澳大利亚医保药品价格协议研究及对我国的启示

目的:通过介绍澳大利亚医保药品价格协议的签订流程、具体条款,为我国药品谈判协议的设置提供借鉴。方法:运用文献研究和政策分析法,对澳大利亚药品价格谈判机制、协议内容进行梳理与分析。结果:澳大利亚针对新药一般会有两种类型的价格协议,即特别定价安排与风险分担协议。不同的协议类型会设置不同的定价条款,并对其进行保密处理。结论:我国谈判药品价格协议可借鉴澳大利亚的成熟经验,设置多类型定价方式,规范协议签订流程,保障签订主体的合作共赢。     

我国药品定价模式探讨与优化建议

针对目前我国药品定价模式出现的主要问题,通过分析澳大利亚和日本两国定价模式特点,提出了以药品定价与医保制度紧密结合为原则的相关优化建议:扩大医保报销目录;优化集中政府定价部门的职能,让医保机构参与到价格制定工作中;引入药物经济学制定药品医保报销参考价,发挥医保控价作用;建立药品价格动态调节机制,及时调整药价。     

澳大利亚经验对我国药品价格管制的启示

通过药品管理体系、定价方法、通用品替代政策和药品价格管制对医药行业的影响等方面，对澳大利亚药品价格管制经验作了详细的介绍，并从中得出中国目前在药品价格管制改革过程中注意的问题。     

药品定价体制探讨

目前，尽管列入国家基本医疗保险药品目录的药品的价格已经一降再降，但人民群众看病贵的情况仍然没有太大的改观，其中重要的原因就是我国缺乏明确的药品定价政策以及合适的定价方法。对此，笔者就国外各种药品定价体系及其特点进行分析归类，旨在寻找适合我国国情的药品定价体系     

澳大利亚专利药价格谈判制度实证研究与启示

文章旨在分析澳大利亚专利药物谈判定价制度,以诺华公司眼科药物诺适得在澳大利亚的药品价格谈判流程为研究对象,采用典型案例实证分析法,探讨其控价效应,为我国在有效控制药品价格、保证新医改政策有效推行的前提下完善专利药物价格谈判政策提供了借鉴意义。     

国际药品价格管制方式及效果研究的系统综述

目的：分析国际药品价格管制方式及效果。方法：采用系统综述的方法归纳不同国家药品价格管制方式、对象、过程及效果。结果：共纳入来自36个国家的130篇文献,其中包括定价管制政策文献97篇,评价定价管制影响文献33篇,且多为评价参考定价效果研究。大多国家主要对报销药品价格进行控制;国家价格比较和参考定价是两种最主要的政府定价方式;药品加成采用递减加成体系;现有证据表明参考定价对于降低药品价格、节省药品开支和对其他卫生服务的影响效果较好。建议：以药物经济学评价为基础,通过参考定价对药品报销价进行有效管制,通过协商谈判、递减加成和完善医保支付方式来控制药品费用不合理增长。     

澳大利亚医保目录动态调整机制管理经验及启示

作为较早启用药物经济学评价工具支持全民医保管理的国家,澳大利亚联邦政府集中运营的药物福利计划始于1948年。澳大利亚在运用以价值为基础的药品报销准入和定价模式以及医保药品目录动态管理中的经验和做法值得我国参考与借鉴。     

以省为单位医院药品集中网上竞价采购的实践与思考

实施以省为单位的医院药品集中网上竞价采购是当前降低药品虚高定价的有效方式。搞好全省医院药品集中网上竞价的前提是确保质量,根本是降低价格,关键是搞好监管,基础是建好平台,核心是遵循公开、公正、公平的原则。对在药品招标中存在的药品质量甄别、自主定价体系等问题进行了剖析,并提出了相应对策。     

中低收入国家药品定价和采购的政策选择

药品支出上涨是全球问题。为应对这一压力,多数高收入国家制定并实施了一系列的药品定价和采购政策。然而,尽管中低收入国家希望能够有效控制药品支出预算,但其药品市场不规范,并缺乏可行的药品定价或采购政策。高收入国家药品支出通常由国家或社会医疗保险机构支付,而中低收入国家大多是个人自付,这会给政策执行造成阻力。由于对药品定价和采购政策是否高效缺乏严谨的调查研究,因而一定程度上阻碍了中低收入国家政策方案的实施。本文对已发表的有关药品定价和采购政策的文章进行综述发现,许多有效的政策也伴随着各种风险。全球尚没有一种最佳的政策选择,各国应根据具体国情,多种政策结合使用。中低收入国家的实证研究尚不足,由于缺乏完善的法律体系以及未建立专门的药品采购机构,任何一种政策选择所伴随的风险在这些国家都会引起更大的争议,然而这或许是帮助其改善药品定价和采购体系的关键因素。     

英国价值定价理念对我国医保药品报销政策的启示

本文在梳理英国医保药品报销政策的基础上,通过对价值定价理念的深入研究和理解,系统探讨其在报销政策制定过程中对药品目录遴选、价值测算、支付标准确定、医保基金平衡和报销效益评估的作用机制,并深入思考通过价值定价理念建立起的药物警戒体系与药品报销政策间的衔接机制。在此基础上总结价值定价理念的特点、应用阶段和具体操作方法,以期为我国提供借鉴。     

我国药品价格政策分析和改革思路探讨

我国政府一直通过不同措施控制药品价格。目前政府对药品实行按社会平均成本,直接制定每一种药品的价格。这种定价机制的困难在于如何获得真实的企业生产成本信息。单纯通过降低药品价格控制药品费用增长,其作用是非常有限的。药品价格改革必须与医院补偿机制改革、社会医疗保险制度改革相协调。在改革药品定价机制时,可以考虑使用参考定价的方法,引入药物经济学的评价;加强对药品价格改革的研究和监督,评价药品价格改革对基本药物可及性的影响。     

Strategies and impacts of new drug introduction: hemophilia treatment

This study examines the impact of the manufacturers' pricing strategy on the growing spending in the drug industry in the case of hemophilia treatment. Testable hypotheses of non-competitive pricing policies are posited to examine whether drug companies manipulate the prices of new drugs at each stage of market adoption. Then, we empirically examine our hypotheses using data from a regional hemophilia drug-purchasing consortium over an eight-year period. The key finding confirms that the pharmaceutical companies engage in non-competitive pricing behavior to maximize their profit given the limited competition in the market. The implications of the findings are considered.     

Consistency of new drug pricing in Korea: Bridging variations among personnel in price negotiations

ObjectivesThis study aims to explore the performance of price negotiations, over a period of 10 years, and identify individual variations in pricing that directly affect the consistency of pricing decisions.MethodsExisting literature and relative regulations were reviewed, and data provided by the National Health Insurance Service (NHIS) was analysed to evaluate the performance of price negotiations. To examine individual variations in pricing, hypothetical scenarios of four types of drugs were developed. These were subsequently given to the reviewers who have been actually conducting price negotiations at the NHIS.ResultsOver the last decade, negotiations succeeded at a rate of 85.5 %, with a higher agreement rate in the more recent years. The reduction rate, via price negotiations, from the price approved for reimbursement by the Health Insurance Review and Assessment Service (HIRA), was 12.2 %. The survey results confirmed a significant individual variation in pricing. Especially, in the case of Drug N1, the higher-grade personnel and non-pharmacists tended to give higher prices with a significant difference.ConclusionsThe individual variations that would greatly affect the financial results were confirmed when making decisions on price of new drugs.For the consistency of drug pricing, some measures to minimise the variation of reviewers’ judgement are needed.     

日本药品价格制度研究及对我国药品价格管理的启示

目的:分析和研究日本药品价格管理机制,为中国药品价格政策制定提供借鉴与参考。方法:文献比较研究和描述性分析。结果:日本药品费用控制合理,很大程度上得益于日本统一、有效的药品价格管理制度,其市场已经建立起价格制定的完整体系,尤其在创新药品定价、国际价格比较、仿制药一致性评价以及仿制药定价等诸方面有较为科学的流程与依据。结论:日本药品价格管理的实质是实施医保支付价管理,这为中国未来医保支付价制定和建立科学价格管理机制提供了参考。     

药品零差率销售的经济学分析

对药品零差率销售产生的现象从价格管制角度进行了经济学理论分析,试图说明该项政策对切割医院及药品厂商的利益联系并非治本之策,并探讨关于切断医药利益链条的制度安排。     

Generic drug cost containment in Medicaid: lessons from five state MAC programs

In Medicaid, generic drug cost containment revolves around two programs: the Federal upper limit (FUL) program and State maximum allowable cost (MAC) programs. This article analyzes MAC programs in five States and finds considerable variation between these programs and the FUL program in both size and pricing aggressiveness. We conclude that expansion of existing MAC programs and creation of new ones could contribute to cost containment efforts nationwide. Options for States seeking to optimize their efforts include focusing on pricing for drugs with high sales volumes, ensuring that MAC lists include prices for all forms and dosages of listed drug entities, and collaborating with other States or the Federal Government on MAC list operations.     

日本的药品定价政策研究

目的：阐述日本药品定价政策,提出借鉴意义。方法：文献研究和描述性分析。结果与结论：严格药品审批;确定合理的药品定价方法;适时调整药价;参考国际药品价格。     

Canadian policy makers’ views on pharmaceutical reimbursement contracts involving confidential discounts from drug manufacturers

Pharmaceutical policy makers are increasingly negotiating reimbursement contracts that include confidential price terms that may be affected by drug utilization volumes, patterns, or outcomes. Though such contracts may offer a variety of benefits, including the ability to tie payment to the actual performance of a product, they may also create potential policy challenges. Through telephone interviews about this type of contract, we studied the views of officials in nine of ten Canadian provinces. Use of reimbursement contracts involving confidential discounts is new in Canada and ideas about power and equity emerged as cross-cutting themes in our interviews. Though confidential rebates can lower prices and thereby increase coverage of new medicines, several policy makers felt they had little power in the decision to negotiate rebates. Study participants explained that the recent rise in the use of rebates had been driven by manufacturers’ pricing tactics and precedent set by other jurisdictions. Several policy makers expressed concerns that confidential rebates could result in inter-jurisdictional inequities in drug pricing and coverage. Policy makers also noted un-insured and under-insured patients must pay inflated “list prices” even if rebates are negotiated by drug plans. The establishment of policies for disciplined negotiations, inter-jurisdictional cooperation, and provision of drug coverage for all citizens are potential solutions to the challenges created by this new pharmaceutical pricing paradigm.     

药品价格指数在医保支付标准中的应用研究

国家发展改革委提出取消大部分药品政府定价,医保目录内药品以医保支付标准进行支付。在市场价格的基础上形成医保支付标准,因此收集和整合药品市场价格信息成为实施这一政策的关键。药品价格指数可以整合药品市场价格信息,反映药品价格的变化水平。本文通过分析医保支付标准制定的需求,明确应当以分位价格指数的方式制定医保支付标准。通过介绍德国参考定价来具体说明利用分位价格确定医保支付标准的做法,并且引入不同的药品价格指数来分析药品价格变化的原因,为医保支付标准的制定和调整提供依据。