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新西兰医保药品竞争性准入管理模式对我国的启示

2021-11-04李燕丁锦希李伟

上海医药 2021年19期

李燕 丁锦希 李伟

摘 要 本文在梳理我国竞价准入通道特点的基础上,研究了新西兰分阶段的准入管理模式,并重点对非独家品种的准入管理进行了对比分析。对比发现,我国与新西兰目录管理模式的差异主要表现在准入流程、目录管理、竞价方法等方面。新西兰按厂牌管理目录是其在分阶段准入中对非独家品种开展竞价准入的前提,而多维度的评审则体现了追求药品供应、疗效与价格三点平衡的思想。通过本研究,明晰了我国竞价准入的现实意义,并为探索目录准入与药品采购的协同化管理奠定了基础。

关键词 新西兰 目录管理 竞价准入 非独家药品

中图分类号:R19-0 文献标志码:C 文章编号:1006-1533(2021)19-0056-05

Enlightenment of the bidding access management mode of New Zealand medical insurance directory to China

LI Yan, DING Jinxi, LI Wei

(China Pharmaceutical University, Nanjing 211198, China)

ABSTRACT On the basis of sorting out the characteristics of Chinese bidding access, this paper studies the multi-stage access management mode of New Zealand and focuses on the comparative analysis of the access management of drugs with generics available. Through comparative analysis, it is found that the differences between China and New Zealand are mainly reflected in admission process, catalog management and bidding method. New Zealands catalogue management by brand is the premise of bidding entry for drugs with generics available, and the multi-dimensional evaluation reflects the idea of pursuing a balance among drug supply, efficacy and price. Through this study, the practical significance of bidding access in China is clarified, and the foundation is laid for exploring the cooperative management of catalog access and drug procurement.

KEy wORDS New Zealand; catalog management; bidding access; drugs with generics available

随着我国医疗卫生体制改革的不断深入,基本医疗保险逐渐向用药科学化、管理精细化发展。2020年7月31日,国家医疗保障局签发1号令《基本医疗保险用药管理暂行办法》[1],规定了目录外的药品可通过谈判准入(针对独家品种)、直接准入(针对集采中标品种)以及竞价准入(除集采中标品种外的非独家品种)3种通道进行准入。但从此轮目录调整的结果来看,暂未对非独家品种实行竞价准入[2]。

对于本轮调整中尚未采用竞价准入的原因,医保局等相关部门并未明确披露。理论上,相较于操作相对成熟的谈判准入通道以及简单明了的直接准入通道,竞价准入通道为首次提出的准入新机制,缺乏相应的理论与实践基础,对于其适用范围、操作流程方法等,均需进行进一步研究。……

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