探索建立药品分剂量调剂服务相关补偿机制研究——以儿童用药为例  

Exploring the Establishment of a Compensation Mechanism for Dose-Splitting Dispensing Services——A case study of pediatric medications

作　　者：于璐 王国华 王晓玲[2] 梅冬 宋子扬 YU Lu;WANG Guohua;WANG Xiaoling;MEI Dong

机构地区：[1]中国价格协会医药价格专业委员会 [2]首都医科大学附属北京儿童医院

出　　处：《价格理论与实践》2024年第12期102-108,共7页Price:Theory & Practice

基　　金：国家重点研发计划“生育健康及妇女儿童健康保障”重点专项“儿童用药改良与临床评价关键技术研究”(2023YFC2706100)

摘　　要：当现有药品规格无法满足医嘱单次服用的剂量时,在无其他可替代方案的前提下,由药师根据用药需求和药品特性进行分剂量,以实现个体化精准用药的目的。药品分剂量作为弥补药品规格短缺的重要手段,在临床中成为常态化工作,尤其是儿童群体,由于用药需求多样,分剂量情况普遍存在。本文通过总结分剂量调剂的基本内涵和临床使用的基本情况及存在问题,梳理出分剂量调剂的基本工作流程及工作步骤。解决当下分剂量存在问题的思路之一是建立相关的补偿机制,对此,探讨了儿童用药分剂量调剂服务补偿的可行性,提出单独立项收费、提高现有项目的兼容性、打包收费等潜在路径,以及完善法规、加强成本核算、循序渐进推进、增强价值认同等配套措施,以构建补偿机制夯实儿童用药分剂量服务长期健康发展的基础,为完善药学服务补偿机制提供参考。When existing drug specifications are unable to meet the prescribed single-dose requirements and no alternative solutions are available,pharmacists perform dose-splitting based on clinical needs and drug characteristics to achieve personalized and precise medication.As a crucial measure to address shortages in drug specifications,dose-splitting has become routine in clinical practice,particularly for the pediatric population with diverse medication needs and widespread dose-splitting requirements.This study summarizes the fundamental principles,clinical applications,and existing challenges of dose-splitting dispensing services,outlining standardized workflows and operational procedures.One proposed solution to current issues is the establishment of a compensation mechanism.Accordingly,this paper examines the feasibility of compensating pediatric dose-splitting services and proposes potential pathways,including separate itemized charges,enhanced compatibility with existing reimbursement models,and bundled payment options.Complementary measures such as improving regulatory frameworks,optimizing cost accounting,phased implementation,and enhancing value recognition are also discussed.These efforts aim to establish a robust compensation mechanism to support the long-term development of pediatric dose-splitting services,offering insights for improving pharmaceutical service reimbursement framework.

关 键 词：儿童用药 分剂量 药学服务 补偿路径 

分 类 号：R95[医药卫生—药学]