白蛋白紫杉醇临床应用及医保报销情况调查  

Investigation on Clinical Application of Nanoparticle Albumin Bound Paclitaxel and Medical Insurance Reimbursement

作　　者：马良[1] 李天俊[1] Ma Liang;Li Tianjun(Medcial Insurance Office of West China Hosptial,Sichuan University,Chengdu,610044,China)

机构地区：[1]四川大学华西医院医保办公室,四川成都610044

出　　处：《成都中医药大学学报》2023年第2期46-49,共4页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：四川省科技厅重点研发项目(2021YFS0145)。

摘　　要：目的:了解白蛋白紫杉醇(Nanoparticle Albumin Bound Paclitaxel,NAB-PTX)在医保患者中的临床使用以及报销情况,为NAB-PTX纳入医保支付后的报销管理提供参考。方法:结合《国家基本医疗保险、工伤保险和生育保险药品目录》(简称:《药品目录》),分析研究单位2021年9月至2022年2月NAB-PTX医保患者的临床使用及医保报销数据。对患者特征、疾病分布、药品用量、医保报销情况等进行描述性统计分析。采用Mann-Whiney U检验比较乳腺恶性肿瘤患者中NAB-PTX是否纳入报销对患者费用负担的影响。结果:医保患者使用NAB-PTX人次排名前三的疾病为乳腺恶性肿瘤、肺恶性肿瘤、食管恶性肿瘤。215人次符合医保支付条件,占使用总人次的7.19%。乳腺恶性肿瘤患者使用NAB-PTX排名前三的情况为乳腺癌术后辅助化疗、乳腺癌术前新辅助治疗、联合化疗失败的转移性乳腺癌。NAB-PTX纳入报销的患者自付费用与NAB-PTX未纳入报销的患者差异较大。结论:NAB-PTX在恶性肿瘤的治疗中应用广泛,2021年《药品目录》报销的覆盖范围有限,2022年《药品目录》取消NAB-PTX支付适应症限定后需要结合药品集中带量采购政策做好药物经济学评价以及基金支出预算分析。Objective:To investigate the clinical use and reimbursement of Nanoparticle Albumin Bound Paclitaxel(NAB-PTX)in medical insurance patients,which could provide reference for the arrangement of NAB-PTX medical insurance reimbursement policy.Methods:Combined with the catalogue of drugs for national basic medical insurance,the clinical use and medical insurance reimbursement data of NAB-PTX medical insurance patients in the research medical institution from September 2021 to February 2022 were analyzed.Descriptive statistical analysis was carried out on patient characteristics,disease distribution,drug consumption and medical insurance reimbursement.Mann-Whitney U test was used to compare the difference of disease burden whether NAB-PTX was included in reimbursement in patients with breast cancer.Results:The top three diseases of medical insurance patients using NAB-PTX were breast cancer,lung cancer and esophageal cancer.215 cases were included in medical insurance,accounting for 7.19%of the total.Breast cancer patients using three of the top NAB-PTX is adjuvant chemotherapy,breast cancer preoperative neoadjuvant therapy,combined chemotherapy failure of metastatic breast cancer.There is a significant difference in the self-expenses of patients with NAB-PTX included in medical insurance payment and patients without medical insurance payment.Conclusion:NAB-PTX is widely used in the treatment of malignant tumors.The coverage of reimbursement of NAB-PTX in 2021 drug catalogue is limited.With the adjustment of medical insurance policies,pharmacoeconomic evaluation and fund expenditure budget analysis should be carried out.

关 键 词：白蛋白紫杉醇 医保药品目录 疾病负担 

分 类 号：R840.684[医药卫生—航空、航天与航海医学] R979.1[医药卫生—临床医学]