部分发达国家药品价格管制政策比较及启示

目的：分析比较主要发达国家的国家药品价格政策或措施，为我国药品定价政策改革提供建议。方法：文献综述和比较法。内容：法国、德国、英国等国家药品价格政策的实施、优缺点等。结果：国家药品价格政策实施具有综合性；政策的因地制宜；影响药品费用的多因素性；政策实施效果的有限性；直接控制的国家比间接控制的国家药品价格水平低。建议：药品价格改革必须与医疗保险等改革配套；采取多种费用控制措施；药品价格改革不应损害本国医药产业的健康发展；充分考虑政策对卫生服务供方的影响，尤其是对医生既得利益的影响。     

欧盟药品政策改革评价

近几十年来,药品费用不断增长,各国药品筹资日益艰难。本文介绍了欧盟各国从20世纪80年代中期到90年代末药品政策的变化,主要讨论了公共药品费用控制政策。在分析中,作者将药品政策(或“一揽子政策”)进行了分类,分析了这些政策对欧盟各国的影响,并对其效果进行了评价。作者认为,欧盟各国的行为极像列队行进的企鹅,他们彼此机械模仿,而对所采取措施的效果和评价却全然不顾。作者还分析了国家及国际组织对药品政策制定的影响;考察了该领域的经济、政治和社会利益集团是如何影响药品政策决策过程的;作者还就该领域的研究指出了新的研究方向。     

意大利药品费用控制和药品价格管理政策

20 0 1年 1 1月中旬 ,国家计委和复旦大学共同开展的药品价格研究课题组组团考察欧洲 ,通过听讲座、参观机构等形式 ,对西班牙和意大利两国的药品政策及药品定价体系有了深刻的了解。本文主要介绍意大利药品费用控制政策及其药品价格管理政策并对其作利弊分析 ,供决策部门参考。1　意大利概况1 .1　人口学特征意大利是欧洲共同体成员国之一 ,也是当今世界上七大主要工业化国家之一。国土面积 30多万平方公里。全国共有 2 0个地区 ,94个省 ,约 1 0 0 0个市 (镇 ) ,人口5 770万 ( 2 0 0 0年 )。 1 999年人均国民生产总值为 2 1 80 0美元 ,失业…     

药品价格比较方法在药品政策中的应用研究

文章从药品价格比较的意义、研究方法、进展以及在国外药品政策中的应用等方面进行研究,旨在总结药品价格比较信息在药品政策中运用的原则,并提出在我国原创药定价、药品招标采购定价以及药品价格监测、评价和报告机制中运用药品价格比较方法的政策建议,进一步提高我国药品价格规制政策的运行效果。     

欧盟药品GMP的演化及其启示

论文回顾欧盟药品GMP的演化,阐述欧盟药品GMP的内容,并分析其的特点及与我国药品GMP规范的异同,以期为我国有关部门借鉴欧盟药品GMP先进的管理理念,完善自身药品GMP规范及药品生产企业改进质量管理提供参考.     

针对当前药品市场和药品价格的分析及政策建议

当前药品市场和药品价格问题备受社会关注，是医药费用持续增长的直接原因。针对目前药品市场和药品价格存在的突出问题加以分析，旨在探索如何加强药品市场和药品价格管理，控制药品价格过度增长，减轻病人负担，促进医疗卫生事业健康地发展。     

发达国家药品价格管制政策的比较研究

药品费用是卫生费用的主要组成部分、也是影响卫生费用急剧增长的主要因素之一。对药品费用的控制需要从消费者、医生和制药公司产、供、销等多方面采取措施。本文中发达国家药品价格的管制政策为发展中国家药品政策的命定与实施提供了有益的参考。     

国家药品价格谈判的法律规范框架研究

药品的可及性是实现全民医保的基础条件,价格则是可及性的重要因素。专利药品和独家生产药品国家价格谈判工作必不可少,作为常态性工作,应将其纳入法治轨道,并制定相应原则和规则。在明确谈判的法律规范框架、构建立法原则的前提下,本文探讨了谈判主体及谈判对象的选择、谈判程序、谈判结果及其履行等具体内容,分析了现实存在的问题,并提出将来立法的相应规则。     

药品价格虚高分析及对策

文章简要介绍药品价格虚高的现状、药品定价政策的演变及企业自主定价的基本方式，分析药品价格虚高的成因，介绍国外药品定价模式，对遏制药品价格虚高提出相应对策。     

药品价格整改对卫生部门的影响：南通市对药品价格整改的调查报告

南通市在江苏省物价局的统一部署下,按照国家计委《药品价格管理暂行办法》要求,自1997年下半年起实施了药品价格整改方案,各地医疗卫生单位特别是乡镇卫生院对此反映强烈。为此,我市物价局、卫生局组成了联合调查组,对城市和农村医疗卫生单位进行了深入细致的调查,现将调查情况简述如下: 一、资料来源 本次调查共涉及7家乡镇卫生院、8家市级医院、1家省级医院,资料均来源于各医疗卫生单位财务决算表及市卫生局年度财务报表。     

The implications of external price referencing on pharmaceutical list prices in Europe

External price referencing (EPR) is a frequently applied cost-containment measure to control pharmaceutical prices. This study aims to determine the implications of EPR on ex-factory pharmaceutical prices in European countries.Prices of 21 pharmaceuticals and 17 non-pharmaceutical services were collected with a survey and price corridors were defined in 7 countries. To increase the sample size for further analysis, pharmaceutical prices were retrieved from EURIPID database for 8 additional countries. Regression analyses were applied to evaluate explanatory variables on pharmaceutical list prices including EPR components, GDP per capita, and population size in 15 European countries.Price corridor was narrower for pharmaceuticals compared to non-pharmaceutical services. In univariate regression analysis, higher GDP per capita and population size were associated with higher prices, and taking lowest price from referenced basket of countries was associated with lower prices. In multiple regression analysis, GDP per capita, population size and number of countries referencing a country had modest, but significant association with prices.Findings indicate small price variation for pharmaceuticals that points towards the occurrence of price-convergence. The relatively minor association of EPR with pharmaceutical list prices could be explained by manufacturers’ compensatory mechanisms including confidential price reductions and discounts while maintaining high list prices in countries with strong price-control measures or delayed product launch in countries with traditionally lower prices. Consequently, EPR cannot be directly associated with narrow European price corridor, and lower income countries still have slightly lower list prices.     

欧盟形成医药单一市场的挑战与趋势

本文通过综述欧盟医药卫生政策,阐述了欧盟相关的平衡医疗保障政策、医药产业政策和公共卫生政策的重要性,欧盟与成员国、成员国内等因素对欧盟医药政策的影响,以及政府与医药企业之间的关系,系统分析了欧洲医药单一市场迟迟没有形成的原因。由于欧盟与成员国、政府与医药企业之间存在强大利益冲突,欧盟目前仍无法形成医药单一市场。     

Occupational physicians' education and training across European Union countries

The framework directive on improvements in the safety and health of workers is being implemented into the national legislation of European Union countries, and occupational physicians are requested to play a key role in undertaking preventive measures. Since there is no common specific requirement for the training and education of these health professionals, this report aims to provide a comparative picture of the educational process across European Union training bodies. Each curriculum provides theoretical knowledge and practical experience, but deep differences exist among different countries. Core knowledge is mainly based on the traditional disciplines (such as occupational hygiene, occupational toxicology, ergonomics, epidemiology and biostatistics, relevant legislation, and preventive medicine). General learning objectives should include assessment of the workplace environment, communication and education, legislation, occupational diseases, and relationships between health and work. Core experience, often based on task-based learning, emphasizes the need for assessment of a range of working environments; for surveillance, including the biological monitoring, of workers at risk; for assessment of disability, impairment, and fitness for work; for the clinical ability to recognize occupational diseases; for the formulation of differential diagnosis; and for management of workers developing disease in the course of their employment. New curricular elements (such as management, economics, quality assurance, and marketing) are being introduced in some institutions with the aim of stressing the renewed role of the occupational physician in meeting society and employers' needs. The need to educate and train a professional figure whose competence should allow the delivery of high-quality occupational health services across European Union countries compels the harmonization of the formative process of occupational physicians. Received: 3 January 1999 / Accepted: 14 January 1999     

欧盟罕见病保障体系及启示

欧盟在2008年正式从全欧洲的战略层面开展罕见病保障专项工作,已经形成的罕见病相关工作经验,非常值得中国借鉴。通过总结欧盟罕见病概况及孤儿药目录、罕见病组织结构与战略计划、罕见病筹资支付体系和服务提供等情况,分析欧盟罕见病保障体系的优缺点,提出我国开展罕见病保障工作的实施建议,如统一罕见病的合理定义、编码与目录;建立罕见病保障工作的组织架构,制定罕见病国家（地区）计划或政策,优化罕见病服务提供,建立可持续性的罕见病筹资体系,注重罕见病工作的综合全面性和地区差异性,为提高我国罕见病防治工作的保障力度和可持续性提供参考。     

中欧药品价格构成比较与对策建议

采用WHO/HAI药品价格构成调查方法,调查2017年版《国家基本医疗保险、工伤保险和生育保险药品目录》中所列2 535种药品的实际出厂价格和市场零售价格,分析药品价格各组成部分在零售价格中所占比例。调查结果显示,在政府取消价格管制后,中国药品价格构成仍然不合理。药品实际出厂价格在零售价格中所占比例仅为25%左右,供应链上出厂价格以外的附加费用占零售价的75%左右。本文分析认为,政府管制药品价格主要源于医药市场的信息不对称引发的药品价格扭曲。借鉴发达国家药品价格管制成功经验,建议实行全部处方药价格管制、采用参考定价以及控制流通加价等政策工具,最终将实现全面降低药价的目标。     

Health impacts of increasing alcohol prices in the European Union: A dynamic projection

Objective

Western Europe has high levels of alcohol consumption, with corresponding adverse health effects. Currently, a major revision of the EU excise tax regime is under discussion. We quantify the health impact of alcohol price increases across the EU.

Data and method

We use alcohol consumption data for 11 member states, covering 80% of the EU-27 population, and corresponding country-specific disease data (incidence, prevalence, and case-fatality rate of alcohol related diseases) taken from the 2010 published Dynamic Modelling for Health Impact Assessment (DYNAMO-HIA) database to dynamically project the changes in population health that might arise from changes in alcohol price.

Results

Increasing alcohol prices towards those of Finland (the highest in the EU) would postpone approximately 54,000 male and approximately 26,100 female deaths over 10 years. Moreover, the prevalence of a number of chronic diseases would be reduced: in men by approximately 97,800 individuals with diabetes, 65,800 with stroke and 62,200 with selected cancers, and in women by about 19,100, 23,500, and 27,100, respectively.

Conclusion

Curbing excessive drinking throughout the EU completely would lead to substantial gains in population health. Harmonisiation of prices to the Finnish level would, for selected diseases, achieve more than 40% of those gains.     

Regulatory agencies, pharmaceutical information and the Internet: a European perspective

The Internet facilitates access to health information and can therefore support the effectiveness of healthcare provision and empower patients in healthcare decisions. In the field of pharmaceutical therapy the electronic provision of information can improve compliance and strengthen the general understanding of pharmaceutical risks and benefits. Current political developments in Europe encourage a stronger role of the pharmaceutical industry in this regard. In light of potential conflicts inherent to the private provision of information and given their public health mandate, regulatory bodies in the pharmaceutical sector may represent an important alternative source of information. The explorative analysis in this paper reviews the websites of European pharmaceutical regulatory agencies regarding the usability and provision of information from a Layman's perspective. It is found that while the majority of agencies do provide product-related information, the usability of websites from the lay perspective is subject to variation. The reluctant position of agencies can be attributed to sectoral path dependencies, the regulatory approach and a lack of regulatory resources.