澳大利亚高值药物医保准入机制简介及对我国罕用药医保准入的启示

发布时间：2018-01-31 01:24

本文关键词： 澳大利亚高值药物医保准入机制罕用药启示　出处：《中国药房》2017年04期 　论文类型：期刊论文

【摘要】：目的:介绍澳大利亚高值药物医保准入机制,为我国罕用药医保准入的完善提供建议。方法:运用文献研究和政策分析法,对澳大利亚高值药物医保准入的遴选原则、风险共担机制、限制使用原则进行概述分析,并对高值药物医保准入机制实施效果进行评价。结果与结论:澳大利亚药物福利计划对高值药物的纳入不仅考虑成本效益比,同时关注药物的临床疗效、不可替代性及药物的社会性原则,通过风险共担机制和限制使用原则在保障患者用药可及性的同时维持医保基金的可持续,在保障患者用药、加强基本医疗保障福利方面取得显著成效。建议完善我国罕用药医保遴选标准,引入风险共担机制及规范罕用药的使用和报销。
[Abstract]:Objective: to introduce the access mechanism of high value drug medical insurance in Australia, and to provide some advice for the perfection of medical insurance access of rare drugs in China. Methods: literature study and policy analysis were used. The selection principle, risk-sharing mechanism and restriction principle of access to high-value drug insurance in Australia are summarized and analyzed. Results and conclusions: the Australian Drug Welfare Plan not only consider the cost-effectiveness ratio, but also focus on the clinical efficacy of drugs. The principle of non-substitutability and the sociality of drugs, through the risk-sharing mechanism and the principle of limiting the use of drugs, can ensure the access of patients to medication while maintaining the sustainability of health insurance funds, and ensure the use of drugs by patients. It is suggested to improve the selection standard of medical insurance for rare drugs, to introduce risk-sharing mechanism and to standardize the use and reimbursement of rare drugs.
【作者单位】：中国药科大学国家药物政策与医药产业经济研究中心;
【分类号】：R951
【正文快照】： *硕士研究生。研究方向:医药政策与法规。电话:025-86185287。E-mail:rfang2011@163.com[7]国家卫生和计划生育委员会.关于印发控制公立医院医疗费用不合理增长的若干意见的通知[EB/OL].(2015-11-06)[2016-10-20].http://www.nhfpc.gov.cn/tigs/s3577/201511/0038da2bf8fe43d6

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