我国台湾地区药品价格管理及其医保支付的经验与启示

Experience and enlightenment of drug price management and medical insurance payment in Taiwan,China

药品费用的急剧增长与医保基金有限承载能力之间的矛盾已经成为世界各国普遍面临的一大难题。我国台湾地区通过学习和探索,逐渐形成了一套较为完善的医保药品价格管理和支付制度,基本实现了从医院药品进价加成到药品支付价格基准分类定价及分组分类调整的跨越和逐步完善。其在药品医保定价、医保准入和价格调整上的独特政策制度设计可为我国大陆地区在医保控费背景下的医保药品管理改革和政策设计提供决策参考。

The contradiction between the rapid growth of drug costs and the limited carrying capacity of medical insurance funds has become a major problem in the world.Through study and exploration,Taiwan has gradually formed a set of relatively perfect medical insurance drug price management and payment system,basically realizing the leap and gradual improvement from the hospital drug price plus to the drug payment price benchmark classification pricing and grouping classification adjustment.The unique policy and system design on the pricing,access and price adjustment of medical insurance can provide decision-making reference for the reform and policy design of medical insurance drug management under the background of medical insurance fee control in China's Mainland.