药品价量协议制度的国际经验及启示

International experience and inspiration of price-volume agreement systems for drugs

本文旨在研究国际上盛行的价量协议制度,为我国药品价格谈判工作的开展提供指导和借鉴。通过文献研究和比较研究,对典型国家和地区价量协议制度的适用范围、财务/医保基金冲击预估方法、具体方案制定和政策效果等加以分析。各国的价量协议制度设计合理、内容丰富,可为我国提供参考。此外,价量协议制度可有效节制药费不合理增长,并在一定程度上压低药价、提高患者用药可及性。建议我国引入价量协议制度,提高降价的科学性和合理性;建立健全医保基金冲击预估机制,确保基金合理支出;参考国际价格做决策时,注意考虑还款方案对国际药价的影响。

Objective： To study the prevailing price-volume agreement systems for drugs in the world in order to provide guidance and reference for China＇s drug price negotiations. Methods： Based on literature research and comparative studies,the scope of application,estimation method for impact of finance / insurance funds,specific programming and policy effect of price-volume agreement systems in the typical countries and regions were analyzed. Results and Conclusion： The rational designs and rich contents of price-volume agreement systems in the typical countries and regions can provide a reference for our country. In addition,the price-volume agreement systems can effectively control unreasonable medical expenses increase,drive down drug prices to a certain extent and improve medication availability to patients. It is suggested that price-volume agreement system be introduced into China to improve the scientificity and rationality of price reduction,medical insurance fund impact forecast mechanism be established to ensure reasonable expenses,and attention needs to be paid to the impact of repayment scheme on international prices while making decisions with reference to international prices.