Presentation (CTI)

OBJECTIVES: With increasing social stress and rising global prevalence of mental disorders, demand for psychotropic drugs has grown substantially. China’s national volume based procurement (VBP) policy has not only improved drug accessibility but also reshaped supply chains and clinical prescribing patterns. Given the risks of tolerance and dependence associated with psychotropic drugs, their use and monitoring demand particular attention. This study aims to analyze the utilization of psychotropic drugs in public medical institutions in Shandong Province, China, identify the key trends, and provide evidence to rational use and effective drug management.
METHODS: Data were retrieved from the Shandong provincial drug utilization monitoring database for 2022- 2024, covering approximately 2,500 public medical institutions, including psychiatric centers. Information regarding drug name, strength, quantity, and cost was collected. Using ATC classification and YPID codes, eight psychotropic drug categories were defined, with additional labeling for essential medicines, national reimbursement drugs, and VBP products. Indicators included defined daily doses (DDDs), total cost, and defined daily dose cost (DDDc).
RESULTS: Over the three year period, total DDDs increased by 27.49%, whereas total cost rose by only 4.75%, demonstrating the “volume for price” effect of VBP. Antipsychotics and antidepressants were the most used. The average DDDc ranged from 19 to 23 CNY, but was higher for imported products and in tertiary hospitals. VBP drugs achieved an availability rate of 72.55%. Geographically, utilization intensity was higher in the eastern part of the province compared to the west part. Although drug overlap across different facility levels exceeded 93%, prescribing patterns varied significantly.
CONCLUSIONS: The use of psychotropic drugs in Shandong exhibits spatial imbalance and structural variation among different facilities. To promote the rational use, we suggest optimizing regional resource allocation, monitoring drug affordability and medication continuity across referral levels, expanding VBP coverage, strengthening primary care capacity, and establishing smart monitoring systems.