国家医保谈判药品“双通道”管理实施现状与政策分析  

The implementation status and policy analysis of the“Dual-channel”management for drugs in national medical insurance negotiations

作　　者：彭博 姜骁桐 张小娟[1] 叶媛 曹晓琳 刘阳 李亚子 PENG Bo;JIANG Xiao-tong;ZHANG Xiao-juan;YE Yuan;CAO Xiao-lin;LIU Yang;LI Ya-zi(Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China;Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院医学信息研究所,北京100020 [2]北京协和医学院,北京100730

出　　处：《中国卫生政策研究》2024年第5期9-16,共8页Chinese Journal of Health Policy

摘　　要：目的:对最新版国家医保谈判药品“双通道”管理省级政策进行文本梳理和分析,对比各省份政策差异与创新举措,为完善“双通道”管理模式提供参考性建议。方法:检索2021年5月10日—2024年4月10日各省医疗保障局和卫生健康委等官方网站“双通道”管理相关政策文件,采用内容分析法对文本资料进行提取和统计分析。结果:各省“双通道”管理政策在药品准入、医药机构遴选、待遇保障、用药管理和限制性政策调整等方面共性与差异性共存。结论:“双通道”政策设计应因地制宜,建议细化药品目录准入标准,规范设置医药机构准入门槛,科学确定医保待遇水平,制定差异化的用药认定管理方式,进一步削弱政策限制性因素。Objective:This study analyzed the provincial policy on the“dual channel”management of drugs,provided suggestions for improving the“dual channel”management models.Methods:From May 10,2021 to April 10,2024,the official websites of the Healthcare Security Administration and the Health Commission of various provinces were searched for policy documents related to the“dual channel”management,and the text data were statistically analyzed.Results:The“dual-channel”management policies of various provinces coexisted with commonalities and differences.Conclusions:It is recommended to refine the access standards of the drug catalog,standardize the setting of the entry threshold of pharmaceutical institutions,scientifically determine the level of medical insurance treatment,and formulate differentiated drug identification and management methods,so as to further weaken the policy restrictive factors.

关 键 词：医保谈判药品 双通道管理 政策比较 

分 类 号：R197[医药卫生—卫生事业管理]