美国《通货膨胀削减法案》对药费支出的影响

Impacts of Inflation Reduction Act on drug spending in the United States

美国《通货膨胀削减法案》(IRA)于2022年生效,其首次允许联邦政府就处方药价格进行谈判,要求制药公司在价格涨幅超过通胀率时向联邦医疗保险(Medicare)支付折扣,并为Medicare Part D中的药品和胰岛素类产品设置了患者自付费用上限,还延续了“安全港”政策,延长了预付保费税收抵免政策的实施时限,并扩展了免费接种的疫苗种类等。IRA对美国医保药费支出有多重影响,但其在价格控制方面仍面临结构性压力。建议我国可继续发挥基本医疗卫生事业的公益性优势,进一步提高相关卫生政策的针对性和可操作性,并在控制药品价格的同时保护创新。

The Inflation Reduction Act(IRA)took effect in the United States in 2022.For the first time,the IRA allows the federal government to negotiate prescription drug prices,requires pharmaceutical companies to pay rebates to Medicare when prices rise above the rate of inflation,caps patient out-of-pocket costs for Medicare Part D drugs and insulin products,continues the“safe harbor”policy,extends the advance premium tax credit policy,and expands the types of free vaccinations.The IRA has multiple impacts on Medicare drug spending,but it still faces structural pressure in terms of price control.It is suggested that China can continue to utilize the public welfare advantages of basic medical and healthcare services,improve the targeting and operability of relevant health policies,and protect innovation while controlling drug prices.