摘要
目的:目前我国心肌梗死的发病率不断增加,给患者和社会带来巨大的经济负担。医疗保障部门正在积极探索提高医保基金使用效率,降低患者的负担。本研究为医保目录药品的遴选决策、医保药品谈判及确定医保支付价格提供借鉴和参考。方法:基于预算影响分析模型,通过查阅文献、卫生统计年鉴、CFDA南方医药经济研究所HDM系统、以及重组人尿激酶原2014—2016年销售数据,分析治疗急性心肌梗死的主要溶栓类药物的市场组成,并预测2017—2021年未来5年内注射用重组人尿激酶原未纳入与纳入医保目录两种情况下医保基金总支出。结果:如果2017年注射用重组人尿激酶原纳入国家医保目录后未降价时,预计未来5年注射用重组人尿激酶原医保支出占医保基金总支出的比例分别为0.003 0%、0.003 6%、0.004 2%、0.005 0%、0.006 0%,医保基金总支出累计增加额约1 291.52万元。当降价率为5.9%时,未来5年的医保总支出差额累计结余1.4万元。结论:随着注射用重组人尿激酶原降价率的提高,国家医疗保险基金总支出差额相比未降价将会进一步减少。
Objective： At present, the incidence of myocardial infarction in China is increasing, giving patients and society a huge financial burden.The health care sector is actively exploring ways to improve the efficiency of medical security fund and to reduce the burden on patients.This study provided reference for the selection decision of health insurance catalog medicine, health insurance drug negotiation and determination of health insurance payment price. Methods： Based on the budget impact analysis model, the main data of treatment of acute myocardial infarction were analyzed by reviewing the literature, health statistics yearbook, CFDA Southern Medical Research Institute HDM system and 2014-2016 rhpro-UK sales data. The market composition of the main thrombolytic drugs for treatment of acute myocardial infarction was compared and analyzed, and 2017-2021 within the next five years was predicted covering rhpro-UK not included in the health insurance catalog and rhpro-UK into the health insurance catalog two cases of health insurance fund total expenditure. Results： If rhpro-UK was included into the 2017 national health insurance catalog and did not cut prices, the next five years rhpro-UK health insurance spending accounted for the proportion of total expenditure of health insurance funds were 0.003 0%, 0.003 6%, 0.004 2%, 0.005 0% and 0.006 0% respectively, health insurance fund total expenditure will increase by about 12 195 200 yuan. If the price reduction rate was 5.9%, the total balance of health insurance would expend as 14 000 yuan within the next five years. Conclusion： With the increase of the price reduction rate of rhpro-UK, total expenditure of health insurance fund will be further reduced.
出处
《临床药物治疗杂志》
2017年第5期16-21,共6页
Clinical Medication Journal
