基于价值定价的多适应证药品医保支付国际经验及启示

目的:为完善我国多适应证药品基于价值定价的医保支付提供参考.方法:梳理多适应证药品价值定价的理论基础和实现流程,分析法国、德国、英国、意大利和瑞典的价值评估指标和基于价值定价的医保支付策略,为我国多适应证药品医保支付提出建议.结果与结论:价值定价的实现首先需要制定一个价值框架以定义、测量、整合价值,再通过建立模型将总价...

International Experience and Enlightenment of Medical Insurance Reimbursement for Multi-indication Drugs Based on Value-based Pricing

OBJECTIVE:To provide reference for improving medical insurance reimbursement for multi-indication drugs based on value-based pricing in China.METHODS:The theory and practice of value-based pricing for multi-indication drugs were sorted out,and the value standards and medical insurance reimbursement strategies based on value-based pricing in France,Germany,UK,Italy and Sweden were analyzed,so as to provide the suggestions for medical insurance reimbursement of multi-indication drugs in China.RESULTS&CONCLUSIONS:The realization of value-based pricing first needed to develop a value framework to define,measure and integrate value,and then established a model to convert the total value into price.The overall idea of value-based pricing for multi-indication drugs was consistent,but there were differences in the value standard.In the UK and Sweden,quality-adjusted life years(QALYs)and incremental cost-effectiveness ratios(ICERs)measured by pharmacoeconomicsare used as the value standard.France,Germany and Italy were more focused on the therapeutic value and clinical benefit improvement.As for medical insurance reimbursement strategies,France adopted single weighting method based on expected volume.Germany adopted combination weighting method based on value and volume.UK introduced the Patient Access Schemes and Italy introduced the Managed Entry Agreements,both based on the nominal reimbursement standard.Sweden adopted independent reimbursement for different indications by different brand names.It is suggested that China can explore the value-based pricing strategies of multi-indication drugs on the basis of the above international experiences,reference and use these variety of medical insurance reimbursement strategies comprehensively.Simultaneously,the information collection mechanism of patients and drug use should be improved to provide data support for the implementation of China’s value-based pricing and reimbursement strategies for multi-indication drugs.