成本-效果阈值在医保准入决策中的应用

The Application of Cost-effectiveness Threshold in Medical Insurance Access Decision-making

随着医疗保险药品谈判及目录动态调整工作的推进,我国医疗保险准入决策机制得到不断完善。现从经济学审评角度出发,深入研究成本-效果阈值的设置、调整方法,及其医疗保险准入决策中的应用模式,旨在基于域外典型应用经验为我国成本-效果阈值在医疗保险准入决策中的应用方案提供可行性建议,进一步完善我国医疗保险准入决策体系。

With the advancement of medical insurance drug negotiations and medical insurance directory dynamic adjustment, China’s medical insurance access decision-making mechanism has been continuously improved. From the perspective of economic evaluation, this paper deeply studies the setting and adjustment methods of cost-effectiveness threshold and the application modes in medical insurance access decision-making, to provide feasible suggestions for China’s application of cost-effectiveness threshold in access decision-making of medical insurance system based on the typical foreign application experience, and to further improve the reimbursement decision-making of medical insurance system.