药物短缺,需要进行影响评估.
- 了解使用者特征对于管理药物短缺至关重要.
研究的目的:
- 估计EMA宣布的药品短缺的发生率和流行率.
- 为了描述使用这些受影响药物的患者群体.
- 分析药物短缺期间药物使用模式的变化.
主要方法:
- 一项跨国网络队列研究利用了来自18个欧洲国家和美国的52个数据库的数据.
- 常规收集的数据包括初级保健,二级保健,保险索赔和疾病登记册.
- 估计了年度发病率和周期流行率,减少>=33%定义了短缺;根据患者和药物因素分析了利用变化.
主要成果:
- 八种药物显示>=33%的发病率降低,九种药物显示>=33%的流行率降低.
- 瓦伦尼克林和阿莫西西林 (有或没有克拉夫兰酸盐) 最常受到影响.
- 观察到改变的适用性 (例如,阿尔特普拉斯,沙利卢马布) 和降低的剂量/持续时间 (例如,沙利卢马布),与国家特定的变化.
结论:
- 药物短缺的公告与药物发病率和流行率的重大变化相关.
- 通过药物指示,持续时间和剂量的变化,患者护理受到影响.
- 观察到的药物使用减少在地理上有所不同,这强调了需要全球战略来解决药物短缺的问题.
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