集采药品结余留用政策实施研究及优化探讨

Research on the implementation and optimization of surplus retention policy for centrally purchased drugs

回顾了结余留用政策的实施情况,包括覆盖范围、计算公式和考核指标。分析了结余留用政策的实施难点,包括如何确定集采前通用名药品加权平均价格、是否剔除过评非中选产品、如何衡量药品费用增长率3点。提出“调整—约束”的优化框架,即调整计算公式,将集采药品医保资金预算调整为集采药品结余留用资金预算,对结余测算基数计算公式进行优化,约束考核条件,严格考核标准,统一数据出口。

This paper reviews the implementation of surplus retention policy including coverage range, computational formula and performance indicators. It analyzes the difficulties of implementation including how to fix weight average price of generic name drugs before central purchase, whether the evaluation of non-selected products and how to measure the growth rate of drug costs. It puts forward an optimization framwork of “adjutment-constraint”,namely adjustment calculation formula. The budget of medical insurance funds for centrally purchased drugs will be adjusted to the budget of surplus retention policy for centrally purchased drugs, the calculation formula of surplus calculation base will be optimized, assessment conditions will be constrained, assessment standards will be strictly enforce, and data exit will be unified.