Objective To study the innovative drug pricing methods and medical insurance payment standards in foreign countries and to provide reference for China’s government.Methods The official websites were searched for info...Objective To study the innovative drug pricing methods and medical insurance payment standards in foreign countries and to provide reference for China’s government.Methods The official websites were searched for information and related literature,and literature review was used.Results and Conclusion In foreign countries,the clinical value of innovative drugs and their impact on medical insurance funds were comprehensively evaluated based on factors such as quality-adjusted life years,clinical benefit,and improvement of clinical benefit.Then,the evaluation results were taken as an important basis for whether innovative drugs were admitted to the medical insurance catalog and establishing medical insurance payment standards.By using international experience for reference,innovative drug pricing methods and medical insurance payment standards for China’s national conditions can be improved by establishing a basic database of clinical value and drug economic evaluation of innovative drugs,as well as innovative drug payment models based on decision thresholds.展开更多
Many countries with health insurance systems conduct periodic payment standards reform. How to reach consensus in setting payment standards among different specialties with different agendas has become a critical issu...Many countries with health insurance systems conduct periodic payment standards reform. How to reach consensus in setting payment standards among different specialties with different agendas has become a critical issue. The purpose of this study is to construct an analytic hierarchy process (AHP) model to obtain judgments from experts about the importance of "factors related to establishing payment standards in the national health insurance program". Under this goal, the first tier contains four evaluation aspects, and the second tier contains sixteen evaluation criteria divided into four groups The AHP model was then used to collect and combine the opinions of experts through an empirical study. The results can be directly used to formulate standard values as the basis for establishing payment standards. The results of our study strongly support that an AHP model is effective in forming a consensus among surgical specialists.展开更多
Objective To provide reference for China’s medical insurance reimbursement plan of multi-indication drugs.Methods By referring to relevant foreign literature,the implementation process and conditions of different rei...Objective To provide reference for China’s medical insurance reimbursement plan of multi-indication drugs.Methods By referring to relevant foreign literature,the implementation process and conditions of different reimbursement management modes of multi-indication drugs were analyzed to provide suggestions for reimbursement of multi-indication drugs in China.Results and Conclusion It is suggested to further explore the suitable conditions and select the corresponding mode in China.Payment standards should be set according to value pricing and budget impact analysis.Besides,data collection and analysis mechanism must be improved.Lastly,reward and punishment mechanism can be adopted to improve management efficiency.展开更多
文摘Objective To study the innovative drug pricing methods and medical insurance payment standards in foreign countries and to provide reference for China’s government.Methods The official websites were searched for information and related literature,and literature review was used.Results and Conclusion In foreign countries,the clinical value of innovative drugs and their impact on medical insurance funds were comprehensively evaluated based on factors such as quality-adjusted life years,clinical benefit,and improvement of clinical benefit.Then,the evaluation results were taken as an important basis for whether innovative drugs were admitted to the medical insurance catalog and establishing medical insurance payment standards.By using international experience for reference,innovative drug pricing methods and medical insurance payment standards for China’s national conditions can be improved by establishing a basic database of clinical value and drug economic evaluation of innovative drugs,as well as innovative drug payment models based on decision thresholds.
基金This study is deeply indebted to the Taiwan’s Bureau of National Health Insurance, Department of Health, Executive Yuan for providing research funding (BNHI Year 2002 Research and Development Project, Doc. No.:DOH91–NH-1040)
文摘Many countries with health insurance systems conduct periodic payment standards reform. How to reach consensus in setting payment standards among different specialties with different agendas has become a critical issue. The purpose of this study is to construct an analytic hierarchy process (AHP) model to obtain judgments from experts about the importance of "factors related to establishing payment standards in the national health insurance program". Under this goal, the first tier contains four evaluation aspects, and the second tier contains sixteen evaluation criteria divided into four groups The AHP model was then used to collect and combine the opinions of experts through an empirical study. The results can be directly used to formulate standard values as the basis for establishing payment standards. The results of our study strongly support that an AHP model is effective in forming a consensus among surgical specialists.
文摘Objective To provide reference for China’s medical insurance reimbursement plan of multi-indication drugs.Methods By referring to relevant foreign literature,the implementation process and conditions of different reimbursement management modes of multi-indication drugs were analyzed to provide suggestions for reimbursement of multi-indication drugs in China.Results and Conclusion It is suggested to further explore the suitable conditions and select the corresponding mode in China.Payment standards should be set according to value pricing and budget impact analysis.Besides,data collection and analysis mechanism must be improved.Lastly,reward and punishment mechanism can be adopted to improve management efficiency.