DRG/DIP支付方式改革下的医保药品研究  

Research on Medicare Drugs under the Reform of DRG/DIP Payment Mode

作　　者：焦建军 JIAO Jianjun(National Institute of Hospital Administration,National Health Commission of the People's Republic of China,Beijing 100044,China)

机构地区：[1]国家卫生健康委员会医院管理研究所,北京100044

出　　处：《中国医药指南》2022年第35期76-78,共3页Guide of China Medicine

摘　　要：随着我国DRG/DIP医保支付方式改革三年行动计划的推进,医保按病种支付改革进入大数据治理的关键阶段,特别是在深化医保药品改革方面,通过以医保支付为基础,病种管理为依据,形成质量可靠、安全有效、竞争充分、价格合理、规范有序的供应保障体系,建立以市场为主导的药品、医用耗材价格形成机制,充分发挥药品、医用耗材集中带量采购在深化医药服务供给侧改革中的引领作用,推进医保、医疗、医药形成“三医联动”。推进和完善DRG/DIP医保支付方式改革和药品招标采购机制,支持优质仿制药研发和使用,促进仿制药的替代将成未来的工作重点和发展方向。文章总结梳理了我国急性脑梗死在DRG/DIP支付方式改革下医保药品观测的临床重点指标,重点分析了医保药品在支付方式改革中关注的主要指标和问题,并据此提出了未来医保药品竞争的方向,为临床开展相关疾病的治疗药品选择提供思考建议。With the promotion of the three-year action plan for the reform of DRG/DIP medical insurance payment mode,the reform of medical insurance payment by disease has entered a critical stage of big data governance,especially in the aspect of deepening the reform of medical insurance drugs,by taking medical insurance payment as the basis and disease management as the basis,a supply guarantee system with sufficient competition,reasonable price and standard order has been formed,and a market-oriented price formation mechanism for drugs and medical consumables has been established,give full play to the leading role of centralized procurement of drugs and medical consumables in deepening the supply side reform of medical services,promote the linkage of medical insurance,medical care and medicine,improve the payment standards of medical insurance and the mechanism of drug bidding and procurement,support the research and development and use of high-quality generic drugs,and promote the substitution of generic drugs will become the focus and direction of future work.The article summarized and combed the indicator monitoring of acute cerebral infarction in China under the reform of DRG/DIP payment method,focused on the analysis of its main indicators and problems in the reform of DRG/DIP medical insurance drugs in the payment method,and accordingly proposed the direction of future medical insurance drug competition,and further improved the medical insurance drugs in China in the medical security mechanism.

关 键 词：DRG/DIP 病种管理 支付方式改革 医保药品 

分 类 号：R9[医药卫生—药学]