PIVAS对奥沙利铂甘露醇注射液开展分剂量调配、收费、报销模式的探索与思考

Exploration and Thoughts on Dosage Allocation,Charging and Reimbursement of Oxaliplatin–Mannitol Injection in PIVAS

目的:探索奥沙利铂甘露醇注射液分剂量调配、收费、报销模式,以期为抗肿瘤药物分剂量使用提供参考。方法:我院静脉用药集中调配中心(Pharmacy Intravenous Admixture Services,PIVAS)与财务部门、信息中心、药品生产厂家、医保部门、临床医生协调沟通,鉴于奥沙利铂甘露醇注射液为单一规格,临床治疗按体表面积用药时,不同患者消耗的药液量不等,可剩余部分药液,通过建立奥沙利铂甘露醇注射液分剂量调配、收费、报销模式,即医生按照患者实际使用剂量开具医嘱,药师按医嘱剂量进行调配,使患者间可共用药品,按照患者实际使用剂量进行收费及报销。同时对该模式实施前后患者用药费用及安全性情况进行统计分析。结果:2020年12月1日至2021年1月31日期间,奥沙利铂甘露醇注射液分剂量调配、收费、报销模式运行前、后,患者用药数量、用药费用及医保报销金额差异均存在统计学意义(P<0.001);共计节省用药费用48412.38元,其中医保报销费用占67.50%。结论:开展奥沙利铂甘露醇注射液分剂量调配、收费、报销模式,可显著减少患者的治疗费用及医保开支,对其他抗肿瘤药物开展分剂量使用模式具有借鉴意义。

Objective:To explore the dosage allocation,charging,and reimbursement of oxaliplatin–mannitol injection to provide evidence for the divided-dose regime of anti-tumor drugs.Methods:After much discussion among Financial Department,Information Center,Medical Insurance Department,Clinicians and pharmaceutical manufacturers,we established a divided-dose regime,charging,and reimbursement of oxaliplatin–mannitol injection in Pharmacy Intravenous Admixture Services(PIVAS).Given that oxaliplatin–mannitol injection was consumed in accordance with body surface area(BSA)of each patient,patients could share the same bottle of solution.Pharmacists in PIVAS would prescribe drugs according to practical use,thus patients were charged and reimbursed accordingly.At the same time,drug expenses and safety before and after the implementation of this regime were statistical analyzed.Results:Between 1 st December 2020 and 31 st January 2021,there were significant differences in the dosage allocation,charging,and reimbursement before and after this regime was established(P<0.001).Drug expenses of 48,412.38 Chinese yuan were saved,of which medical insurance reimbursement accounted for 67.50%.Conclusion:The development in the dosage allocation,charging,and reimbursement of oxaliplatin–mannitol injection can significantly reduce patients’costs and medical insurance expenditure,and can be useful for the divided-dose regime of other anti-tumor drugs.