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引用本文:韩欣茹, 曾康妮, 谭佳龙, 王健.部分国家和地区医保药品续约政策经验及启示[J].中国卫生政策研究,2024,17(7):75-80
部分国家和地区医保药品续约政策经验及启示
投稿时间:2024-03-25  修订日期:2024-06-28  PDF全文浏览  HTML全文浏览
韩欣茹1, 曾康妮1, 谭佳龙1, 王健1,2
1. 武汉大学董辅礽经济社会发展研究院 湖北武汉 430072;
2. 武汉大学健康经济与管理研究中心 湖北武汉 430072
摘要:目的:归纳分析澳大利亚、韩国、日本和我国台湾地区的医保药品准入和续约规则,为完善我国医保药品目录续约政策提供经验借鉴。方法:采用文献分析、专家访谈等方法,从药品续约政策类型、政策内容、续约期限等角度出发,对比分析不同药品续约政策的经验。结果:部分国家和地区医保药品续约政策大致分为单一药品量价协议、联合量价协议和基于疗效风险共担协议。结论:建议我国在医保政策中加入独家药品续约联合测算、量价效相结合、非独家药品续约共担协议和设置首次续约降幅上限等内容。
关键词:续约  共担协议  联合测算  量价协议
Lessons and enlightments of health insurance drug renewal policy in some countries and regions
HAN Xin-ru1, ZENG Kang-ni1, TAN Jia-long1, WANG Jian1,2
1. Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan Hubei 430072, China;
2. Research Center for Health Economics and Management, Wuhan University, Wuhan Hubei 430072, China
Abstract:Objective: Summarizing and analyzing the rules of access and renewal of drugs in Australia, Japan, South Korea, and Chinese Taiwan, this paper aims to provide experience for the improvement of China's policy on national drug reimbursement list renewal. Methods: Through literature review, expert interviews, and other academic methods, it compares the different experience of drug renewal policy from the perspectives of the type, content, and renewal period. Results: Internationally representative national or regional medical insurance drug renewal policies are broadly categorized into single-drug price-volume agreements, joint price-volume agreements, and efficacy-based risk-sharing agreements. Conclusion: It is recommended that China should introduce new content such as joint measurement for renewal of exclusive drugs, combination consideration of quantity, price, and effectiveness, risk-sharing agreement for renewal of non-exclusive drugs, and placing an upper limit on the rate of reduction for the first renewal in its medical insurance policy.
Key words:Renewal  Risk-sharing agreement  Joint measurement  Price-volume agreement
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