我国高值药品医疗保险管理策略探讨  

Discussing the Management Strategy of Medical Insurance of High Price Drugs in China

作　　者：方鹏骞[1] 赵圣文[1,2] 乐曲 张霄艳[3] FANG Peng - qian;et al(School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, P, R. Chin)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]滨州医学院公共卫生与管理学院 [3]湖北大学政法与公共管理学院

出　　处：《中国卫生事业管理》2017年第11期826-828,共3页Chinese Health Service Management

基　　金：国家自然科学基金重点项目"基于利益均衡和制度整合的我国全民医疗保险体系构建和制度安排研究"(编号:71333005);国家社科基金重大项目"基于全民健康覆盖的推进健康中国发展战略研究"(编号:15ZDC037)

摘　　要：高值药品医疗保障对于重特大疾病保障、防范重大疾病患者经济风险具有重要作用,也是当前重大疾病患者关心的热点问题,我国部分省份也正在积极筹划制定相关政策。文章根据高值药品及所对应疾病特点,参考国内外现有的高值药品管理政策,对高值药品医疗保障的保障对象、保障范围、资金筹集、管理方式、保障水平、医疗服务管理、基金结算、保障措施等,以肿瘤靶向药物为例,提出思考和政策制定建议,以利于完善我国多层级精准医疗保障政策。High price pharmacy insurance plays an important role in protecting patients with critical illness from economic risk, which was concerned currently by patients with critical illness. According to the characteristics of the high price pharmacy and the corresponding diseases, considering the existing domestic and international related drug policy, some countermeasures were put forward, mainly in its guarantee object, scope of insurance, fund raising, medical service management, and fund settle- ment, to improve the accurate and multilevel medical insurance policy.

关 键 词：高值药品 医疗保险 靶向药物 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]