日本、韩国及我国台湾地区多适应证药物医保准入与支付策略研究及启示

Research and Enlightenment on Medical Insurance Access and Payment Strategy of Multi-indication Drugs in Japan,South Korea and Taiwan,China

在梳理与我国医疗保险制度相似的日本、韩国及我国台湾地区的多适应证药物医保准入管理、支付标准制定、续增适应证规则等具体做法的基础上,得到如下启示:(1)应积极探索建立应用风险分担协议机制;(2)应加强医保机构内设的卫生技术评估队伍建设;(3)应积极探索比较成本与奖励溢价的定价模式。

As with similar to China’s medical insurance system,it has important reference value to take Japan,South Korea and Taiwan,China as the research object.By learning from the specific practices such as the management of medical insurance access,the formulation of payment standards and the continuation of indication rules for multi-indication drugs in these areas,it proposes to actively explore the pricing model of comparative cost and reward premium,explore the establishment and application of RSA(Risk-Sharing Agreement) mechanism,and strengthen the construction of health technology evaluation team in medical insurance institutions.