摘要
目的:基于医院视角,构建预算影响分析模型,探索医院住院打包支付(DRG或DIP)模式下,重组人白介素-11部分替代重组人血小板生成素对医疗机构药品费用可能产生的影响。方法:目标人群为化疗所致严重血小板减少症中使用重组人白介素-11或重组人血小板生成素的患者。根据患者年均化疗疗程数、平均用药天数和两类药品的日均剂量计算患者年均用药支数,并结合药品价格计算患者年均药品费用。目标人数根据药物历史销售金额和患者年均药品费用推测计算获得,药品的市场份额则基于不同情境进行假设。结果:在住院打包支付情境下,在当前市场价格下,如果重组人白介素-11替代重组人血小板生成素30%的市场份额,2021—2023年全国医院的药品费用分别节约4.4亿元、9.5亿元和15.0亿元,患者年人均自付药品费用分别降低571元、1141元和1712元。重组人血小板生成素价格变动下的全国医院药品费用分析、单个医院药品费用分析和单因素敏感性分析结果显示预算影响分析结果较为稳健。结论:如果重组人白介素-11部分替代重组人血小板生成素,可以节约医院用于化疗所致严重血小板减少症患者的药品费用,这将有利于医院在DRG或DIP支付模式下有效控制医疗费用。
Objective:Budget impact analysis model from hospital perspective was constructed to explore possible impact of part replacement of recombinant human thrombopoietin(rhTPO)with recombinant human interleukin 11(rhIL-11)on hospital drug cost in hospitalization package payment mode(DRG or DIP).Methods:Target population were severe chemotherapy induced thrombocytopenia(CIT)patients with rhIL-11 or rhTPO treatment.The annual average vials per patient were calculated based on annual average chemotherapy courses,average medication days and average daily dose of the two drugs.According to annual average vials and drug price,annual cost can be estimated.Therefore,Patient number can be estimated from historical sales value and annual cost per patient.The market share was assumed in different scenarios.Results:If rhIL-11 replaces 30%market share of rhTPO in hospitalization package payment mode,the national hospital drug cost will be saved by ￥440 million,￥950 million and ￥1.5 billion from 2021 to 2023.The average annual self-pay per patient will be reduce by ￥571,￥1141 and ￥1712 respectively.The national hospital drug cost analysis considering rhTPO price change,the individual hospital drug cost analysis and one-way sensitivity analysis all indicated that the basic results are robust.Conclusion:If rhIL-11 partially replace rhTPO,hospital drug costs for severe CIT patients will be saved,which will help hospitals to effectively manage medical cost in DRG or DIP payment mode.
作者
官海静
封宇飞
冷家骅
李正翔
张洁
吴晶
GUAN Hai-jing;FENG Yu-fei;LENG Jia-hua;LI Zheng-xiang;ZHANG Jie;WU Jing(Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Peking University People′s Hospital,Beijing 100044,China;Beijing Cancer Hospital,Beijing 100142,China;Tianjin Medical University General Hospital,Tianjin 300052,China;Tianjin Medical University Cancer Institute&Hospital,Tianjin 300060,China;School of Pharmaceutical Science and Technology,Tianjin University,Tianjin 300072,China)
出处
《中国药物评价》
2021年第3期229-234,共6页
Chinese Journal of Drug Evaluation
