国家医保药品目录与其他药品目录收录胰岛素制剂的差异分析

Analysis on the differences of insulin preparations between national medical insurance drug catalogue and other drug catalogues

目的比较并分析国家医保药品目录(以下简称医保目录)与其他国家和地区药品目录收录胰岛素制剂的差异,为我国医保目录的进一步完善提供参考。方法了解我国2000—2020年间各版医保目录中胰岛素制剂收录的变动情况,并比较医保目录、《英国国家处方集》《世界卫生组织基本药物标准清单》、澳大利亚《药物福利计划》、中国台湾地区《全民健康保险用药品项表》(以下简称中国台湾地区健保目录)中胰岛素制剂的分类、数量、品种及支付限定范围差异,对我国医保目录特点和存在的问题进行分析。结果 5个目录共收录胰岛素制剂17种,其中中国台湾地区健保目录收录品种最多,为15种。2000—2020年,我国医保目录所收录胰岛素制剂品种从3种增加到13种,已覆盖我国上市的所有胰岛素品种。与其他目录相比,我国医保目录胰岛素部分品种存在重复分类、因通用名称不规范导致的重复收录、使用建议和支付限定范围不够细化等问题。结论目前我国医保目录所收录胰岛素品种较为全面,能够满足临床基本需求,胰岛素类别及品种数与我国国情和疾病负担基本相符,但目录结构、分类及药品使用管理仍有不足。与其他目录的比较研究对我国持续修订和完善医保目录具有借鉴作用和指导价值。

Objective This study was designed to compare and analyze the differences of insulin preparations between national medical insurance drug catalogue(NMDC)and other drug catalogues in order to provide reference for the revision of NMDC in the future. Methods Various editions of NMDC were analyzed on the collection of insulin preparations. The difference in the classification,variety,number and restricted benefit were compared between the NMDC,British national formulary,pharmaceutical benefits scheme of Australia and Medicine reimbursement list in Chinese Taiwan and then the characteristics and problems in NMDC were analyzed. Results The 5 catalogues contain a total of 17 insulin preparations,of which the list in Chinese Taiwan contains the most varieties with 15. From 2000 to 2020,the number of insulin preparations in NMDC has been updated from 3 to 13,which has covered all the insulin preparations on the market. Compared with other drug catalogues,some varieties were sorted by different classification or collected repeatedly,and the recommendations and restricted benefit were not detailed enough in the NMDC. Conclusion The insulin preparations included in the NMDC are relatively comprehensive and reasonable which can meet the clinical needs. It is basically consistent with the disease burden of China. But the structure,classification and usage management of NMDC should be further improved. The study provides reference and guidance to the revision and improvement of NMDC.