台湾地区健保支付中仿制药价格制定与调整方式分析  

Analysis on the Strategy of Pricing Decision and Adjustment on Generic Drugs Payment of Health Insurance System in the Taiwan Region

作　　者：蒋蓉[1] 沈洁[1] 任磊 邵蓉[1] JIANG Rong;SHEN Jie;REN Lei;SHAO Rong(China Pharmaceutical University,Nanjing 211198,China;National Committee on the Assessment of the Protected Traditional Chinese Medicine Preparations,Beijing 100070,China)

机构地区：[1]中国药科大学,南京211198 [2]国家中药品种保护审评委员会,北京100070

出　　处：《医药导报》2020年第3期411-414,共4页Herald of Medicine

基　　金：国家社会科学基金重大资助项目(15ZDB167);2017年国家人力资源和社会保障部项目《医疗保险用药管理政策体系研究》;中国药科大学“双一流”学科创新团队建设项目(CPU2018GY39)。

摘　　要：目的分析我国台湾地区健保支付中仿制药价格管理,为我国大陆仿制药医保支付价格管理提供决策依据。方法系统剖析我国台湾地区健保支付中的仿制药分类、仿制药支付价格确定和调整,总结其仿制药价格管理特点,结合大陆地区仿制药医保支付价格管理现状提出相应建议。结果台湾地区健保支付中仿制药分为生物利用度或生物等效性(BA/BE)仿制药与一般仿制药。仿制药价格管理特点包括:按质量分类定价、内部与外部结合的参考定价、动态化分类价格调整。我国大陆地区针对已上市仿制药正在分类分批开展一致性评价工作,未通过一致性评价品种差异化支付政策尚未明确。结论建议大陆地区结合仿制药一致性评价工作进展分类设定支付标准、建立支付标准调整机制,同时借鉴我国台湾地区经验,根据仿制药不同生命周期生产成本的差异,对不同阶段仿制药分类制定支付标准调整方式与比例,合理调控药品费用。Objective To introduce the management of generic drugs payment price of health insurance system in the Taiwan region and to provide references for decision making about managing the generic drugs payment price of health insurance system in Chinese mainland. Methods The classification of generic drugs and the determination and adjustment of payment price of generic drugs in the Taiwan region were systematically analyzed,and the characteristics of generic drug price management was summarized to put forward suggestions for Chinese mainland based on the condition of its management of generic drugs payment price of health insurance system. Results In the Taiwan region,generic drugs are divided into two types,the ones that have went through BA/BE studies and the others. The characteristics of generic drug price management include pricing according to quality classification,reference pricing based on the condition of home and abroad,and dynamic classified price adjustment. The generic quality and consistency equivalency(GQCE) is classified to be carried out in batches in the Chinese mainland,and the policy of differential payment of generic drugs has not been made clear. Conclusion It is suggested to set different payment criteria, payment criteria adjustment mechanism. At the same time, combining with the experience of the Taiwan region, it is suggested to control drug cost to set different ways of adjustment and portion about payment depending on the life cycle of generic drugs.

关 键 词：仿制药 台湾地区 支付价格 分类管理 

分 类 号：R951[医药卫生—药学]