Complete Precision Algorithm and Simple Adjustment Algorithm——Comparative Study of Multi-indication Drug Access Evaluation methods

China Health Insurance ›› 2022, Vol. 0 ›› Issue (7) : 9-14.

China Health Insurance ›› 2022, Vol. 0 ›› Issue (7) : 9-14. DOI: 10.19546/j.issn.1674-3830.2022.7.002
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Complete Precision Algorithm and Simple Adjustment Algorithm——Comparative Study of Multi-indication Drug Access Evaluation methods

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Abstract

With the rapid growth of multi-indication drugs on the market, designing access assessment methods for multi-indication drugs is a new challenge for the adjustment of the National Catalog of Drugs Covered by Basic Medical Insurance. This paper believes that the management of multi-indication drug by generic name is still the mainstream mode of medical insurance management in China at present. The assessment method system of “simple adjustment calculation method” as the main and “complete actuarial method” as the supplement should be built. When the indications of drug meet the standard of "one indication with large population and multiple indications with small population", simple adjustment calculation method is applied. The simple adjustment calculation method means "one reference drug, one measurement, and adjustment by population", which can control the fund expenditure effectively and fit into the current medical insurance management structure. When the indications of drugs are roughly equal in population, the complete actuarial method is applied. The complete actuarial method means "multiple reference drugs, multiple measurements, weighted average", fully reflecting the value orientation.

Key words

multi-indication drug / assessment methods / medical insurance access

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Complete Precision Algorithm and Simple Adjustment Algorithm——Comparative Study of Multi-indication Drug Access Evaluation methods[J]. China Health Insurance. 2022, 0(7): 9-14 https://doi.org/10.19546/j.issn.1674-3830.2022.7.002

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