Uterine Inertia

编者按：本文来自新康界，作者Fariy；赛柏蓝授权转载，编辑yuki 近日，上海阳光医药采购网发布《关于公示2024年5月部分短缺药全国平均价的公告》。据统计，自2023年11月至今，上海阳光医药采购网先后公布了6批部分短缺药平均价名单。 仅今年来看，2024年上半年下调的7个易短缺药品，包括呋塞米注射液、葡萄糖酸钙注射液、注射用氢化可的松琥珀钠、维生素K1注射液、盐酸精氨酸注射液、硝酸甘油片、注射用盐酸多巴胺。 来源：上海阳光医药采购网 01 销售额大涨186%后 全国平均价迎来“三连降” 在这6份名单中，维生素K1注射液3次上榜。从2023年11月的15.78元/支，到2024年3月的12.59元/支，再到5月的11.11元/支，维生素K1注射液的全国平均价一降再降。 维生素K1注射液是一种止血剂，主要用于维生素K缺乏引起的出血。中康开思系统数据显示，维生素K1注射液在2023年等级医院销售额同比下滑15.3%，达5.26亿元，2024年一季度销售额达1.28亿元。 维生素K1注射液 全国等级医院销售情况 同样“三连降”的还有注射用氢化可的松琥珀酸钠。从2023年11月的17.30元/支，到2023年12月的16.08元/支，再到今年3月的11.74元/支。 注射用氢化可的松琥珀酸钠是一种肾上腺皮质激素类药，是医保甲类和基药品种，数据显示，该产品在等级医院销售额已实现连续3年攀升，在2022年全国等级医院，其销售规模首次达到5600万，同比增长112.6%，2023年更以186%的同比增长率卖出1.59亿元。 注射用氢化可的松琥珀酸钠 全国等级医院销售情况 据了解，目前国内有烟台东诚北方制药、天津生物化学制药、福安药业、常州四药制药、天津力生制药等企业可生产注射用氢化可的松琥珀酸钠；福安药业在今年1月通过一致性评价，为国内首家过评。 02 国采保障短缺药供应 降价超92%，销售额仍上涨21% 在集采方面，第八批国家集采纳入了部分国家短缺药监测名单中的品种，并且在规则制定上给予短缺药品一定倾斜。例如，针对一些特殊级的抗生素和短缺药品，通过适度降低带量比例，以给临床使用更大的选择空间，保障药品落地实施的实操性。 同时，为保障相关药品供应，在第七批集采“一省双供”的基础上，第八批集采针对氨甲环酸注射剂、依诺肝素注射剂等急抢救用药和短缺药品，探索了“一主双备”的供应模式，进一步保障了特殊药品的市场供应和用药需求。 其中，依诺肝素钠注射液11.67元/支，降幅均达到60%左右，中标企业为深圳市天道医药、健友股份、辰欣药业、红日药业和千红制药等9家国产厂商。依诺肝素注射剂在2023年等级医院销售额达25.05亿元，同比下滑0.1%，2024年一季度销售4.09亿元，同比下滑55.5%。 依诺肝素注射剂 全国等级医院销售情况 而第九批国家集采也在短缺药的供应保障方面取得突破，卡贝缩宫素注射液、硫酸阿托品注射液迎来大幅降价。 此前，卡贝缩宫素注射液的挂网价格普遍都在每支百元以上，经此次集采降价，中标产品价格降至30-50元之间。其中，原研辉凌制药以23元/支的最低价中标，较最高有效申报价降价超70%。国产企业中，翰宇药业和辰欣药业也双双中标。 卡贝缩宫素是产后出血的临床急救药，临床上主要用于选择性硬膜外或腰麻下剖腹产术后，以预防子宫收缩乏力和产后出血，其在2022年进入国家短缺药品清单。从数据上看，卡贝缩宫素注射液在2023年等级医院销售额达2.71亿元；2024年一季度销售6.6千万元，同比下滑8.1%。 卡贝缩宫素注射液 全国等级医院销售情况 卡贝缩宫素注射液的原研企业为辉凌制药，其在2023年等级医院市占率最高，国产仿制药的圣诺生物以27.29%的市场份额位居第二。 硫酸阿托品注射液适用于各种内脏绞痛，如胃肠绞痛及膀胱刺激症状。第九批国家集采药品价格平均降幅达58%，而硫酸阿托品注射液（1ml:0.5mg），降幅达92.92%，集采前价格9.75元/支，集采价格0.69元/支。 硫酸阿托品注射液 全国等级医院销售情况 从数据上看，硫酸阿托品注射液在今年一季度等级医院销售额仍实现21.4%的同比增长，达4.6千万元。但由于第九批集采正式落地执行时间为今年3月底，因此后续能否保持如此高的增长率，尚不能下定论。 END 内容沟通：郑瑶（13810174402） 医药代理商产品交流群 扫描下方二维码加入 银发经济市场机遇交流群 扫描下方二维码加入 左下角「关注账号」，右下角「在看」，防止失联

NMPA发布，2023年03月29日药品批准证明文件送达信息，本批次共有4个受理号获批，其中3品规缩宫素注射液通过一致性评价。上海上药第一生化药业有限公司，缩宫素注射液深圳翰宇药业股份有限公司，2品规缩宫素注射液缩宫素注射液可用于引产，催产，产后及流产后因宫缩乏力等引起的子宫出血。缩宫素注射液也可以用于了解胎盘储备功能。同时缩宫素注射液能促进黄体退化，具有利钠作用，以及促进精子从阴道向输卵管方面运输。

The most effective intervention to prevent preterm birth is the administration of a natural hormone, progesterone, in patients at risk for premature delivery. Two categories of patients have been eligible for this treatment: those with a short cervix and those with a previous preterm birth. But new research indicates that progesterone is not effective in reducing the rate of preterm birth in women with a prior history of preterm birth. The most effective intervention to prevent preterm birth is the administration of a natural hormone, progesterone, in patients at risk for premature delivery. Two categories of patients have been eligible for this treatment: those with a short cervix and those with a previous preterm birth. But research published this week in the American Journal of Obstetrics and Gynecology by researchers of the Perinatology Research Branch at the Wayne State University School of Medicine indicates that progesterone is not effective in reducing the rate of preterm birth in women with a history of such birth. In the article, "Does vaginal progesterone prevent recurrent preterm birth in women with a singleton gestation and a history of spontaneous preterm birth? Evidence from a systematic review and meta-analysis," the researchers call for revision of American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine guidelines that recommend the use of progesterone in women with a history of spontaneous pre-term birth. "We have advocated that vaginal progesterone reduces the rate of preterm birth in women with a short cervix. This evidence is solid and derived from multiple studies including randomized clinical trials, meta-analyses and implementation research," said Roberto Romero, M.D., DMedSci, chief of the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Perinatology Research Branch and Professor of Molecular Obstetrics and Genetics at the Wayne State University School of Medicine. "Some people believe that vaginal progesterone is effective not only in women with a short cervix but also in patients with a prior history of preterm birth. We have completed a systematic review and meta-analysis that shows that this is not the case." The effective use of vaginal progesterone in women identified with a short cervix via sonograph to prevent pre-term birth was identified and developed by the PRB in 2010. But extrapolating these findings to patients with a prior history of preterm birth is not correct, the latest findings show. Women with a history of spontaneous preterm birth have a 2.5- to four-fold increased risk of subsequent such issues compared to women with no history of pre-term birth. The American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine recommend the use of vaginal progesterone or 17α-hydroxyprogesterone caproate for all pregnant women with a history of pre-term birth. "We believe it is important to understand the limitations of a successful strategy to avoid overtreatment. We advocate for universal screening of cervical length and the identification of patients who may benefit from a specific intervention. In other words, individualized medicine and not one size fits all," said Dr. Romero, who published the findings with Agustin Conde-Agudelo, M.D., M.P.H., Ph.D., adjunct professor of Obstetrics and Gynecology, and head of the Unit of Perinatal Epidemiology, Systematic Reviews and Meta-analyses. The team reviewed findings from 10 randomized controlled trials that compared vaginal progesterone to placebo or no treatment in asymptomatic women with a singleton gestation and a history of spontaneous preterm birth. They found no convincing evidence that the use of progesterone prevented pre-term birth in these women. Preterm labor, Dr. Romero explained, is a syndrome associated with multiple mechanisms of disease, including infection and/or inflammation, decidual hemorrhage and vascular disease, uterine overdistention, cervical disease, disruption of maternal-fetal tolerance, maternal stress and decline in progesterone action. The syndromic nature of preterm labor explains why a single method of intervention does not prevent all or even predict most cases of preterm birth, he said. For more information, please see this video: