药品目录2009版实行后参保住院患者用药变化分析

Analysis of Medicine Utilization Variation of Inpatient Participated Insurance after Implementing the 2009 Edition of National Reimbursement Drug List

目的:了解药品目录调整对参保患者待遇、医保基金支出以及具体药品市场销售的影响。方法:以全国参保住院患者医疗服务利用情况调查数据为基础,进一步进行统计分析2009—2011年的用药变化情况。结果:2011年全国参保住院患者的药品费用约为1 327亿元,较2009年增长了37%,目录内药品费用占整体药品费用的比例稳定在76%左右。新增药品2011年费用为135亿元,较2009年增长了98%。结论:目录调整对于参保患者住院用药整体费用的增长影响不大,但导致了目录内药品费用结构发生变化,部分新增品种费用增长明显。今后目录调整可以逐步从保障基本用药转到促进临床合理用药上来。

Objective： To understand the impact of adjusting national drug reimbursement list（NDRL） have on the benefits of patient covered by Basic Health lnsurance（BHI）, medical insurance fund expenditure and specific drug marketing. Methods： Based on the survey data of medical service utilization situation of national inpatients participated BHI, to summarize and analyze the change of drug usage from 2009 to 2011. Results： In 2011, the drug expense of the national inpatient covered by BHI is approximately 132.7 billion yuan, increased by 37% compared to that of 2009; among which, the expense of entry drug accounts for about 76% out of the total drug use. In 2011, new increased expense on drug use is 13.5 billion, which increased to 98% compared to that of 2009. Conclusion： Adjustment of NDRL had little effect on total drug expenses increasing, but lead changes of the drug expense structure; and expense on some new entry drugs increased obviously. The focus of future adjustment of NRDL could gradually transfer from guaranteeing on basic medicine use to the promotion on clinical rational drug use.