“双通道”模式对直接抗病毒药物治疗慢性丙型肝炎医保预算、患者负担、外部成本的影响  

The Influence of "Dual Channel" Model on the Budget, Patient Burden and External Cost of Medical Insurance for Direct Antiviral Therapy of Chronic Hepatitis C

作　　者：梁乐怡 邢倩 周大创 邵翰乔 王珺琦 唐文熙[1] LIANG Le-yi;XING Qian;ZHOU Da-chuang;SHAO Hanqiao;WANG Jun-qi;TANG Wen-xi(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 211198,China)

机构地区：[1]中国药科大学国际医药商学院,南京211198

出　　处：《中国卫生经济》2023年第4期56-60,共5页Chinese Health Economics

基　　金：江苏省医疗保险研究会委托课题;江苏省研究生科研与实践创新计划项目(KYCXZZ_C837)。

摘　　要：目的:评估将直接抗病毒药物纳入“双通道”模式对医保预算、患者负担、外部成本的影响。方法:构建动态传染路径和Markov模型测算“双通道”模式所避免传染节约的外部成本。结果:直接抗病毒药物纳入“双通道”模式按单独支付下,各年医保支出增额分别为3 992万元、6 505万元、9 307万元,患者人均负担降低3 887元/年;按病种定额支付下,各年医保支出增额分别为4626万元、7516万元、1.07亿元,患者人均负担降低4582元/年;按门诊参照住院支付下,各年医保支出增额分别为5 135万元、8 300万元、1.18亿元,患者人均负担降低5 120元/年。“双通道”模式各年所节约的外部医疗成本分别为313万元、742万元、1 226万元。结论:“双通道”模式下各支付方式不同程度上增加了医保支出,减轻了患者负担,同时为社会节约了外部成本。Objective:To evaluate the impact of incorporating direct antiviral drugs into the"dual channel"model on the medical insurance budget,patient burden and external costs.Methods:Dynamic transmission pathways and Markov models were constructed to measure the external cost savings from avoided transmission in the"dual channel"model.Results:Under the"dual channel"model of direct antiviral drugs,the increase in annual health insurance expenditure were 39.92 million yuan60.05 million yuan and 93.07 million yuan respectively under individual payment,with the per capita burden of patients reduced by 3,887 yuan/year;under the fixed payment by disease type,the increase in annual health insurance expenditure were 46.26 million yuan75.16 million yuan and 107 million yuan respectively,with the per capita burden of patients reduced by 4582 yuan/year.Under the outpatient referral hospitalization payment,the incremental health insurance expenditure were 51.35 million yuan83 million yuan and 118 million yuan respectively,and the per capita burden of patients was reduced by 5120 yuan/year.The savings in external medical costs under the"dual channel"model were 3.13 million yuan7.42 million yuan and 12.26 million yuan in each year.Conclusion:Each payment mode of"dual channel"mode increases the medical insurance expenditure to varying degrees,reduces the burden of patients and saves external costs for the society.

关 键 词：药品“双通道”政策 慢性丙型肝炎 直接抗病毒药物 动态传染 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F224.5[经济管理—国民经济]