Objective：To analyze the changes in the clinical use structure of proton pump inhibitors for injection before and after the implementation of the “national-centralized drug procurement” and “national medical insurance negotiation” policies in Zhengzhou Second People’s Hospital, and to explore the potential drug use problems in the process of implementation of the “national-centralized drug procurement” and “national medical insurance negotiation” policies, so as to provide reference for promoting rational clinical use of drugs and optimizing policy implementation. Methods：The usage data of injectable proton pump inhibitors from 2019 to 2024 were extracted from the hospital drug usage database, the variations in key indicators, including the defined daily dose (DDDs) and its usage proportion, as well as the defined daily cost (DDDc) and the proportion of usage amount, specifically for injectable proton pump inhibitors were analyzed and compared. Results：Under the influence of the “national-centralized drug procurement” and “national medical insurance negotiation” policies, the use structure of injectable proton pump inhibitors in our hospital has undergone major changes, and unselected drugs have gradually been withdrawn from the hospital catalog. After 2023, the use of injectable proton pump inhibitors in our hospital were only selected drugs, temporary harvest varieties and “national medical insurance negotiation” varieties left. Among the selected drugs, [national-centralized drug procurement] Omeprazole B for injection DDDs and the proportion of usage are increasing year by year, but they account for a smaller proportion; [national-centralized drug procurement] Lansoprazole for Injection DDDs will be on the rise from 2022 to 2023, but due to the small tendency for clinical use, they will basically no longer be used in 2024; [national-centralized drug procurement] the proportion of DDDs and usage of pantoprazole for injection is increasing. In 2024, the proportion of DDDs and usage of pantoprazole ranks first in the hospital. The DDDs of the “national medical insurance negotiation” variety of iprazole for injection showed an increasing trend year by year from 2020 to 2023. After hospital control, the proportion of DDDs and usage has declined, but still accounts for a large proportion. Conclusion：The “national-centralized drug procurement” and “national medical insurance negotiation” policies have lowered the price of injectable PPIs, reduced patients’ medication burden, increased the accessibility of drugs, and saved a large amount of medical insurance funds. However, they have also derived some potential medication behaviors, only by strengthening the supervision of drug use can we ensure the rational use of drugs and promote the stable and long-term implementation of favorable policies.