Using Shanghai Drug Monitoring System To Carry Out Antineoplastic Drugs Regional Pharmacoepidemiology Study

Purpose:1. To carry out the study of antineoplastic drug drug utilization in Putuo area in Shanghai by using Shanghai drug monitoring system.2. To study the pharmacoepidemiology of antineoplastic drug chemosensitivity in vitro by using antineoplastic drug chemosensitivity database.Methods:1. Designing and setting up the ARMLS computer mode。According to inpatients'chart of Shanghai hospital and inputting inpatients'drug utilization information of 5 hospitals in Putuo area of Shanghai to form IDUD.2. Using the method of the defined daily dose (DDD), the kinds of antineoplastic drug, consumption, dosage, frequency of drug application, daily drug cost were satistically analyzed and ranked in their order. Comparing drug ulilization among domestic drugs, imported drugs and joint-drugs. Comparing drug utilization among in 2002, 2003, and 2004.3. Using tumor chemosensitivity tesing database inquiry system, chemosensitivity in vitro of 18 kinds of antineoplastic drugs to 7 kinds of tumors were satistically analyzed. That if every kind of antineoplastic drug was sensitive to very tumor was investigated. Results:1. Setting up the Shanghai drug monitoring system computer mode and the first big and kinesic IDUD in China in which drug utilization information of 107,301 inpatients was input by August 2006. The information included of inpatients'basic information, disease diagnose information, drug utilization information, biochemical indicator.2. During 2002– 2004, DDDs and the cost of antineoplastic drugs in PuTuo area increased 11.16% and 12.3% respectively. The cost of domestic drugs decreased 11.37%, but imported drugs and jointed drugs increased 10.17% and 1.2% respectively. The cost increase of FUB, VP-16, Ara-C and HHRT is coincide with the DDDs increase. The DDDs of FUB, MTX, 5-FU, DDP was greater than that of other drugs, the cost of FUB, OPT, THP was more than that of other drugs. The daily cost of OPT, EPI, and IFO was higher, the daily cost of DDP, CBP, VCR, HU, MTX was lower. From 2002 to 2004, the daily cost of most drugs decreased except the daily cost of DDP, CBP, Ara-C, VCR increased, the daily cost of a few drugs was unchanged.3. There was significant difference among mean inhibition rates of different antineoplastic drugs on same tumor( P<0.05). There was significant difference among mean inhibition rates of same antineoplastic drugs on different tumor( P<0.05). Among 18 kinds of antineoplastic drugs, Pingyang's mean inhibition rate was highest on enteric tumor, next was DDP and MMC .5-Fu's mean inhibition rate was highest on gastric tumor, next was DDP and Pingyang . VM-26's mean inhibition rate was highest on lung tumor. All drugs'mean inhibition rate was very close and low on pancreas tumor. DDP's mean inhibition rate was highest on kidney tumor, VDS and VCR's mean inhibition rate was lowest on kidney tumor. ACTD's mean inhibition rate on kidney tumor was higher than other drugs. VM-26's mean inhibition rate was highest on leukemia, next was EPI.Conclusions:1. Setting up the ARMLS computer mode first time, IDUD was the big and kinetic database about inpatients'drug utilization in China.2. Under the circumstances of drugs'price adjusted by the government, during 2002– 2004, the cost increase of drug was coincided with the DDDs increase in Putuo area. The cost of domestic drugs decreased 11.37%, the daily cost of most drugs decreased, which was benefit for the patient.3. The results of chemosensitivity in vitro by MTT in double layer agarose were very close to clinical therapy effect. Chemosensitivity in vitro can offer conference and support for cancer patients'therapy.