1.Expert consensus on perioperative rational use and comprehensive clinical evaluation of NSAIDs in Shandong Province
Association CLINICAL ; Association CLINICAL ; Association COMPREHENSIVE ; Association PAIN ; Province WORKING
China Pharmacy 2025;36(4):385-394
OBJECTIVE To provide a basis for the rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the perioperative period, and provide practical methods and technical references for the evaluation and selection of NSAIDs in medical institutions. METHODS Initiated by the Affiliated Hospital of Qingdao University, Clinical Pharmacy Professional Committee of the Shandong Pharmacists Association, Clinical Individualised Drug Testing and Guidance Branch of the Shandong Medical Association, Comprehensive Clinical Medication Evaluation Working Committee of the Shandong Pharmacists Association, Pain Branch of the Shandong Medical Association in conjunction with several medical institutions in Shandong Province organized 22 pharmaceutical experts and medical experts from 17 hospitals in Shandong Province to form a consensus on the rational use and comprehensive clinical evaluation of NSAIDs in the perioperative period through the literature research method, expert interview method and questionnaire survey method based on evidence-based medicine. A comprehensive clinical evaluation was also conducted on a total of 13 specifications of 9 commonly used clinical drug varieties in Shandong Province, including celecoxib, etoricoxib, imrecoxib, ibuprofen (containing reference/original drugs and national/Shandong Province’s centralized volume-based procurement varieties). RESULTS & CONCLUSIONS A consensus opinion was formed on preoperative prophylactic use and postoperative use of NSAIDs, as well as contraindications, digestive tract risk, cardiovascular system risk, bleeding risk and kidney injury risk in the perioperative period. The evaluation and selection criteria of perioperative use of NSAIDs were established, involving 6 dimensions of safety, efficacy, economy, innovation, appropriateness, and accessibility. The results of comprehensive clinical evaluation showed that the top 6 drugs (scores over 70) were Celecoxib capsules (Celebrex) and Celecoxib capsules (Naiqi), Diclofenac sodium sustained-release tablets,Etocoxib tablets (Arcoxia) and Etocoxib tablets (Qimingshu), and Parecoxib sodium for injection. With the progress of clinical research, this consensus will be further updated and adjusted, and medical institutions can combine with the practice to develop a comprehensive clinical evaluation system of NSAIDs suitable for their institutions.
2.Economic evaluation of cefuroxime sodium powder-liquid dual-chamber bags for perioperative patients from the hospital perspective
Haijing GUAN ; Zhigang ZHAO ; Changsheng FAN
China Pharmacy 2025;36(4):454-458
OBJECTIVE To evaluate the possible effects of Cefuroxime sodium for injection/Sodium chloride injection (referred to as “Cefuroxime powder-liquid dual-chamber bag”) or Cefuroxime sodium for injection (referred to as “Cefuroxime powder injection”) used in perioperative patients on hospital costs under the background of medical insurance payment reform from the perspective of the hospital. METHODS Assuming that the effectiveness and safety of Cefuroxime powder-liquid dual-chamber bag (scenario 1) and Cefuroxime powder injection (scenario 2) were the same for perioperative patients, the cost-effectiveness of both scenarios was compared by calculating the costs of drug, infusion sets, and labor in the pharmacy intravenous admixture service. The robustness of the results was explored through univariate sensitivity analysis and different centralized procurement share scenarios analysis. RESULTS The base-case analysis showed that the average cost per treatment course for patients using cefuroxime in scenario 1 and scenario 2 were 314.54 yuan and 349.41 yuan, respectively, meaning scenario 1 saved 34.87 yuan per capita compared to scenario 2. The univariate sensitivity analysis and scenario analysis indicated that the research results were robust. CONCLUSIONS The application of Cefuroxime powder-liquid dual-chamber bag in perioperative patients can save medical costs while ensuring the quality and efficiency of medical services, compared to Cefuroxime powder injection.
3.Expert consensus on dispensing management of intravenous infusion drugs for clinical trials in PIVAS
Xingchen YANG ; Wenhuan FU ; Donghui LAO ; Jing ZHAO ; Jianzhong ZHANG ; Group PHARMACY ; Committee HOSPITAL ; Association Pharmaceutical SHANGHAI
China Pharmacy 2025;36(1):1-6
OBJECTIVE To further standardize the dispensing management standard of intravenous infusion drugs for clinical trials in pharmacy intravenous admixture services (PIVAS), and provide reference for medical institutions to provide high-quality pharmaceutical services. METHODS Initiated by PIVAS Group, Hospital Pharmacy Professional Committee, Shanghai Pharmaceutical Association, jointly led by Longhua Hospital, Shanghai University of Traditional Chinese Medicine and Shanghai Geriatric Medical Center, a writing group was established by PIVAS experts from multiple medical institutions to discuss the basic requirements and dispensing process of intravenous infusion drugs for clinical trials in PIVAS. The experts from the leading unit sorted out, summarized, analyzed, fed back and revised the opinions, and finally reached Expert Consensus on Dispensing Management of Intravenous Infusion Drugs for Clinical Trials in PIVAS. RESULTS & CONCLUSIONS The main contents of this consensus include information management, operation process, fund management and document management of intravenous infusion drugs for clinical trials in PIVAS. This consensus establishes a more standardized model for dispensing management of intravenous infusion drugs for clinical trials in PIVAS, by standardizing clinical trail drug management operational procedures, accurately recording and preserving drug-related information, with the aim of achieving standardized and meticulous management of PIVAS’s receipt of clinical trial drugs.
4.Cost-utility analysis of benmelstobart plus anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer
Bing FENG ; Ning GAO ; Shengnan GAO ; Yuxi ZHANG ; Ranran ZHANG ; Guoqiang LIU
China Pharmacy 2025;36(5):579-583
OBJECTIVE To evaluate the cost-utility of benmelstobart combined with anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer (ES-SCLC) from the perspective of China’s healthcare system. METHODS Based on the data from the ETER 701 study, a partitioned survival model was constructed with a cycle of 3 weeks to simulate the total cost, quality-adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER) over 10 years for patients with ES- SCLC treated with benmelstobart plus anlotinib and chemotherapy, or chemotherapy alone. One-way sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the simulation results. The willingness-to-pay (WTP) threshold was set at 3 times the per capita gross domestic product (GDP) of China in 2023, which amounted to 268 074 yuan/QALY. RESULTS Compared with chemotherapy alone, benmelstobart combined with anlotinib and chemotherapy gained 0.438 QALY more at the cost of 403 505.55 yuan more, with an ICER of 922 031.37 yuan/QALY, which was higher than the WTP threshold set in this study. One-way sensitivity analysis showed that benmelstobart’s cost and utility value of the progression-free survival state had a greater impact on the ICER value; probabilistic sensitivity analysis confirmed the robustness of the model; only when the price of benmelstobart was reduced by 75.4%, the combined regimen would be cost-effective. CONCLUSIONS The first-line treatment of ES-SCLC with benmelstobart combined with anlotinib and chemotherapy is not cost-effective from the perspective of China’s healthcare system at present.
5.Investigation on the current status of pharmaceutical care in medical institutions in China
Tingting ZHENG ; Yuqing ZHANG ; Sitong LIU ; Wei ZHANG ; Jin LU ; Qunhong SHEN ; Jiancun ZHEN
China Pharmacy 2025;36(9):1117-1122
OBJECTIVE To investigate the current status of pharmaceutical care in medical institutions in China, and provide experience and suggestions for better development of pharmaceutical care. METHODS Questionnaire survey was used to investigate the development of pharmaceutical care in medical institutions in 31 provinces (autonomous regions and municipalities directly) in March 2023, and descriptive analysis and binary logistic regression analysis on the influencing factors of pharmaceutical care were conducted. RESULTS A total of 1 368 questionnaires were sent out, and 1 304 valid questionnaires were collected with the effective recovery rate of 95.32%. Pharmaceutical care was carried out in 671 medical institutions (51.46%), and the rates of pharmaceutical care in tertiary, secondary, primary and other medical institutions were 74.79%, 27.97% and 7.35%, respectively. The average number of patients receiving pharmaceutical care was 2 638.96 per year, and there were 8.33 pharmacists in each medical institution to carry out pharmaceutical care, among which 93.68% were clinical pharmacists. The main departments covered by pharmaceutical care services included respiratory and critical care medicine, cardiology, intensive care unit, endocrinology, oncology, gastroenterology, obstetrics and gynecology and other departments. There were only 48 medical institutions (7.15%) with additional compensation for pharmaceutical care services. The main experiences of developing pharmaceutical care were to pay attention to talent cultivation and discipline construction, but the main difficulties were serious shortage of staff and qualified talents, low compensation level and low enthusiasm. Grade of medical institutions, the number of pharmacists engaged in clinical pharmacy, the number of qualified clinical pharmacists and the degree of information in the pharmacy department were the main influencing factors for carrying out pharmaceutical care (P<0.05). CONCLUSIONS In recent years, pharmaceutical care in Chinese medical institutions has made certain progress, while that of primary medical institutions, secondary medical institutions and other medical institutions should be improved. In the future, it is still necessary to further enhance the implementation of pharmaceutical care, promote personnel training, and attach importance to demonstrating the value of pharmaceutical care, thereby promoting the sustainable and high- quality development of pharmaceutical care.
6.Cost-effectiveness of vitamin D analogue for postmenopausal osteoporosis in women
Haijing GUAN ; Yanan XU ; Zhigang ZHAO ; Changsheng FAN
China Pharmacy 2025;36(10):1209-1215
OBJECTIVE To evaluate the cost-effectiveness of vitamin D analogue for postmenopausal osteoporotic women in China. METHODS A Markov microsimulation model was developed to analyze the clinical and economic outcomes of eldecalcitol, alfacalcidol and calcitriol for postmenopausal osteoporosis from the healthcare system perspective in China. The clinical parameters required for the model were derived from network meta-analysis, while cost and utility data were primarily obtained from the literature. The cycle length was 1 year , the time horizon was life time, and the willingness-to-pay threshold was 0.5 times the gross domestic product per capita in China in 2023(44 679 yuan/QALY). Model uncertainty was tested with one-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis. RESULTS The quality-adjusted life years (QALYs) for eldecalcitol were calculated to be 12.03 QALYs, which were higher than those for alfacalcidol (11.94 QALYs) and calcitriol (11.92 QALYs). Meanwhile, the direct medical cost associated with eldecalcitol treatment amounted to 38 805 yuan, which was lower than that of alfacalcidol (45 173 yuan) and calcitriol (45 821 yuan). The results of the one-way sensitivity analysis showed that the risk ratio of hip fracture and vertebral fracture had a significant impact on the result. The probabilistic sensitivity analysis and scenario analysis showed the robustness of the findings from the base-case analysis. CONCLUSIONS Compared with alfacalcidol and calcitriol, eldecalcitol is likely to be a cost-effective treatment for postmenopausal osteoporotic women in China.
7.Expert consensus on artificial intelligence-assisted pharmaceutical care
Commission PHARMACY ; Association GERIATRIC ; Society SUB-ASSOCIATION
China Pharmacy 2025;36(13):1553-1562
OBJECTIVE To provide guidance for the scientific and standardized application of artificial intelligence (AI) technology in supporting pharmaceutical care services, and to promote the high-quality development of pharmaceutical care. METHODS Using keywords such as “artificial intelligence” and “pharmaceutical care”, a comprehensive search was conducted across domestic and international databases and relevant policy documents. Drawing upon practical experience in AI-assisted pharmaceutical care services in China, a consensus framework and preliminary recommendations were drafted. Consensus was defined as agreement by 70% or more of expert panel members. RESULTS & CONCLUSIONS Through two rounds of the Delphi method and multiple rounds of discussions, 23 strong recommendations (approval rate >90%) were formulated. These address the definition, scope, objectives, multiple application scenarios (including pharmaceutical outpatient, medication reconciliation, medication education, adverse drug event prediction and monitoring, home-based pharmaceutical care services, and drug supply), ethical considerations and accountability, challenges encountered, and quality control recommendations for AI-assisted pharmaceutical care. Intended for use by professional technical staff engaged in pharmaceutical care, managers, and AI technology developers within healthcare institutions, these recommendations provide guidance for the practice of pharmaceutical care in the era of AI.
8.Investigation on the current status and optimization strategies for the standardized on-the-job training for community clinical pharmacists in Shanghai
Yangjiayi XIANG ; Jing SHENG ; Liping WANG ; Lie LUO ; Yuan YUAN ; Xiaodan ZHANG ; Yan LI ; Bin WANG ; Guanghui LI
China Pharmacy 2025;36(13):1568-1573
OBJECTIVE To systematically investigate the current status and effectiveness of the standardized on-the-job training program for community clinical pharmacists in Shanghai, and to provide a scientific basis for optimizing the training scheme. METHODS A questionnaire survey was conducted to collect the data from trainees and mentor pharmacists who participated in the program between 2016 and 2024. The survey examined their basic information, evaluations of the training scheme, satisfaction with training outcomes, and suggestions for improvement. Statistical analyses were also conducted. RESULTS A total of 420 valid responses were collected, including 340 from trainees and 80 from mentor pharmacists. Before training, only 30.29% of trainees were engaged in clinical pharmacy-related work, whereas this proportion increased to 73.24% after training. Most mentor pharmacists had extensive experience in clinical pharmacy (76.25% with ≥5 years of experience) and mentoring (78.75% with ≥3 teaching sessions). Totally 65.59% of trainees and 55.00% of mentor pharmacists believed that blended training yielded the best learning outcomes. Over 80.00% of both trainees and mentor pharmacists considered the overall training duration, theoretical study time, and practical training time to be reasonable. More than 95.00% of trainees and mentor pharmacists agreed that the homework and assessment schemes were appropriate. Trainees rated the relevance of training content to their actual work highly (with an average relevance score >4.5), though they perceived the chronic disease medication therapy management module as significantly more challenging than the prescription review and evaluation module and the home-based pharmaceutical care module. The average satisfaction score of trainees and mentor pharmacists with the training effectiveness of each project was above 4 points, indicating a high overall satisfaction. Inadequate provision of teaching resources was unanimously recognized by trainees and mentor pharmacists as the key area requiring improvement. CONCLUSIONS The standardized on-the-job training program for community clinical pharmacists in Shanghai has contributed to improving pharmaceutical services in community healthcare settings. However, ongoing improvements must concentrate on content design, resource development, and faculty cultivation.
9.Evaluation and prospect of clinical pharmacist instructor training reform oriented toward enhancing clinical teaching competence
Li YOU ; Jiancun ZHEN ; Jing BIAN ; Zhuo WANG ; Yunyun YANG ; Jin LU ; Jing LIU
China Pharmacy 2025;36(17):2085-2091
OBJECTIVE To summarize the implementation experiences of the China Hospital Association’s Clinical Pharmacist Instructor Training Program Reform, and to evaluate the effectiveness of the reform, thus continuously enhancing the quality and standards of clinical pharmacist instructor training. METHODS The study drew on project evaluation methodologies to summarize the main characteristics of the comprehensive system and new model for clinical pharmacist instructor training established through the reform by literature review. The “learning assessment” and “reaction assessment” were conducted by using Kirkpatrick’s four-level model of evaluation in order to evaluate the effectiveness of the clinical pharmacist instructor training reform through statistically processing and analyzing the performance data and teaching evaluation data of the instructor participants. Based on problem and trend analysis, the future development directions were anticipated for the reform of clinical pharmacist instructor training. RESULTS & CONCLUSIONS The latest round of clinical pharmacist instructor training reform initiated by the Chinese Hospital Association had initially established a four-pronged training system encompassing “recruitment, training, assessment, and management”. It had also forged a training 。 model “oriented towards enhancing clinical teaching competency, with practical learning and skill-based assessment conducted on clinical teaching sites as its core”. Following a period of over three years of gradual reform, the new training system and model became increasingly mature. In both 2023 and 2024, the participants achieved relatively high average total scores in their initial completion assessments [with scores of (84.05± 5.83) and (85.82±4.35) points, respectively]. They also reported a strong sense of gain from the training reform [with self- perceived gain scores of (4.80±0.44) and (4.85±0.39) points, respectively]. The operation and implementation effects of the reform were generally satisfactory. In the future, clinical pharmacist instructor training reforms should continue to address the issues remaining from the current phase, while aligning with global trends in pharmacy education and industry development. Additionally, sustained exploration and practice will be carried out around the core objective of “enhancing clinical teaching competence”.
10.Guideline for the workflow of clinical comprehensive evaluation of drugs
Zhengxiang LI ; Rong DUAN ; Luwen SHI ; Jinhui TIAN ; Xiaocong ZUO ; Yu ZHANG ; Lingli ZHANG ; Junhua ZHANG ; Hualin ZHENG ; Rongsheng ZHAO ; Wudong GUO ; Liyan MIAO ; Suodi ZHAI
China Pharmacy 2025;36(19):2353-2365
OBJECTIVE To standardize the main processes and related technical links of the clinical comprehensive evaluation of drugs, and provide guidance and reference for improving the quality of comprehensive evaluation evidence and its transformation and application value. METHODS The construction of Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs was based on the standard guideline formulation method of the World Health Organization (WHO), strictly followed the latest definition of guidelines by the Institute of Medicine of the National Academy of Sciences of the United States, and conformed to the six major areas of the Guideline Research and Evaluation Tool Ⅱ. Delphi method was adopted to construct the research questions; research evidence was established by applying the research methods of evidence-based medicine. The evidence quality classification system of the Chinese Evidence-Based Medicine Center was adopted for evidence classification and evaluation. The recommendation strength was determined by the recommendation strength classification standard formulated by the Oxford University Evidence-Based Medicine Center, and the recommendation opinions were formed through the expert consensus method. RESULTS & CONCLUSIONS The Guideline for the Workflow of Clinical Comprehensive Evaluation of Drugs covers 4 major categories of research questions, including topic selection, evaluation implementation, evidence evaluation, and application and transformation of results. The formulation of this guideline has standardized the technical links of the entire process of clinical comprehensive evaluation of drugs, which can effectively guide the high-quality and high-efficient development of this work, enhance the standardized output and transformation application value of evaluation evidence, and provide high-quality evidence support for the scientific decision-making of health and the rationalization of clinical medication.
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