Abstract: OBJECTIVE To learn about the drug utilization situation and problems in medical institutions based on the drug purchasing database, and give corresponding suggestions. METHODS Based on the drug purchasing statistics of 2 555 public medical institutions in Jiangsu Province in 2019, analyzing the median drug using quantity and concentration, coherence of drug usage between different medical facilities at different levels, and the drug using situation of the National Essential Medicine List(NEML) and National Reimbursement Drug List(NRDL). RESULTS At present, medical institutions at different levels usually use about 3 200 drugs in daily practice, which was far less than drugs on the market in China. The numbers of drug whose concentration was lower than 10% was over 1 000. In terms of drugs mainly equipped and used in medical institutions, the coherence of drug usage between different medical facilities at different levels seemed good. Among drugs with concentration over than 30% in medical institutions, the coincidence rate of drugs between primary and secondary medical institutions was 74.29%, and that of drugs between secondary and tertiary medical institutions was 97.99%. Though medical institutions now have basically formed a “1+X” drug using mode, which was dominated by the NEML list and focused on the NRDL list, the scaling of essential medicines doesn’t achieve the goal of “986”. CONCLUSION In the future, it is necessary to improve the hospital pharmacy management, ameliorate the concentration and rationality of drug use in medical institutions. Strengthen the drug use connection to promote the construction of hierarchical diagnosis and treatment system. Adjusting the NEML list according to basic medical and health needs, basic medical security level and the changes of disease spectrum, so that the guiding role of the NEML and NRDL list in clinical drug use should be continuously consolidated.