我国罕见病及罕用药基本医疗保险覆盖现况分析  

Analysis on the coverage of basic medical insurance for rare diseases and orphan drugs in China

作　　者：胡娟娟[1] 龚时薇[1] 许燚[1] 王英晓[1] 

机构地区：[1]华中科技大学同济医学院药学院,武汉430030

出　　处：《中华医院管理杂志》2013年第8期573-577,共5页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金青年基金项目(70903025);中央高校基本科研业务费专项资金资助(HUST2012QN005)

摘　　要：目的探究适应于中国国情的罕见病医疗保险模式。方法以6大疾病系统的11类罕见疾病、35种治疗药品为研究对象，对比分析了这些罕见病和罕用药在我国不同基本医疗保险体系中的覆盖现况。结果35种罕用药，在我国的基本药物目录2009版和2012版中覆盖率分别为0和37．1％；在国家基本医疗保险目录中覆盖率为54．3％（19种），8个省份新型农村合作医疗药品目录中的平均覆盖率约为33．6％。总体上，我国基本医保纳入的罕见病种类过少。结论我国罕见病患者总体的基本医疗保障水平较低，应提高罕用药保险报销目录覆盖率，建立罕见病及罕用药的专项报销计划，完善我国罕见病医疗救助机制，着手提高罕见病患者的医疗保障水平，减轻其经济负担。Objective To explore a medical insurance model for rare diseases and orphan drugs applicable in China. Methods Eleven rare diseases from six disease systems and thirty-five orphan drugs covered were pinpointed for comparative analysis of their present coverage in various medical insurance systems in China. Results The coverage of 35 orphan drugs in the national essential drug list（2009）and the national essential drug list（2012）is 0 and 37.1%respectively; the coverage in the national essential insurance medicine list is 54. 3% （19 types）, and the average coverage in the medicine list for the New Rural Cooperative Medical Insurance Scheme is 33. 6%. The study found insuS/icient rare diseases included in the Basic Medical Insurance Schemes in general. Conclusion The coverage of basic medical insurance {or rare disease patients is low in China. In this regard, such measures should be taken to mitigate the economic burden for these patients, namely expanding the coverage of reimbursement list of orphan drugs, building the special reimbursement system of rare diseases and orphan drugs and improving the medical rescue system for rare diseases in China and their medical care level.

关 键 词：罕见病 罕用药 医疗保险 药品目录 覆盖 

分 类 号：F842.684[经济管理—保险]