美国药品利益管理公司的服务内容  

The activities and services of Pharmacy Benefit Management Companies

作　　者：胡海宁[1] 雷海潮[1] 

机构地区：[1]北京市疾病预防控制中心,北京100013

出　　处：《卫生经济研究》2002年第3期18-20,共3页

摘　　要：药品利益管理公司 (PBMs)的综合服务内容包括 :管理并制订药品报销目录 ,同时为制定国家药品目录提供信息支持及指导 ;建立提供药品的服务网络 ,为相关会员服务 ,通常是通过邮购或BtoC(BusinesstoClient)的方式为慢性病患者提供大宗的处方药物 ;通过建立信息网络实时处理处方和单据 ,并记录药品使用和药费等数据 ,以利用这些数据做出多种报告或研究论文 ;通过信息分析 ,采用多种形式鼓励有关医疗机构的医生使用普通药品 ;与药品生产企业商讨药品采购折扣 ,并进行大宗采购 ;在病人支出能力范围内和临床工作的基础上 ,完善疾病管理项目 ;综合不同地区患者的药物治疗信息提供支出和用药评价等内容。PBMs对控制药品费用起到了积极的作用。The activities of Pharmacy Benefit Management Companies (PBMs) included implementing drug expense formularies, providing information to establish customized formularies or national drug formulary, establishing pharmacies networks for plan members, offering programs in which prescription for maintenance medications were filled less frequently with larger amounts by mail or business to client, providing a service of drugs reprocessing claims electronically at the same time a prescription was filled and thus maintaining a database on drug use and cost, using the data to generate various reports, encouraging the doctors to use basic drugs, negotiating the rebates with drug manufacturers, developing disease management programs based on clinical practice guidelines and measurements of the patient outcome, and evaluating the outcomes by summarized data on the drug therapy in the patients everywhere. In a word, PBMs played an important role in containing drug cost in the medical market in the U.S.A.

关 键 词：药品利益管理公司 药品目录 疾病管理 医药票据审核处理 

分 类 号：R955[医药卫生—药学]