国家医保谈判药品在某院可及性的现状和影响因素研究

目的:阐述国家医保谈判药品(国谈药品)在华中科技大学同济医学院附属协和医院整体入院及使用情况,分析可能的影响因素,为国家医保药品谈判机制更好落地进行前期调研和理论探讨。方法:运用Excel统计入院率及国谈前后药品用量的变化,回顾性分析国谈药品在该院准入和使用情况。针对用量下降明显的药品,统计其院内所有竞品同期用量的变化。结果:2016-2019年总体入院率分别为100%,75%,100%,69.07%。国谈后入院率分别为100%,35.71%,100%,50.82%。部分国谈品种降价后用量发生严重下滑,其主要原因是临床需求不高以及自身竞争力不强。结论:国家医保药品谈判机制大大提高了谈判药品可及性,但仍需进一步落地和完善。针对部分品种入院难和使用情况不理想的问题,国家发布国谈药品"双通道"政策,但仍需要提高医院和药店的积极性;国谈药品的遴选除考察药品创新性以外,应以临床为导向,充分考虑药品的市场需求以及自身竞争力。

Study on the current situation and influencing factors of drug accessibility in a hospital under the negotiation of National Health Insurance

OBJECTIVE To provide meaningful preliminary research and theoretical discussion for the better implementation of the national reimbursement negotiation drugs,the analyses were performed in sample hospital.METHODS The access and use of national medical insurance negotiation drugs in sample hospital were analyzed retrospectively.RESULTS The overall admission rates from 2016 to 2019 were 100%,75%,100% and 69.07% respectively.The admission rates after the national talks were 100%,35.71%,100% and 50.82% respectively.The consumption of some internationally negotiated varieties fell sharply after price reduction,mainly due to low clinical demand and weak competitiveness.CONCLUSION The national reimbursement negotiation drugs management mechanism has greatly improved the accessibility of negotiated drugs and been beneficial to patients.In order to solve the difficulty of access to hospitals and unsatisfactory use of some national medical insurance negotiation drugs,the country has issued a series of policies to promote the "dual channel".But it is still necessary to improve the enthusiasm of hospitals and pharmacies.In addition to the innovation of drugs,the selection of national medical insurance negotiation drugs must be clinically oriented and fully consider the market demand of drugs and their own competitiveness.