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价值医疗视角下国家药品集中带量采购在某公立医院的实施效果评价
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篇名: 价值医疗视角下国家药品集中带量采购在某公立医院的实施效果评价
TITLE:
摘要:
目的评价某公立医院对国家药品集中带量采购以下简称国采”)政策的实行情况以期为推进以价值医疗为导向的国采政策提供参考方法对重庆市某公立医院涉及的国采中选的抗菌药物共计6个品种12个品规进行具体分析调取该医院国 采实施前12019420-2020419和实施后12020420-2021419的药品使用数据析其价格变化仿制药替代率日均费用DDDc)、实际节省费用等指标提出问题及建议并评估国采政策实施效果是否体现价值医疗的核心内涵结果国采实施后该医院中选抗菌药物价格平均降幅为63.44原研药价格平均降幅为27.38仿制药替代率平均为25.59该医院中选抗菌药物的DDDc均有不同程度下降其中4种药物的降幅在10~40盐酸莫西沙星片降幅达80.146种抗菌药物相较国采前共节省约52.13万元其中进口药盐酸莫西沙星片和盐酸莫西沙星氯化钠注射液共节省49.53 万元占抗菌药物总节省费用的94.97)。结论基于价值医疗角度的国采政策的价值主要体现在药品双通道管理机制提高了药品可获得性可以有效控制医疗费用不合理增长减少医保基金支出有助于进一步减轻患者用药负担而目前国采政策实施面临的困难还包括药品价格需回归合理区间外企需改变策略寻求突破中选仿制药与原研药之间的质量差异会导致疗效 差异等为此笔者认为医药市场结构应正向转变以价值医疗助力医保调控优化一致性评价体系从而进一步提高患者健康 水平
ABSTRACT:
OBJECTIVETo evaluate the implementation of national drug centralized volume-based procurement called VBPfor shortin a public hospitalso as to provide reference for promoting VBP policy guided by value-based healthcare. METHODSA total of 6 varieties and 12 specifications of antibiotics included in VBP in a public hospital in Chongqing were analyzed. The drug use data of the hospital one year before the implementation of VBPi.e. April 202019- April 192020and one year after the implementationi.e. April 202020-April 192021were collected and analyzed in respects of price changegeneric drug substitution rateaverage daily costDDDc),actual cost savings and other indicators. The problems and suggestions were put forwardand the effects of VBP policy implementation whether reflects the core connotation of value-based healthcare were evaluated. RESULTSAfter the implementation of VBPdrug prices fell by an average of 63.44the average price drop of
original drugs was 27.38and substitution rate of generic drugs was 25.59. DDDc of selected antibiotics in the hospital
decreased in varying degreesof which the decline of four drugs was 10-40and that of Moxifloxacin hydrochloride tablets
was 80.14. Compared with bef VBP6 kinds of antibiotics saved about 521 300 yuanof which the imported Moxifloxacin
hydrochloride tablets and Moxifloxacin hydrochloride sodium chloride injection saved 495 300 yuanaccounting for 94.97of the total cost savings of antibiotics. CONCLUSIONSThe value of VBP based on the perspective of value-based healthcare is mainly reflected in the dual channel management mechanism of drugswhich improves the availability of drugseffectively controls the unreasonable growth of medical expensesreduces the expenditure of medical insurance fundand helps to further reduce the drug burden of patients. At presentthe implementation of VBP still faces difficultiesincluding the need for drug prices to return to a reasonable rangethe need for foreign enterprises to change strategies to seek a breakthroughand different therapeutic efficacy due to the difference in quality between the selected generic drugs and the original drugs. Thereforethe author believes that the pharmaceutical market structure should be transformed positivelyvalue-based healthcare should help the regulation of medical insuranceand the consistency evaluation system should be optimizedso as to further improve the health level of patients.
期刊: 2021年第32卷第19期
编辑: 赵 洁,李 巍,王皋俊
AUTHORS: ZHAO Jie,LI Wei,WANG Gaojun
关键字: 药品;国家药品集中带量采购;价值医疗;实施效果
KEYWORDS: Drug;National drug centralized volume-based procurement;Value-based healthcare;Implementation effect
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