部分国家和地区医保药品续约政策经验及启示  

Lessons and enlightments of health insurance drug renewal policy in some countries and regions

作　　者：韩欣茹 曾康妮 谭佳龙 王健[1,2] HAN Xin-ru;ZENG Kang-ni;TAN Jia-long;WANG Jian(Dong Fureng Institute of Economic and Social Development,Wuhan University,Wuhan Hubei 430072,China;Research Center for Health Economics and Management,Wuhan University,Wuhan Hubei 430072,China)

机构地区：[1]武汉大学董辅礽经济社会发展研究院,湖北武汉430072 [2]武汉大学健康经济与管理研究中心,湖北武汉430072

出　　处：《中国卫生政策研究》2024年第7期75-80,共6页Chinese Journal of Health Policy

摘　　要：目的:归纳分析澳大利亚、韩国、日本和我国台湾地区的医保药品准入和续约规则,为完善我国医保药品目录续约政策提供经验借鉴。方法:采用文献分析、专家访谈等方法,从药品续约政策类型、政策内容、续约期限等角度出发,对比分析不同药品续约政策的经验。结果:部分国家和地区医保药品续约政策大致分为单一药品量价协议、联合量价协议和基于疗效风险共担协议。结论:建议我国在医保政策中加入独家药品续约联合测算、量价效相结合、非独家药品续约共担协议和设置首次续约降幅上限等内容。Objective:Summarizing and analyzing the rules of access and renewal of drugs in Australia,Japan,South Korea,and Chinese Taiwan,this paper aims to provide experience for the improvement of China's policy on national drug reimbursement list renewal.Methods:Through literature review,expert interviews,and other academic methods,it compares the different experience of drug renewal policy from the perspectives of the type,content,and renewal period.Results:Internationally representative national or regional medical insurance drug renewal policies are broadly categorized into single-drug price-volume agreements,joint price-volume agreements,and efficacy-based risk-sharing agreements.Conclusion:It is recommended that China should introduce new content such as joint measurement for renewal of exclusive drugs,combination consideration of quantity,price,and effectiveness,risk-sharing agreement for renewal of non-exclusive drugs,and placing an upper limit on the rate of reduction for the first renewal in its medical insurance policy.

关 键 词：续约 共担协议 联合测算 量价协议 

分 类 号：R197[医药卫生—卫生事业管理]