经济学视角下我国多适应证药物定价方式探究

Research on pricing methods of multi-indication drugs from the perspective of economics

目的 从经济学角度探讨适合我国的多适应证药物定价方式。方法 通过梳理多适应证药物近几年在我国医保谈判准入的情况和定价方式,从品牌定价、加权平均标价、风险分担协议下的单一标价3种方式探讨典型国家(瑞典、德国、英国、意大利等)对多适应证药物的价值测算、准入与管理经验,并以社会福利相关理论为支撑,探究单一标价、适应证定价2种多适应证药物定价方式的优劣及使用条件,从而提出适合我国多适应证药物的定价方式。结果与结论 多适应证药物采用单一标价模式定价在现阶段存在一定的弊端,应适当以协议定价的方式进行补充完善。我国可在借鉴国际经验的基础上,探索合理的药品适应证管理模式,采用以协议定价为主、多种定价方式并存的定价模式,并推进药物经济学评价发展和用药信息收集机制的完善。

OBJECTIVE To explore the pricing methods of multi-indication drugs suitable for China from the economic perspective.METHODS By sorting out the situation and pricing methods of multi-indication drugs in China's health insurance negotiation in recent years,the experience of typical countries(Sweden,Germany,Britain,Italy,etc.) in the value measurement,access and management of multi-indication drugs were explored with 3 methods,namely,branded pricing,weighted average bidding pricing,and single bidding pricing under the risk sharing agreement.The advantages and disadvantages of the 2 types of multi-indication drug pricing methods,such as single bidding pricing and indication-based pricing,and conditions of use were explored,so as to put forward a pricing method suitable for multi-indication drugs in China.RESULTS CONCLUSIONS The pricing of multi-indication drugs by single bidding pricing mode has certain disadvantages at this stage,and should be supplemented and improved by agreement pricing.Based on international experience,China can explore a reasonable management mode of drug indications,adopt a pricing mode with agreement pricing as the main mode and multiple pricing modes as the coexisting mode,and promote the development of pharmacoeconomic evaluation and the improvement of drug use information collection mechanism.