典型国家或地区药品医保支付标准制定方法的国际经验及启示  

International experience and enlightenment of the formulation method of drug medical insurance payment standard in typical countries or regions

作　　者：聂浩淼 陈怡娜 张珂 周明 柳鹏程[1] NIE Haomiao;CHEN Yi’na;ZHANG Ke;ZHOU Ming;LIU Pengcheng(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：《上海医药》2024年第1期60-64,共5页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的 :为丰富和完善我国药品医疗保障基金支付(以下简称医保支付)标准制定方法提供参考。方法 :通过系统梳理德国、英国、日本和中国台湾地区药品医保支付标准制定方法的政策文件和相关文献,总结其共性和特色。结果 :德国采取参考价格制度和新药定价机制;英国采用以价值为基础的定价方式;日本采取新药创新性加价、仿制药递减定价法;中国台湾地区则对药品分类分组进而差别定价。结论 :德国、英国、日本和中国台湾地区均对药品进行分类,创新药主要依照临床价值及成本进行定价,非创新药主要依照竞争递减比例以及参考药价的方式定价,我国在丰富和完善药品医保支付标准制定方法时可有所借鉴。Objective:To provide reference for enriching and improving the formulation method of drug medical insurance payment standards in China.Methods:Through systematically sorting the policy documents and relevant literature on the standard formulation methods of drug medical insurance payment in Germany,the United Kingdom,Japan and Taiwan of China,their commonalities and characteristics were summarized.Results:A reference price system and a new drug pricing mechanism are adopted in Germany,a value-based pricing approach in the UK,the innovative price increase of new drugs and the decreasing pricing method of generic drugs in Japan while drugs are first grouped and then differently priced in China Taiwan region.Conclusion:Drugs are all classified in those countries and region.Innovative drugs are mainly priced according to clinical value and cost,and non-innovative drugs are mainly priced according to the decreasing proportion of competition and reference drug prices,which can be used as reference for our country in enriching and perfecting the method for formulating the standard of payment for medicines in the medical insurance.

关 键 词：医药改革 国际经验 支付标准 

分 类 号：R951[医药卫生—药学]