维格列汀治疗2型糖尿病预算影响分析

Budget Impact Analysis on Vildagliptin in Treating Type 2 Diabetes in China

目的 :基于医保付费方角度,预测假设维格列汀进入国家基本医保目录后,未来5年对医保基金可能产生的影响。方法:依据医保补偿水平,将中国2型糖尿病患者分为职工医保人群和城乡居民医保人群,基于药品中标价和临床常用剂量计算人均日费用和年费用。依据中国口服降糖药的历史销售数据,并根据临床专家咨询,确定对照药品及与维格列汀之间的替代关系,预测未来5年维格列汀对口服降糖药市场结构和医保基金的影响。结果 :如果维格列汀进入国家医保目录,由于其人均药品年费用(3283元)低于进口药年费用加权均值(3847元),2016-2020年可分别节省医保基金459、817、1250、1769、2392万元。敏感性分析显示了结果的稳定性。结论 :维格列汀进入医保目录会不同程度替代其它进口药品,并节约医保总开支。

Objectives： To analyze the impact of vildagliptin on insurance fund budget in future 5-years, and make a reference for medical insurance policy-decision. Methods： According to the reimbursement level, the population with type 2 diabetes was divided into resident population and employee population. The daily and annual average drug cost was calculated by using the bidding price and daily drug dose. Basing on the historic sale scale of oral anti-diabetic drugs（OAD） in China and by consulting with clinical specialists, we determined the substantial relation between vildagliptin and other OAD, and predicted the impact of using vildagliptin on the market structure of other OADs and insurance budget. Results： In 2016-2020, the health insurance fund would be decreased by 4.59, 8.17, 12.50, 17.69, 23.92 million CNY, respectively if vildagliptin was reimbursable since the annual cost（3283 CNY） of vildagliptin is lower than the weighted average annual cost of other OAD（3847 CNY）. Sensitivity analysis showed the results were robust. Conclusion： Vildagliptin could replace other imported OAD drugs and save health insurance fund.