4.4 Article

Reevaluation of adverse drug reactions of psychiatric drugs under the chinese drug volume-based procurement policy

Journal

BMC HEALTH SERVICES RESEARCH
Volume 22, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12913-022-07851-4

Keywords

4+7; Psychiatric drugs; Adverse drug reactions; Rational drug use

Funding

  1. National Natural Science Foundation of China [8210131157]
  2. Science and Technology Development Foundation of Nanjing Medical University [NMUB2020296, NMUB2020297]
  3. Wuxi Municipal Health Commission [Q202101, ZH202110]
  4. Jiangsu Research Hospital Association for Precision Medication [JY202105]

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This study analyzed the occurrence characteristics and related influencing factors of adverse reactions of psychiatric drugs under the Chinese drug volume-based procurement policy (4+7 policy). It was found that these adverse reactions mainly involved the digestive system, nervous system, cardiovascular system, and blood and lymphatic system, with the digestive system being the most common. Most adverse reactions improved or were cured after discontinuation or dose reduction, with no deaths, disabilities, or teratogenicity.
Background The 4 + 7 volume-based procurement is a large group purchase led by the Chinese government, with the aim of reducing the price of medicines by trading volume for price. Although the 4 + 7 drugs had passed the national consistency evaluation, the adverse drug reactions need to be further evaluated to ensure the safety of the 4 + 7 drugs with low prices. We aimed to analyze the occurrence characteristics and related influencing factors of adverse reactions of psychiatric drugs under the chinese drug volume-based procurement policy(4 + 7 policy), and provide references for clinical medication. Methods 137 cases of adverse drug reactions of four psychotropic drugs reported under the 4 + 7 policy in Wuxi Mental Health Center in 2020 were collected. The gender and age of patients, related 4 + 7 drugs, involving organs / systems, clinical manifestations, distribution of new / serious adverse reactions, clinic outcomes were analyzed. Results Among the 137 cases of adverse drug reactions, the incidence of adverse drug reactions was the highest in patients aged 61-70 (25.38%). Mainly involved 4 4 + 7 psychiatric drugs, of which olanzapine tablets caused the most adverse reactions (54, 39.24%). The adverse reactions mainly involved the digestive system, nervous system, cardiovascular system, blood and lymphatic system, among which the digestive system was the most common (61, 44.53%). A total of 8 cases (6.16%) of new and 26 cases of serious adverse reactions were reported, all of which led to the prolongation of disease course. Except for the transient side effects, most of that were improved or cured with no death, disability or teratogenicity after stopping or reducing the dose with symptomatic treatment. Conclusion Since more and more drugs will be included in 4 + 7 for clinic, clinical pharmacists should strengthen the publicity and training of the knowledge of 4 + 7 drugs, strengthen the monitoring of adverse drug reactions, and provide timely feedback to the clinic, in order to achieve early prevention, early identification, timely diagnosis and reasonable intervention of the adverse drug reactions under the context of 4 + 7 policy.

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