摘要
目的: 为我国药品价格改革和医保支付标准优化提供参考。方法: 通过检索各国政府官方政策文件和期刊文章,研究德国、日本、澳大利亚、英国、丹麦、加拿大和新加坡的药品价格治理手段,分析药品全生命周期内的不同价格形成机制。结果与结论: 各国在药品全生命周期的不同阶段综合运用了自由定价、基于价值定价、参考定价、成本定价、支出总额控制、价格冻结、强制回扣、最高限价、平行进口等价格治理方法。建议围绕药品生命周期采取差异化的治理策略,完善参考定价机制和卫生技术评估在我国药品定价与医保准入中的应用,对药品价格进行动态调整,加强相关组织机构之间的协同合作。
Abstract
Objective: The paper attempts to provide a reference for pharmaceutical price reform and optimization of the payment standard of medical insurance in China. Methods: We studied the pharmaceutical price governance tools in Germany, Japan, Australia, the United Kingdom, Denmark, Canada and Singapore by searching official policy documents issued by governments and journal articles, and analyzed the different price formation mechanisms during the drug life cycle. Results and Conclusions: All the countries have comprehensively utilized price governance methods such as free pricing, value-based pricing, reference pricing, cost-based pricing, total expenditure control, price freezing, mandatory rebates, ceiling price and parallel import at different stages of the drug life cycle. It is recommended to adopt differentiated governance strategies around the drug life cycle, improve the reference pricing mechanism and the application of health technology assessment in China's drug pricing and medical insurance access, dynamically adjust drug prices, and strengthen the synergy and cooperation between related organizations.
关键词
药品价格治理 /
医保支付标准 /
药品全生命周期 /
卫生技术评估
Key words
pharmaceutical price governance /
the payment standard of medical insurance /
drug life cycle /
health technology assessment
张欣桐, 吕兰婷.
药品价格治理国际经验与启示——基于药品全生命周期视角[J]. 中国医疗保险. 2024, 0(12): 95-103 https://doi.org/10.19546/j.issn.1674-3830.2024.12.014
The International Experience and Enlightenment of Pharmaceutical Price Governance——From the Perspective of Drug Life Cycle[J]. China Health Insurance. 2024, 0(12): 95-103 https://doi.org/10.19546/j.issn.1674-3830.2024.12.014
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参考文献
[1] VERNON R.International investment and international trade in the product cycle[J].The quarterly journal of economics, 1966, 80(2):190-207.
[2] 袁妮,周娜,张海军,等.药品全生命周期视角下中国罕见病药物保障政策简析[J].中国新药杂志,2021,30(01):1-5.
[3] Bundesministerium für Gesundheit. Um jeden Preis? Wie Arzneimittelpreise entstehen[EB/OL]. (2024-10-30)[2024-11-18]. https://www.bundesgesundheitsministerium.de/arzneimittelpreise.html.
[4] IQWiG. Drug approval and early benefit assessment in Germany[EB/OL].[2024-11-06]. https://www.iqwig.de/en/presse/in-the-focus/new-drugs-approval-benefit-assessment-coverage/1-drug-approval-and-early-benefit-assessment-in-germany/.
[5] Bundesministerium für Gesundheit. Preismoratorium für Arzneimittel[EB/OL]. (2024-04-22)[2024-11-06]. https://www.bundesgesundheitsministerium.de/preismoratorium.html.
[6] 吕兰婷,傅金澜.国家治理变革视角下的“药品医保生命周期”管理——来自日本的启示[J].中国卫生政策研究,2020,13(04):73-80.
[7] CARE A G D of H and A. Pharmaceutical Benefits Scheme (PBS)-8.1 Pricing pathways [Z/OL].[2024-11-11]. https://www.pbs.gov.au/info/industry/listing/procedure-guidance/8-procedures-positive-recommendation-list/8-1-price-agreement.
[8] CARE A G D of H and A. Pharmaceutical Benefits Scheme (PBS)-8.4 Negotiation and agreement[Z/OL].[2024-11-05]. https://www.pbs.gov.au/info/industry/listing/procedure-guidance/8-procedures-positive-recommendation-list/8-4-negotiation-and-agreement.
[9] 陈童,蒋蓉,邵蓉.英国癌症药物基金管理模式及其对我国的启示[J].中国医院药学杂志,2020,40(16):1700-1704.
[10] NHS England.Innovative Medicines Fund[EB/OL].[2024-11-05].https://www.england.nhs.uk/medicines-2/innovative-medicines-fund/.
[11] Association of the British Pharmaceutical Industry. How company payments are calculated under the2024 VPAG[EB/OL]. (2024-10-22)[2024-11-09]. https://www.abpi.org.uk/value-and-access/uk-medicine-pricing/voluntary-scheme-on-branded-medicines/how-company-payments-are-calculated-under-the-2024-vpag/.
[12] INDENRIGS-OG SUNDHEDSMINIST ERIET. Bekendtgørelse af lov om lægemidler: LBK nr 339 af 15/03/2023[A/OL]. (2023-03-15)[2024-11-05]. https://www.retsinformation.dk/eli/lta/2023/339.
[13] DANISH MEDICINES AGENCY. Medicinal product groups-substitution groups[EB/OL]. (2015-04-24)[2024-11-05]. https://laegemiddelstyrelsen.dk/en/reimbursement/prices/medicinal-product-groups-substitution-groups/.
[14] 张欣桐,胡云鹤,吕兰婷.市场机制与政府干预在药品价格形成中的协同作用——来自丹麦的启示[J].中国医疗保险,2024(05):53-59.
[15] Canada's Drug Agency. Reimbursement Review Reports[EB/OL].(2024-12-11)[2024-12-12]. https://www.cda-amc.ca/reimbursement-review-reports.
[16] CANADA P M P R B. PMPRB Guidelines [EB/OL].(2020-10-23)[2024-11-06]. https://www.canada.ca/en/patented-medicine-prices-review/services/legislation/about-guidelines/guidelines.html.
[17] Pan-Canadian Pharmaceutical Alliance. Generic drugs[EB/OL].[2024-11-06]. https://www.pcpacanada.ca/generic-drug-framework.
[18] Agency for Care Effectiveness. Methods & Process[EB/OL].(2024-04-04)[2024-11-05]. https://www.ace-hta.gov.sg/resources/process-methods.
基金
国家社会科学基金青年项目“社会医疗保险‘新卑斯麦’改革模式的国际比较研究” （18CSH060）
