高值医用耗材医保准入的分类评估机制研究

王锐; 李佳明; 李伟; 杨烁; 丁锦希

doi:10.19546/j.issn.1674-3830.2024.6.003

中国医疗保险 ›› 2024, Vol. 0 ›› Issue (6) : 21-28. DOI: 10.19546/j.issn.1674-3830.2024.6.003

观察思考

高值医用耗材医保准入的分类评估机制研究

王锐, 李佳明, 李伟, 杨烁, 丁锦希

作者信息 +

Research on the Classification and Evaluation Mechanism of High-Value Medical Consumables Medical Insurance Access

Author information +

文章历史 +

摘要

高值医用耗材品规复杂、证据质量较差,导致其评估成本高、难度大。建立分类评估机制是提高医保准入审评效率的关键措施。本文基于医保战略性购买原则,通过市场竞争格局和患者临床获益两个分类标准差异化设计评估方法,分类评估已有功能、改良创新和完全创新三类高值医用耗材,为优化我国医保耗材目录准入管理提供参考。

Abstract

High-value medical consumables have complex specifications and poor-quality evidence, which leads to high costs and difficulties in medical insurance access assessment. Establishing a classified assessment mechanism is the key to improving the efficiency of medical insurance access review. Based on the principle of medical insurance strategic purchasing, this paper divides high-value medical consumables into existing function, improved innovation, and complete innovation according to the criteria of market competition and patients' clinical benefits, and designs differentiated assessment methods, to provide a reference for the optimization of medical consumables list access management in China.

导出引用

王锐, 李佳明, 李伟, 杨烁, 丁锦希. 高值医用耗材医保准入的分类评估机制研究[J]. 中国医疗保险. 2024, 0(6): 21-28 https://doi.org/10.19546/j.issn.1674-3830.2024.6.003

Research on the Classification and Evaluation Mechanism of High-Value Medical Consumables Medical Insurance Access[J]. China Health Insurance. 2024, 0(6): 21-28 https://doi.org/10.19546/j.issn.1674-3830.2024.6.003

中图分类号： F840.684 C913.7

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