【摘要】：目的:分析臺(tái)灣地區(qū)醫(yī)保藥品在采購(gòu)和支付方面的做法和經(jīng)驗(yàn),為大陸地區(qū)推進(jìn)藥品采購(gòu)模式和支付價(jià)格改革提供參考。方法:系統(tǒng)梳理臺(tái)灣地區(qū)在醫(yī)保藥品采購(gòu)和支付方面的政策文件和相關(guān)文獻(xiàn),并與大陸地區(qū)藥品采購(gòu)和支付政策進(jìn)行對(duì)比分析。結(jié)果:臺(tái)灣地區(qū)醫(yī)療機(jī)構(gòu)根據(jù)自身用藥需求,自主采購(gòu)藥品,采購(gòu)價(jià)格由供需雙方直接談判形成。政府僅對(duì)醫(yī)保藥品的價(jià)格進(jìn)行管理,對(duì)新藥采用國(guó)際參考定價(jià)辦法;原廠藥、BA/BE學(xué)名藥、一般學(xué)名藥的支付價(jià)以國(guó)際參考價(jià)格為上限,依次降低。藥品質(zhì)量也在醫(yī)保支付標(biāo)準(zhǔn)考慮之列。此外,藥品的支付價(jià)格依據(jù)采購(gòu)價(jià)格實(shí)行動(dòng)態(tài)調(diào)整,當(dāng)二者差值大于30%時(shí),健保署便會(huì)調(diào)整支付價(jià)格以減小二者的差價(jià)。結(jié)論:臺(tái)灣地區(qū)通過(guò)制度設(shè)計(jì)和調(diào)整,較好地統(tǒng)籌了藥品采購(gòu)和補(bǔ)償兩個(gè)環(huán)節(jié),形成了合理的藥品采購(gòu)價(jià)格和支付價(jià)格,這些經(jīng)驗(yàn)可為中國(guó)大陸地區(qū)完善藥品采購(gòu)和支付政策提供參考。
[Abstract]:Aim: to analyze the practice and experience of purchase and payment of medical insurance drugs in Taiwan, so as to provide reference for the reform of drug purchase mode and payment price in mainland China. Methods: the policy documents and related literatures on medical insurance drug purchase and payment in Taiwan were systematically combed and compared with those in mainland China. Results: according to their own demand for drugs, medical institutions in Taiwan procured drugs on their own, and the purchase price was formed by direct negotiation between the suppliers and the suppliers. The government only manages the price of medical insurance drugs, and adopts the international reference pricing method for new drugs, and the payment price of original medicine, BA/BE medicine and general name medicine is reduced in turn with the international reference price as the upper limit. Drug quality is also considered in the Medicare payment criteria. In addition, the payment price for drugs is dynamically adjusted based on the purchase price, and when the difference is greater than 30 percent, the agency adjusts the payment price to reduce the difference between the two. Conclusion: through the system design and adjustment in Taiwan, the two links of drug purchase and compensation have been well coordinated, and a reasonable purchase price and payment price of drugs have been formed. These experiences can provide reference for the improvement of drug purchase and payment policy in mainland China.
【作者單位】： 沈陽(yáng)藥科大學(xué)工商管理學(xué)院;北京大學(xué)中國(guó)衛(wèi)生經(jīng)濟(jì)研究中心;
【分類號(hào)】：R95

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