| 引用本文：卢梦情,蒋理添,伍丽群.我国医保药品目录准入路径与集中带量采购政策协同机制研究[J].中国卫生政策研究,2025,18(5):66-73 |
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| 我国医保药品目录准入路径与集中带量采购政策协同机制研究 |
| 投稿时间：2025-04-03 修订日期：2025-05-09 PDF全文浏览 HTML全文浏览 |
| 卢梦情，蒋理添，伍丽群 |
| 深圳卫生健康发展研究和数据管理中心 广东深圳 518028 |
| 摘要:目的 探讨我国医保药品目录准入路径与集中带量采购政策的协同机制，分析不同准入路径下政策协同的成效与矛盾，为优化政策提供参考。方法 采用文献分析法和政策评估法，梳理医保药品目录直接准入、谈判准入与竞价准入路径的特点，结合国家集中带量采购实施现状，对比分析不同准入路径与集采政策的协同效应与问题。结果与结论 直接准入路径下，医保药品目录调整与集中带量采购形成了高效协同的政策闭环，通过支付端与采购端双向激励推动了集采药品的临床使用。谈判准入路径下，协议期独家国谈药集采面临证据缺口、实施对象不兼容、价格机制冲突与采购量测算困难等现实障碍；而协议期国谈仿制药集采需警惕政策叠加对创新动力的抑制效应。竞价准入路径下，竞价药品集采既要重视政策的协同效应，亦要关注竞价药品符合集采的前置条件，与过度降价对医药企业供应药品稳定性冲击。 |
| 关键词:医保 直接准入 谈判准入 竞价准入 集中带量采购 协同机制 |
| 基金项目:国家卫生健康委卫生发展研究中心委托课题；深圳市“医疗卫生三名工程”项目（SZSM202111001） |
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| Study on synergistic mechanism between the access path to national medical insurance catalogue and centralized volume-based procurement policy in China |
| LU Meng-qing, JIANG Li-tian, WU Li-qun |
| Shenzhen Health Development Research and Data Management Center， Shenzhen Guangdong 518028， China |
| Abstract:Objective To investigate the synergistic effect and deficiencies between the access path to national medical insurance catalogue and centralized volume-based procurement（VBP） policy， and to provide scientific references to further improve its synergistic effect.Method The literature analysis method and policy evaluation method were adopted to explore the characteristics of the direct access， negotiated access and bidding access of medical insurance catalogue， and expound the synergistic effect and problems between different inclusion paths and the centralized VBP.Results and Conclusions The direct access of medical insurance and the VBP policy have formed a policy loop， and have promoted the clinical application of the procured drugs. Under the negotiated access， the VBP of patented drugs is confronted with several practical problems such as the lack of evidence， incompatibility of implementation targets， conflicts in pricing mechanisms and calculation of procurement quantities. The VBP of generic drugs should be vigilant against the inhibitory effect of policy stacking on the innovation impetus. Under the bidding access， the VBP of bidding drugs should not only pay attention to the synergy effect of policies， but also focus on whether the bidding drugs meet the preconditions for centralized procurement， and the impact of the excessive price cuts on the stability of drug supply for pharmaceutical enterprises. |
| Key words:Medical insurance Direct access Bidding access Negotiation access Centralized volume-based procurement policy Synergistic mechanism |
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