3种抗肿瘤靶向药物的可负担性评价——以湖北省为例

发布时间：2018-12-06 06:34

【摘要】：目的:评价湖北省城乡居民对吉非替尼、曲妥珠单抗、舒尼替尼3种抗肿瘤靶向药物的可负担性,为我国恶性肿瘤靶向药物的医保准入提供参考。方法:参考湖北省肿瘤登记年报中3种恶性肿瘤的发病率和湖北省城乡居民收入数据,结合国家药价谈判中的"降低50%进口药价格"的政策,假设药物进入医保报销目录,分别采用世界卫生组织/国际健康行动组织(WHO/HAI)标准调查法、灾难性卫生支出评价法和致贫作用评价法计算3种药物的可负担性。结果:按WHO/HAI标准调查法,3种药物降价50%报销前后的可支付性增量为64.00%~74.00%;按灾难性卫生支出评价法,吉非替尼、曲妥珠单抗、舒尼替尼3种药物降价50%再经医保报销,分别会造成20.00%、59.28%、35.48%的城镇用药患者,以及50.63%、74.72%、75.93%的农村用药患者产生灾难性支出;按致贫作用评价法,3种药物降价50%且报销后在城镇与农村造成因病致贫的患者占比均不超过31.95%。结论:国家药价谈判降价50%后3种抗肿瘤靶向药物对农村居民造成的经济负担较城镇居民严重。在制定政策时应根据城乡、药价及病种来调整相应报销比例,平衡不同疾病患者的经济负担。
[Abstract]:Objective: to evaluate the affordability of gefitinib, tritozumab and sulnitinib in urban and rural residents of Hubei province, and to provide a reference for medical insurance of malignant tumor targeting drugs in China. Methods: referring to the incidence rate of three kinds of malignant tumors and the income data of urban and rural residents in Hubei Province, combined with the policy of "reducing the price of imported drugs by 50%" in the negotiation of national drug price, we assumed that the drugs entered the medical insurance reimbursement list. The affordability of the three drugs was calculated by the World Health Organization / International Health Action Organization (WHO/HAI) standard survey method, the catastrophic health expenditure evaluation method and the poverty impact evaluation method. Results: according to the WHO/HAI standard, the affordability increment of the three drugs before and after the reduction of 50% was 64.00% and 74.00% respectively. According to the method of catastrophic health expenditure evaluation, gefitinib, tritozumab, and sulnitinib were reduced by 50% and reimbursed by medical insurance, which resulted in 20.00% 59.28% of the patients in cities and towns, and 50.63% of the patients, respectively. 74.72% of the patients in rural areas had catastrophic expenses. According to the evaluation method of the effect of poverty, the proportion of patients with poverty caused by illness in town and countryside after reimbursement was less than 31.955.The price of three drugs was reduced by 50% and the proportion of them was not more than 31.95%. Conclusion: after the price reduction of 50%, the economic burden of three kinds of anti-tumor drugs on rural residents is more serious than that of urban residents. In order to balance the economic burden of patients with different diseases, the proportion of reimbursement should be adjusted according to the urban and rural areas, drug prices and diseases.
【作者单位】：武汉大学健康学院全球健康研究中心;
【分类号】：R956

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