国家医保药物目录遴选的临床证据支持:以甲类抗高血压药物为例

Supporting clinical evidence for national medical insurance drug list selection: A case of antihypertensive drugs of class A

目的:以甲类抗高血压药物为例,了解我国在国家医保药物目录遴选方面的临床证据支持现状,为建立完善的动态药物目录提供依据。方法:以美国和英国的高血压指南、WHO的基本药物目录以及我国在药物开展方面的系统评价或者Meta分析作为我国医保药物遴选的临床证据支持依据。结果:在2009版的国家医保药物目录中,总共有17种甲类抗高血压药物,其中11种甲类抗高血压药物有充分的临床证据支持依据,其它6种缺乏相应的证据支持。结论:部分国家医保药物目录中的甲类抗高血压药物的遴选尚缺乏相应的临床证据支持,应对那些证据力度不高、缺乏证据级别的药物进行相应的评价和更新,从而建立和完善适合我国用药国情、具有较高证据支持的动态医保药物目录机制。

Objectives：To understand the current state of supporting clinical evidence for the drugs on the national medical insurance drugs list.Methods：With the example of antihypertensive drugs of class A,evidence-based recommendations of the US,UK,and WHO were adopted and the meta-analysis or systematic reviews published in Chinese journals were referred to.Results：11 antihypertensive drugs of class A were included in the national medical insurance drugs list with supporting clinical evidence.The other 6 antihypertensive drugs of class A lacked sufficient supporting clinical evidence.Conclusions：several antihypertensive drugs of class A are included in the national medical insurance drugs list without supporting clinical evidence.More reseach is needed to establish a dynamical medical insurance list system that is evidence-based.