目的: 从药品配备角度分析国家医保谈判药品落地情况,探究落地过程中存在的问题并提出对策建议。方法: 收集国家医保服务平台公示的协议期内388种谈判药品在全国的配备数据,从不同地区、机构类型、疾病领域、药品剂型、谈判批次等角度分析国谈药品在定点医药机构的配备品种数、配备率以及可获得率等指标。结果: 超50%的被研究药品覆盖了全国30个及以上省份和50%以上的地市级城市,江苏和浙江的国谈药品配备情况较好,西藏、新疆和青海的国谈药品配备情况较差。平均每个省和地市级城市分别配备了330种和209种国谈药品,药品配备率分别为85.0%和53.8%。三线及以下城市的药品平均配备率（49.4%）低于一线城市（87.3%）,非省会城市（51.5%）低于省会城市（80.3%）。口服剂型药品、慢性病用药和罕见病用药平均覆盖的零售药店数量高于医疗机构的数量。国谈药品在全国三级医院的平均可获得率非常低,仅为10.2%,肿瘤用药、注射剂型药品以及2018年首谈药品在三级医院的可获得率高于其他类型国谈药。罕见病用药在三级医院和罕见病协作网医院的平均可获得率较低,分别为3.2%和12.8%。结论: 国谈药品在全国的落地情况存在品种、病种和地区等维度差异,本文将从零售药店供应、医疗机构临床使用以及企业推广等角度进行具体讨论,并提出对策建议,以期不断优化国谈药品的供应保障。

Objective: The paper analyzes the implementation of national medical insurance negotiation drugs from the perspective of drug supply, finds the problems and puts forward countermeasures and suggestions. Methods: The national supply data of 388 negotiated drugs in the agreement period announced by the national medical insurance service platform were collected, and the indicators such as the number of varieties, the supply rate and the availability rate of negotiated drugs in designated medical institutions were analyzed from the perspectives of different regions, institution types, disease fields, drug dosage forms, and negotiation batches. Results: More than 50% of the drugs covered more than 30 provinces and more than 50% of prefecture-level cities, Jiangsu Province and Zhejiang Province were better supplied, and Xizang Autonomous Region, Xinjiang Uygur Autonomous Region and Qinghai Province were worse supplied. On average, each provincial and prefecture-level city is equipped with 330 and 209 kinds of national negotiation drugs, and the drug supply rate is 85.0% and 53.8%, respectively. The average drug supply rate (49.4%) in third-tier cities and below is much lower than that in first-tier cities (87.3%), and that in non-provincial capitals (51.5%) is much lower than that in provincial capitals (80.3%). The average number of retail pharmacies covering oral dosage forms, chronic disease drugs and rare disease drugs is higher than that of medical institutions. The average availability rate of national negotiation drugs in tertiary hospitals across the country is very low, i.e 10.2%. The availability rate of oncology drugs, injectable drugs, and the first national negotiation drugs in 2018 are higher than other types of national negotiation drugs in tertiary hospitals. The average availability of drugs for rare diseases was lower in tertiary hospitals and rare disease collaboration network hospitals (3.2% and 12.8%, respectively). Conclusion: There are differences among varieties, diseases and regions in the implementation of national negotiation drugs. The paper will discuss in detail from the perspectives of retail pharmacy supply, clinical use in medical institutions, and enterprise promotion, and propose countermeasures and suggestions in order to continuously optimize the supply of national negotiation drugs.