中国药房2024，Vol.35Issue(8)：901-905,5.DOI:10.6039/j.issn.1001-0408.2024.08.01
日本成本-效用评估制度对我国医保目录药品准入定价的启示
Insights from Japan's cost-effectiveness analysis policy on pricing for China's NRDL access
摘要
Abstract
The cost-effectiveness analysis policy for drugs was institutionalized in Japan since 2019,realizing quantitative adjustment of price across varieties.A hierarchical categorization approach was adopted to select medicines with high expected annual sales.For selected medicines,adjustments were made to the premium and profit components within the existing price structure based on a pre-defined incremental cost-effectiveness ratio(ICER)threshold,effectively resolving the issue of inconsistent criteria and magnitudes caused by subjective judgment.Meanwhile,incentive measures like evaluation exemption or threshold enhancement were granted for specific medicines.Besides,a price adjustment mechanism,which was allowed for upward and downward adjustments,involving tiered ICER threshold and quantified formulas,had been established for the premium and profit components of drug price.In China's National Reimbursement Drug List(NRDL)access,certain issues remained to be addressed:insufficient clarity in the quantitative mechanism of price formation,incomplete price adjustment measures,and lagging in the communication channels.It is recommended that the following measures could be referred to when further improving the scientificity and fairness of drug pricing during China's NRDL access,such as enhancing the ICER threshold for medicines catering to special populations,quantifying criteria and extents for price adjustment,granting preferential pricing policies to pharmaceutical companies that present high-quality evidence of effectiveness,preceding communication channels with pharmaceutical companies,as well as exploring a price floor mechanism for the drugs with excessive price reduction.关键词
医保目录/药品准入/定价/医保谈判/成本-效用评估/阈值Key words
reimbursement drug list/drug access/pricing/NRDL negotiation/cost-effectiveness analysis/threshold分类
医药卫生引用本文复制引用
王琳宁,杨盟雨,虞杰,路云..日本成本-效用评估制度对我国医保目录药品准入定价的启示[J].中国药房,2024,35(8):901-905,5.基金项目
国家医疗保障局医药价格和招标采购指导中心药品国内外价格的对比分析项目(No.7422200094-001) （No.7422200094-001）
