典型地区医保特药谈判制度研究及对医保药品目录谈判的启示

收集典型地区青岛市、江苏省、内蒙古自治区、江西省和湖南省医保特药谈判制度的运行情况,分析谈判制度的异同点.结果发现典型地区医保特药谈判制度在药品遴选、谈判过程、结果保障方面较为一致,但在资金来源、支付范围和比例方面做法有所不同.认为医保药品目录谈判工作应坚持公平对等的原则,加强相关配合部门间的沟通协作,科学稳步扩大医保药品目录谈判范围.

Study on the price negotiation system of special medical insurance drugs in typical provinces and its inspiration for medical insurance catalogue negotiation

To study of the operation of the price negotiation system of special medical insurance drugs in Qingdao, Jiangsu, Inner Mongolia, Jiangxi and Hunan, and analyze the similarities and differences between the negotiation systems. This findings show that the aspects of drug selection, negotiation process and supply guarantee have something in common, while the aspects of financing source, medical coverage and reimbursement proportion display differences in some way. In order to promote the development of medical insurance catalogue negotiation, we should insist the principle of fairness, strengthen communication among government departments, and broaden the coverage of medical insurance catalogue negotiation.