日本医保药品目录动态调整机制研究及对我国的启示

Research on the Dynamic Adjustment Mechanism of Japanese Medical Insurance Drug Catalogue and Its Enlightenment for China

目的:通过研究日本药品的医保准入流程、调整周期及退出流程,为我国医保目录动态调整机制的建设提供参考和借鉴。方法:梳理日本药品的医保准入流程,结合近5年来日本医保目录药品调整相关数据,从调入数量、调出数量、调整周期、新药当年医保目录纳入率等角度出发,分析日本的医保目录动态调整机制。结果:日本通过建立完善的医保目录动态调整,保障了药品的高效准入,新药可及性高。结论:通过借鉴日本经验,建议我国建立医保目录分类准入机制,完善医保目录的动态调整机制的建设。

Objective: To provide references for the construction of the dynamic adjustment mechanism of medical insurance catalogues in China by studying the medical insurance access process, adjustment cycle and exit process of Japanese medicines. Methods: Carding the medical insurance access process for Japanese medicines, then combining the relevant data of drug adjustment in Japan's medical insurance catalogue in the past 5 years, analyzing the dynamic adjustment mechanism of medical insurance catalogue in Japan from the perspectives of the number of transfers, the number of adjustments, the adjustment cycle, and the inclusion rate of post-marketing drugs in the current year. Results: Japan had established a comprehensive medical insurance catalogue to ensure timely access to medicines and high accessibility of new drugs. Conclusion: By drawing on the experience of Japan, it was suggested that China should establish a medical insurance catalogue classification access mechanism and improve the construction of the dynamic adjustment mechanism of medical insurance catalogue.