| 引用本文：张欲晓, 崔丹, 毛宗福.高值药物支付机制的国际比较及启示[J].中国卫生政策研究,2016,9(12):44-49 |
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| 高值药物支付机制的国际比较及启示 |
| 投稿时间：2016-05-11 修订日期：2016-07-11 PDF全文浏览 HTML全文浏览 |
| 张欲晓1, 崔丹1, 毛宗福2 |
1. 武汉大学公共卫生学院 湖北武汉 430071;
2. 武汉大学健康学院 湖北武汉 430071 |
| 摘要:目的：介绍美国、澳大利亚、德国的高值药物支付机制，为完善我国高值药物支付机制提供参考。方法：基于文献，从共付模式、药物遴选标准、谈判定价方式、药物使用管理办法四个方面，探索三国高值药物支付主要内容和特点，并针对我国高值药物支付现状，提出启示及建议。结果：医疗保障制度不同决定了各国共付模式、谈判主体层次的差异，但其药物遴选均与药物经济学评价密切结合，并构建了防止药物滥用的配套管理方法。结论：我国应在大病医疗保险的基础上探索可持续的共付模式，在国家层面探索适宜的药物经济学评价方法，建立相关指标体系，为药物遴选及退出提供科学依据。发挥国家专利高值药集中谈判优势，构建“风险共担”机制降低基金风险，平衡各方利益；探索以明确适应症为主的高值药物使用管理方法。 |
| 关键词:高值药物 支付机制 药物价格谈判 |
| 基金项目:国家自然科学基金（71573192）；湖北省医保协会资助项目（湖北省创新药物医保准入机制研究） |
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| International comparative study on high-value drugs payment system and its implications for China |
| ZHANG Yu-xiao1, CUI Dan1, MAO Zong-fu2 |
1. School of Public Health, Wuhan University, Wuhan Hubei 430071, China;
2. School of Health Sciences, Wuhan University, Wuhan Hubei 430071, China |
| Abstract:Objective:The aim of the present study was to conduct an international comparison of the high-value drugs payment systems of some selected countries, and introduce them to the Chinese context. Australia, America and Germany's high-value drugs payment systems were selected to serve as references for China.Methods:The main content and characteristics of three countries' payment systems were analyzed in four aspects:expenditure copayment mode, paid-scope selection, drug price negotiation, and drug rational use management which were then compared with the Chinese status.Results:Through the difference in healthcare system tradition, the above countries have various copayment mode, but they all select paid-drug by cost-effectiveness analysis with corresponding control measures. Conclusions:China should:establish a co-payment mode for the high-value drugs on the basis of a critical illness medical insurance found; build a national pharmaco-economic evaluation index system and improve the national negotiation superiority, while emphasizing on risk-sharing mechanism; and make series specifications to guarantee the drug to be rationally used. |
| Key words:High-value drugs Payment system Drug price negotiation |
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