基于高血压药品价格指数的福建省医保药品支付标准改革实施效果研究

Study of Hypertension Drug Price Index in Evaluating Implementation Effect of Medical Insurance Drug Payment Standards Reform in Fujian Province

目的:评估福建省医保药品支付标准改革实施效果。方法:分析福州市职工、城镇居民于福建省医保药品支付标准改革前后各6个月在定点医院发生的高血压西药类全部用药数据,按是否列入支付标准目录分类统计用药频度DDDs、日均用药金额DDC,并分别计算其药品价格指数DPI。结果:改革前后DDDs、DDC差异无统计学意义,但DPI下降有统计学极显著性差异(P<0.001);改革前支付标准目录内药品DDDs、DPI与非支付标准目录药品均无显著性差异(P>0.05),改革后差异有统计学意义(P<0.05);改革前后DDC均有显著性差异,改革前支付标准目录内药品DDC高而改革后相反。结论:福建省医保药品支付标准改革降低了药品价格指数,以药品集中采购形成的医保药品支付标准有利于引导医保药品价格趋向合理,医保消费大数据结合药物经济学理论有利于建立客观全面的药品价格指数评价方法。

Objective： To evaluate the effect of the policy on payment of medical insurance. Methods： Analyzing all the med- ication data of high blood pressure occurred in hospitals of the urban and rural population 6 months before and after the reform re- spectively. The data of DDDs and daily DDC were collected and counted in categories according to whether the payment standard in the directory, as well as the Drug Price Index （DPI） was calculated respectively. Results： Before and after the reform, there was no statistical significance in DDDs and DDC, but there were an extreme statistical significance in terms of the decrease of DPI（ P〈 0.001 ）. There was no statistical significance in DDDs and DPI of drugs within directory of payment standards, as well as non-pay- ment standard drugs before the reform （P〉0.05）. There was a statistical significance after the reform （P〈0.05）. The DDCs before and after the reform both have an obvious statistical significance. DDC in the pre-reform payment standard within directory of drugs was higher, on the contrary, DDc was lower after the reform. Conclusion： The reform of the payment standard of medical insurance in Fujian Province reduced the drug price index, the payment standard of medical insurance drugs formed by centralized purchasing of medicines was conducive to guiding the price of medical insurance drugs to be reasonable, Big data of medical insurance con- sumption combined with the theory of pharmaceutical economics was favorable for the establishment of comprehensive and objective drugs price index evaluation method. The reform is with further value of research and promotion.