| 引用本文：邵蓉, 王梦媛, 颜建周, 张伶俐.我国网售处方药报销面临的问题及对策分析——基于美国药品福利管理模式[J].中国卫生政策研究,2016,9(4):31-36 |
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| 我国网售处方药报销面临的问题及对策分析——基于美国药品福利管理模式 |
| 投稿时间：2015-12-08 修订日期：2016-03-14 PDF全文浏览 HTML全文浏览 |
| 邵蓉1, 王梦媛2, 颜建周1, 张伶俐3 |
1. 国家药物政策与医药产业经济研究中心 江苏 南京 211198;
2. 中国药科大学国际医药商学院 江苏 南京 211198;
3. 南京军区南京总医院 江苏 南京 210002 |
| 摘要:我国医药电子商务发展已有十余年历史,然而在B2C(Business-to-Customers)业务尤其是处方药的互联网交易业务领域发展缓慢,其中,处方的审核及报销是相关部门制定政策时面临的主要问题之一。药品福利管理模式是美国广泛用于药品费用支出管理的一种手段,目前已经形成较为完善的运营方式和服务体系,在处方报销、处方集管理、疾病健康管理、药品利用评价等多个方面起到了重要作用。本文将基于文献分析法,深入讨论我国网售处方药中处方报销存在的问题,并借鉴美国药品福利管理模式,结合我国国情,最终构建出处方报销过程中以药品福利管理公司为核心的药品信息网络和处方报销流程。 |
| 关键词:网售处方药 医药电子商务 处方报销 药品福利管理 |
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| The problems and countermeasures of the online prescription drugs reimbursement in China: Based on the US Pharmacy Benefits Management model |
| SHAO Rong1, WANG Meng-yuan2, YAN Jian-zhou1, ZHANG Ling-li3 |
1. National Drug Policy and Medical Industry Economy Research Center, Nanjing Jiangsu 211198, China;
2. School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing Jiangsu 211198, China;
3. Nanjing General Hospital of Nanjing Military Command, Nanjing Jiangsu 210002, China |
| Abstract:It has been more than ten years since pharmaceutical e-commerce began to develop in our country. However, the pharmaceutical business's B2C (Business-to-Customers) e-commerce, particularly in the field of online trading of prescription drugs, has experienced a slow development, and prescription audit and reimbursement policies has been one of the most important issues that policy makers confronted with. The Pharmacy Benefit Management (PBM) model is a tool which is widely used in the control of pharmaceutical products expenditures in the United States of America. After decades, it has formed a relatively complete operating model and service system, as well as played an important role in many aspects including prescription reimbursement, disease and health state management, formulary management, drug utilization review etc. In this article, the prescription reimbursement issues which exist in the process of net online prescription drugs will be thoroughly discussed based on the literature analysis. Besides, based on national conditions, the US PBM model will be used for reference to help ultimately build a prescription reimbursement process and drug information networks to the pharmacy benefit management companies at the core. |
| Key words:Online prescription drugs Pharmaceutical e-commerce Prescription reimbursements Pharmacy Benefit Management (PBM) |
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