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。

The UK value-based pricing concept and its enlightenment on China's medical insurance drug reimbursement policy

Through the study on China''s distinctive value-based pricing concept (VBP concept) and based on medical insurance and drug reimbursement policy in the United Kingdom, this paper systematically explored how the VBP concept acts on the reimbursement catalog access, the mechanism of drug price adjustment, the medicare fund balancing and the reimbursement benefit assessment. By exploring the connection mode between pharmacovigilance system and medical insurance access by using VBP concept which emphasizes on the clinical value-oriented, the distribution of health insurance fund resources, the characteristics, application stage and concrete operation methods of the VBP concept were rationally summarized in order to provide reference for China''s medical insurance drug reimbursement policy.