OBJECTIVE: To investigate the application of tamoxifen and torremifen in the treatment of breast cancer

and to probe into the application and changes of selective estrogen receptor modulator（ SERM） of sample hospitals in Shanghai. METHODS: Outpatient and emergency prescriptions and inpatient medical orders of 15 gradeⅢ

level A hospitals in Shanghai during 10 working days each quarter from 2015 to 2019 were extracted as the research samples. Breast cancer patients received tamoxifen or torremiphene were taken as the objectives

and the number of prescriptions

drug consumption sum

defined daily dose system（ DDDs）

defined daily cost（ DDC） and other indicators were recorded. The characteristics of medication were analyzed. RESULTS: A total of 49 178 prescriptions for tamoxifen and toremifene were collected

with a total consumption sum of 11 280 872. 38 yuan. The number of prescriptions and consumption sum of torremifen were respectively 29 926 prescriptions（ 60. 85%） and10 164 229. 64 yuan（ 90. 10%）

significantly higher than 19 252 prescriptions（ 39. 15%） and 1 116 642. 74 yuan（ 9. 90%） of toremifene. The composition ratio of tamoxifen prescriptions decreased year by year

which had the clear selection advantage among breast cancer patients paid by public medical care

non-local medical insurance and the new rural cooperative medical system（ 6 527 prescriptions with tamoxifen

accounting for 60. 45% of the total 10 798 prescriptions for the above three items）. The DDDs of torremiphine increased year by year

which was higher than tamoxifen from 2017. The DDC of torremiphen decreased year by year

which was still much higher than that of tamoxifen

suggesting that tamoxifen still had significant advantages in terms of cost. CONCLUSIONS: Torremiphene is the most commonly used SERM by breast cancer patients in grade III

level A hospital in Shanghai

yet tamoxifen has significant advantages in terms of health insurance and DDC

and clinical recommendations should take various factors into consideration.