Objective To analyze changes in drug cost characteristics of antibacterial and cardiovascular system drugs in a hospital under the national centralized drug volume-based procurement policy based on the A.M index.

Methods Drug procurement and usage data of antibacterial drugs and cardiovascular system drugs from 2019 to 2024 were extracted from the Medical Support Center, No. 969 Hospital of the Joint Logistics Support Force, and changes in drug cost structure were analyzed using the defined daily doses (DDDs), defined daily cost (DDC), and A.M index method.

Results From 2019 to 2024, a total of 63 antibacterial and cardiovascular system drugs were procured. The total procurement amount decreased from 7.95 million yuan in 2019 to 2.98 million yuan in 2024, with a decline of 62.52%. The procurement quantity increased from 769,000 DDDs in 2019 to 1,161,000 DDDs in 2024. The top ten antibacterial and cardiovascular drugs by procurement amount showed an overall increase in DDDs and a decrease in DDCs. In the A.M index system, the overall substitution index was greater than 1, primarily driven by antibacterial drugs, while the substitution index for cardiovascular system drugs remained consistently below 1.

Conclusion During the implementation of the national centralized drug volume-based procurement policy, drug costs in the sample hospital decreased overall, drug use frequency increased, and patient access to drugs improved. Meanwhile, attention should be paid to the clinical behavior of replacing drugs with low average daily prices with drugs with high average daily prices.

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