吉非替尼和埃克替尼对南京地区医保预算的影响分析  

Analysis on the Impact of Gefitinib and Icotinib on Medical Insurance Budget

作　　者：房文通[1] 戴惠珍 陶琳[3] 罗璨[1] 

机构地区：[1]南京医科大学第一附属医院,南京210029 [2]江苏省医药情报研究所,南京210029 [3]上海市食品药品监督管理局科技情报研究所,上海200010

出　　处：《中国卫生经济》2017年第12期35-39,共5页Chinese Health Economics

摘　　要：目的:对吉非替尼和埃克替尼对南京地区医保预算的影响进行分析。方法:2010-2015年南京地区吉非替尼、埃克替尼、厄洛替尼、肿瘤分子靶向药物、抗肿瘤药物和全部药物的用药数据来自江苏省医药情报研究所。抗肿瘤药品和全部药品的医保支出费用按平均报销比例计算。根据2010-2015年的情况,预测2018年的用量和医保支付费用。假设医保覆盖导致不同的新增用量比例,按照90%、80%和70%的报销比例分别计算新增的医保支出及其对抗肿瘤药品和全部药品医保支出的影响。结果:预测的2018年抗肿瘤药物医保支付费用为13.27亿元,南京地区全部药物医保支付费用为124.03亿元。当吉非替尼和埃克替尼被医保覆盖,按照90%的报销比例,其新增用量为0~100%时,医保支出增加为1 353~3 444万元,抗肿瘤药物医保支出增加1.02%~2.60%,全部药品医保支出增加0.11%~0.28%。按照80%和70%的报销比例,其医保支出的增量则相应减少。若仅埃克替尼被医保覆盖,其医保支出的增量则相应减少。结论:吉非替尼和厄洛替尼进入目录对抗肿瘤药物医保支出的影响不大,对全部药品医保支出的影响则很小。Objective： To analyze the impact of gefitinib and icotinib on medical insurance budget. Methods： The consumption of gefitinib, icotinib, erlotinib, molecular targeted anti-tumor drugs, antitumor drugs and all drugs in 2010-2015 was from Jiangsu medicine information institute. The insurance expenditure of antitumor drugs and all drugs was calculated by average reimbursement rate. The consumption and insurance expenditure in 2018 was predicted according to that in 2010-2015. The expenditure growth and its impact on anti-tumor drugs and all drugs were calculated under 90%, 80% and 70% reimbursement rate as the different incremental proportion of gefitinib and icotinib. Results： The predicted medical insurance expenditure of anti-tumor drugs and all drugs will be 1.327 and 12.40 billion in 2018. According to 90% reimbursement rate, the insurance expenditure of gefitinib and icotinib will increase to 13.53-34.44 million yuan, while anti-cancer drugs and all medical insurance drugs expenditure increased by 1.02%-2.60% and 0.11%-0.28% respectively while the consumption of gefitinib and icotinib increased 0-100% in 2018. The increment of medical insurance expenditure reduced accordingly under the reimbursement ratio of 80% and 70%. The increment of medical insurance expenditure reduced accordingly when only icotinib are covered by medical insurance. Conclusion： The budget impact of gefitinib and icotinib was not great on medical insurance expenditure of anti-cancer drugs,which was very limited on the medical insurance expenditure of all drugs.

关 键 词：吉非替尼 埃克替尼 医疗保险预算 南京 

分 类 号：R956[医药卫生—药学]