多适应症药物准入支付标准测算模式研究

Research on the Medical Insurance Payment Standard Calculation Model of Multi-indication Drugs in Medical Insurance Access

近年来,我国多适应症药物上市数量快速增长,医保准入面临新的挑战。如何合理测算多适应症药物医保支付标准,提高医保准入决策科学性,成为社会关注的热点问题。本文立足于多适应症药物特征与准入现状,结合域外实践经验与我国实际需求,从测算思路、参照药物选择和测算规律三方面展开分析,优化多适应症药物准入支付标准测算模式,推进医保目录动态调整机制的良性发展。

With the rapid increase in the number of multi-indication drugs on the market,the pressure in China’s National Reimbursement Drug List(NRDL)access is also increasing.How to reasonably calculate multi-indication drugs’medical insurance payment standards,and improve the scientifi city of NRDL access on decision-making have become a core social concern.Based on the characteristics and access status of multi-indication drugs,this article combines the foreign practice model of payment standards calculation and the actual needs of China,and analyzes the calculation ideas,comparator selection and calculation rules to optimize the access mechanism of multiindication drugs and to put the NRDL dynamic adjustment mechanism on a more scientifi c basis.