我国医保药品支付标准建设的理论与现实分析

建立针对药品的医疗保险支付标准(参考价)是多国控制药品费用不合理增长的重要措施。医保药品支付标准通过药品价格竞争刺激患者需求和增强患者选择的权利来影响医生行为和药品企业定价。我国放开药品政府定价后也亟需建立适应药品市场发展的价格形成机制,建立医保药品支付标准需要从我国药品管理政策转变和现状出发,厘清控费的具体机制,根据当前我国实践中存在的问题,从药物经济学评价、药品分级分类管理、完善医保药品支付方式和补偿机制、合理分配补偿结余等方面入手,提升药品的可及性、费用的可控性和政策的激励性。

The theoretical and realistic analysis of medical insurance payment standard for pharmaceutical in China

It is an important countermeasure in the world to establish the medical insurance payment standard (reference price) to control the growth of pharmaceutical costs. Medical insurance payment standards for pharmaceuticals affect patients'' behavior and pharmaceutical pricing through enhancing competition for pharmaceutical demand and patients'' choice. After the liberalization of government pricing in China,it was also needed to establish the price formation mechanism to adapt to the development of pharmaceutical market. To establish the medical insurance payment standards, one should know more about the development of China''s pharmaceutical policy and the current situation and clarify the specific mechanism of controlling expenses. To achieve a sustainable availability of drugs, the control of costs and policy incentives, it is crucial to identify the problems in practice, pay close attention to the establishment of pharmaco-economic evaluation system, drug classification management, the medical insurance payment and compensation levels, a reasonable allocation of compensation balance and so on.