三医联动下的药品医保支付标准结算模式及其社会效应探讨

Discussion on the Settlement Patterns and Social Effects of the Drug Health Insurance Payment Standard of China Under the Policy Framework of Tripartite System Reform

药品医保支付标准制度的实施将对药品供应、流通和使用产生重大影响。本文在我国医保支付标准发展路径的基础上,探讨我国药品零售价低于和高出医保支付标准部分的结算处理方案,并充分剖析各方案所产生的社会效应,以期为我国设计医保支付标准结算模式提供科学合理的参考依据。

The implementation of the Health Insurance Payment Standard will affect the supply, distribution and use of drugs. Based on the development path of China＇s medical insurance payment standard, this paper discusses on treatment schemes when the actual retail prices of drugs are lower or higher than the payment standard, and sufficiently analyzes the social effects of each scheme with an aim to provide scientific and reasonable reference for the settlement pattern of health insurance payment standards.