药品集中带量采购政策与我国医保支付制度的协同作用探讨-中国药房

药品集中带量采购政策与我国医保支付制度的协同作用探讨

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篇名：	药品集中带量采购政策与我国医保支付制度的协同作用探讨
TITLE：	Investigation on Synergistic Effect between Centralized Drug Quantity Purchase Policy and Medical Insurance Reimbursement System
摘要：	目的：探讨我国药品集中带量采购政策与医保支付制度的协同作用及尚存不足，为进一步提升其协同水平提出可行性建议。方法：采用文献分析法和政策评估法，分别对目前我国药品集中带量采购政策与医保支付制度的直接协同与间接协同作用进行阐述，分析其存在问题，并提出可行性建议。结果与结论：药品集中带量采购政策对我国医保支付制度在技术层面的付费方式、效果层面的绩效评估、管理层面的过程管控等方面有着直接影响。其间接协同作用包括：药品集中带量采购政策可促使药品供应保障体系作出调整以适应医保支付改革；可调整医药市场，影响医保支付制度改革。不足之处为：中选药品品种少，采购范围与医保降费均有进一步提升空间；医保对于非中选药品“一刀切”的支付标准可能会削弱药企对仿制药研发的积极性等。因此，下一步还需大幅扩大药品采购品种和范围，对于本身品种就较少的药品，可以适当放开医保支付限制；协调医保报销政策和采购方案，提升医保支付的合理性和完善性；引导医疗机构从“价格医疗”到“价值医疗”理念的转变，兼顾市场多方利益，形成全方位的药品价格与医保支付制度的协同调整机制。
ABSTRACT：	OBJECTIVE：To investigate the synergistic effect and deficiencies between centralized drug quantity purchase policy and medical insurance reimbursement system ，and to provide feasible suggestion to further improve its synergistic effect. METHODS：The literature analysis method and policy evaluation method were adopted to expounds the direct and indirect synergistic effect between the current centralized drug quantity purchase policy and medical insurance reimbursement system in China，and analyze the existing problems so as to put forward the feasible suggestions. RESULTS & CONCLUSIONS ：The centralized drug quantity purchase policy had a direct impact on the payment mode of medical insurance reimbursement system in technical level ，performance evaluation in effect level and process control in management level. The indirect synergy included ： centralized drug quantity purchase policy could promote the adjustment of drug supply security system to adapt to the reform of medical insurance payment ；it could adjust the pharmaceutical market ，and affect the reform of medical insurance reimbursement system. The disadvantages were as follows ：the varieties of selected drugs was still narrow ，and there was room for further improvement in purchasing scope and medical insurance fee reduction ；“one-size-fits-all”payment standard for unselected drug might weaken pharmaceutical companies ’enthusiasm for generic drug research and development. Therefore ，the next step is to significantly expand the variety and scope of procurement ，and appropriately liberalize the medical insurance payment restrictions for drugs with fewer varieties ；coordinate medical insurance reimbursement policies and procurement programs ，and improve the rationality and perfection of medical insurance payment ；guide the medical institutions to change the concept from “price-based medical treatment ”to“value-based medical treatment ”，take into account the interests of all parties in the market ，so as to form a comprehensive coordination adjustment mechanism of drug price and medical insurance reimbursement system.
期刊：	2021年第32卷第02期
作者：	谭清立，高江源，林岱衡
AUTHORS：	TAN Qingli，GAO Jiangyuan ，LIN Daiheng
关键字：	药品集中带量采购政策；医保支付制度；药品供应保障体系；协同作用
KEYWORDS：	Centralized drug quantity purchase policy ；Medical insurance reimbursement system ； Drug supply security
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