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基于价值定价的多适应证药品医保支付国际经验及启示
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| 篇名： | 基于价值定价的多适应证药品医保支付国际经验及启示 |
| TITLE： | International Experience and Enlightenment of Medical Insurance Reimbursement for Multi-indication Drugs Based on Value-based Pricing |
| 摘要： | 目的：为完善我国多适应证药品基于价值定价的医保支付提供参考。方法：梳理多适应证药品价值定价的理论基础和实现流程，分析法国、德国、英国、意大利和瑞典的价值评估指标和基于价值定价的医保支付策略，为我国多适应证药品医保支付提出建议。结果与结论：价值定价的实现首先需要制定一个价值框架以定义、测量、整合价值，再通过建立模型将总价值转化为价格。各国多适应证药品根据价值定价的整体思路一致，但价值评估指标存在差异。英国和瑞典主要以药物经济学方法测得的质量调整生命年（QALYs）和增量成本-效果比（ICERs）为价值标准，法国、德国和意大利则更侧重于以药品的临床治疗价值和临床指标改善程度为标准。在多适应证药品的医保支付策略方面，法国采取的是基于预期使用量的单一加权法，德国采取的是基于价值和使用量的组合加权法，英国采取的是名义医保支付标准结合患者准入协议法，意大利采取的是名义医保支付标准结合管理准入协议法，瑞典则采用不同适应证不同商品名的独立支付法。我国可在借鉴上述多国经验的基础上，探索适应我国国情的多适应证药品的价值定价策略，综合借鉴和使用多种医保支付策略，完善患者及药品使用信息收集机制，为实施多适应证药品价值定价和医保支付策略提供信息支持。 |
| ABSTRACT： | OBJECTIVE：To provide reference for improving medical insurance reimbursement for multi-indication drugs based on value-based pricing in China. METHODS：The theory and practice of value-based pricing for multi-indication drugs were sorted out，and the value standards and medical insurance reimbursement strategies based on value-based pricing in France，Germany，UK，Italy and Sweden were analyzed，so as to provide the suggestions for medical insurance reimbursement of multi-indication drugs in China. RESULTS & CONCLUSIONS：The realization of value-based pricing first needed to develop a value framework to define，measure and integrate value，and then established a model to convert the total value into price. The overall idea of value-based pricing for multi-indication drugs was consistent，but there were differences in the value standard. In the UK and Sweden， quality-adjusted life years （QALYs） and incremental cost-effectiveness ratios （ICERs） measured by pharmacoeconomicsare used as the value standard. France，Germany and Italy were more focused on the therapeutic value and clinical benefit improvement. As for medical insurance reimbursement strategies，France adopted single weighting method based on expected volume. Germany adopted combination weighting method based on value and volume. UK introduced the Patient Access Schemes and Italy introduced the Managed Entry reements，both based on the nominal reimbursement standard. Sweden adopted independent reimbursement for different indications by different brand names. It is suggested that China can explore the value-based pricing strategies of multi-indication drugs on the basis of the above international experiences，reference and use these variety of medical insurance reimbursement strategies comprehensively. Simultaneously，the information collection mechanism of patients and drug use should be improved to provide data support for the implementation of China’s value-based pricing and reimbursement strategies for multi-indication drugs. |
| 期刊： | 2021年第32卷第02期 |
| 作者： | 代展菁，薛天祺，向贵圆，常峰，路云 |
| AUTHORS： | DAI Zhanjing ，XUE Tianqi ，XIANG Guiyuan ，CHANG Feng，LU Yun |
| 关键字： | 多适应证药品；价值定价；医保支付；法国；德国；英国；意大利；瑞典；启示 |
| KEYWORDS： | |
| 阅读数： | 413 次 |
| 本月下载数： | 13 次 |
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