台湾地区医保药品的采购模式和支付价格

发布时间：2019-04-02 01:29

【摘要】：目的:分析台湾地区医保药品在采购和支付方面的做法和经验,为大陆地区推进药品采购模式和支付价格改革提供参考。方法:系统梳理台湾地区在医保药品采购和支付方面的政策文件和相关文献,并与大陆地区药品采购和支付政策进行对比分析。结果:台湾地区医疗机构根据自身用药需求,自主采购药品,采购价格由供需双方直接谈判形成。政府仅对医保药品的价格进行管理,对新药采用国际参考定价办法;原厂药、BA/BE学名药、一般学名药的支付价以国际参考价格为上限,依次降低。药品质量也在医保支付标准考虑之列。此外,药品的支付价格依据采购价格实行动态调整,当二者差值大于30%时,健保署便会调整支付价格以减小二者的差价。结论:台湾地区通过制度设计和调整,较好地统筹了药品采购和补偿两个环节,形成了合理的药品采购价格和支付价格,这些经验可为中国大陆地区完善药品采购和支付政策提供参考。
[Abstract]:Aim: to analyze the practice and experience of purchase and payment of medical insurance drugs in Taiwan, so as to provide reference for the reform of drug purchase mode and payment price in mainland China. Methods: the policy documents and related literatures on medical insurance drug purchase and payment in Taiwan were systematically combed and compared with those in mainland China. Results: according to their own demand for drugs, medical institutions in Taiwan procured drugs on their own, and the purchase price was formed by direct negotiation between the suppliers and the suppliers. The government only manages the price of medical insurance drugs, and adopts the international reference pricing method for new drugs, and the payment price of original medicine, BA/BE medicine and general name medicine is reduced in turn with the international reference price as the upper limit. Drug quality is also considered in the Medicare payment criteria. In addition, the payment price for drugs is dynamically adjusted based on the purchase price, and when the difference is greater than 30 percent, the agency adjusts the payment price to reduce the difference between the two. Conclusion: through the system design and adjustment in Taiwan, the two links of drug purchase and compensation have been well coordinated, and a reasonable purchase price and payment price of drugs have been formed. These experiences can provide reference for the improvement of drug purchase and payment policy in mainland China.
【作者单位】：沈阳药科大学工商管理学院;北京大学中国卫生经济研究中心;
【分类号】：R95

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