| 引用本文：TuanAnh Nguyen, Rosemary Knight, Elizabeth Ellen Roughead, Geoffrey Brooks, Andrea Mant.中低收入国家药品定价和采购的政策选择[J].中国卫生政策研究,2015,8(4):1-11 |
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| 中低收入国家药品定价和采购的政策选择 |
| 投稿时间：2015-03-06 修订日期：2015-03-19 PDF全文浏览 HTML全文浏览 |
| TuanAnh Nguyen1,2, Rosemary Knight3, Elizabeth Ellen Roughead1, Geoffrey Brooks4, Andrea Mant3 |
1. 南澳大学药学与医学院 澳大利亚阿德莱德 SA5000;
2. 河内医药大学药品经济与药品管理系 越南河内 13-15;
3. 新南威尔士大学公共卫生与社区医学院 澳大利亚肯辛顿 NSW2052;
4. 医药顾问 阿德莱德广场 澳大利亚沃拉拉 NSW2025 |
| 摘要:药品支出上涨是全球问题。为应对这一压力, 多数高收入国家制定并实施了一系列的药品定价和采购政策。然而, 尽管中低收入国家希望能够有效控制药品支出预算, 但其药品市场不规范, 并缺乏可行的药品定价或采购政策。高收入国家药品支出通常由国家或社会医疗保险机构支付, 而中低收入国家大多是个人自付, 这会给政策执行造成阻力。由于对药品定价和采购政策是否高效缺乏严谨的调查研究, 因而一定程度上阻碍了中低收入国家政策方案的实施。本文对已发表的有关药品定价和采购政策的文章进行综述发现, 许多有效的政策也伴随着各种风险。全球尚没有一种最佳的政策选择, 各国应根据具体国情, 多种政策结合使用。中低收入国家的实证研究尚不足, 由于缺乏完善的法律体系以及未建立专门的药品采购机构, 任何一种政策选择所伴随的风险在这些国家都会引起更大的争议, 然而这或许是帮助其改善药品定价和采购体系的关键因素。 |
| 关键词:药品定价 药品采购 基于价值定价 药品支出 发展中国家 |
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| Policy options for pharmaceutical pricing and purchasing: Issues for low- and middle-income countries |
| TuanAnh Nguyen1,2, Rosemary Knight3, Elizabeth Ellen Roughead1, Geoffrey Brooks4, Andrea Mant3 |
1. School of Pharmacy and Medical Sciences, University of South Australia, Adelaide SA 5000, Australia;
2. Pharmacoeconomic and Pharmaceutical Administration Department, Hanoi University of Pharmacy, Hanoi 13-15, Vietnam;
3. School of Public Health and Community Medicine, University of New South Wales, Kensington NSW 2052, Australia;
4. Pharmaceutical Consultant, Adelaide Parade, Woollahra NSW 2025, Australia |
| Abstract:Pharmaceutical expenditure is rising globally. Most high-income countries have exercised pricing or purchasing strategies to address this pressure. Low- and middle-income countries (LMICs), however, usually have less regulated pharmaceutical markets and often lack feasible pricing or purchasing strategies, notwithstanding their wish to effectively manage medicine budgets. In high-income countries, most medicines payments are made by the state or health insurance institutions. In LMICs, most pharmaceutical expenditure is out-ofpocket which creates a different dynamic for policy enforcement. The paucity of rigorous studies on the effectiveness of pharmaceutical pricing and purchasing strategies makes it especially difficult for policy makers in LMICs to decide on a course of action. This article reviews published articles on pharmaceutical pricing and purchasing policies. Many policy options for medicine pricing and purchasing have been found to work but they also have attendant risks. No one option is decisively preferred; rather a mix of options may be required based on country-specific context. Empirical studies in LMICs are lacking. However, risks from any one policy option can reasonably be argued to be greater in LMICs which often lack strong legal systems, purchasing and state institutions to underpin the healthcare system. Key factors are identified to assist LMICs improve their medicine pricing and purchasing systems. |
| Key words:Pharmaceutical pricing Pharmaceutical purchasing Value-based pricing Pharmaceutical expenditure Developing countries |
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