本文選題：國際經(jīng)驗(yàn)　切入點(diǎn)：調(diào)整機(jī)制　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：我國現(xiàn)行的政府定價(jià)、集中招標(biāo)采購、醫(yī)院藥品加成管制這三項(xiàng)管制政策下,出現(xiàn)了"藥價(jià)虛高""看病難,看病貴""廉價(jià)藥中標(biāo)死"的難題。鑒于此,2015年5月,國家發(fā)改委等7部委聯(lián)合發(fā)布了《關(guān)于印發(fā)推進(jìn)藥品價(jià)格改革意見的通知》,決定"從6月1日起取消絕大部分藥品政府定價(jià)……藥品實(shí)際交易價(jià)格主要由市場競爭形成"。同時(shí)該文件指出"醫(yī)�；鹬Ц兜乃幤�,由醫(yī)保部門會(huì)同有關(guān)部門擬定醫(yī)保藥品支付標(biāo)準(zhǔn)……探索建立引導(dǎo)藥品價(jià)格合理形成的機(jī)制"。"藥品支付標(biāo)準(zhǔn)"這一概念主要來自實(shí)施社會(huì)醫(yī)保制度的德、日、中國臺(tái)灣等國家和地區(qū)。他們將"醫(yī)保支付標(biāo)準(zhǔn)"作為藥價(jià)管理核心,合乎其醫(yī)療體制的內(nèi)在邏輯,既然公共醫(yī)保體系導(dǎo)致藥品需方性質(zhì)和行為發(fā)生變化,藥價(jià)管理就應(yīng)以醫(yī)保支付標(biāo)準(zhǔn)為核心,通過報(bào)銷政策,以約束藥價(jià)的形成,使之既保障公共醫(yī)保體系的有效運(yùn)行,又不過于抑制產(chǎn)業(yè)的活力。我國藥品支付標(biāo)準(zhǔn)使用范圍包括醫(yī)保目錄內(nèi)的所有中西藥,但中西藥存在使用原則、臨床適應(yīng)癥、成分組方、原料來源等各方面差異,如何充分針對(duì)中成藥的特殊性制定合理的支付準(zhǔn)及后期配套政策值得深入探索。盡管國外先進(jìn)理論和經(jīng)驗(yàn)表明藥物價(jià)格參考體系是目前公認(rèn)的最合理,應(yīng)用最廣泛,較成熟的支付政策,但其中部分理論并不能完全適用于中醫(yī)理論指導(dǎo)下,組分復(fù)雜、化學(xué)成分不完全明確的中成藥。如何借鑒國外和臺(tái)灣地區(qū)相對(duì)成熟的醫(yī)保支付制度其理論機(jī)制和實(shí)踐經(jīng)驗(yàn)對(duì)我國占據(jù)醫(yī)藥市場19%左右份額的中成藥進(jìn)行支付,是否適合我國中藥市場情況,能否從他國和先進(jìn)地區(qū)政策理論和經(jīng)驗(yàn)中找到滿意答案,都是值得關(guān)注和思考的。本文通過對(duì)中成藥相對(duì)化藥主要差異性進(jìn)行研究,借鑒國外和先進(jìn)地區(qū)藥品支付標(biāo)準(zhǔn)對(duì)中成藥支付標(biāo)準(zhǔn)和配套政策探索,同時(shí)繼承中成藥特色,研究具有中醫(yī)藥特色的中成藥醫(yī)保支付標(biāo)準(zhǔn)。制定科學(xué)的中成藥支付標(biāo)準(zhǔn)一方面有利于引導(dǎo)中成藥價(jià)格回歸于市場,促進(jìn)企業(yè)增強(qiáng)對(duì)提升藥品質(zhì)量的動(dòng)力從而占領(lǐng)更多的市場份額,有效提升藥品質(zhì)量,另一方面對(duì)促進(jìn)中成藥質(zhì)量標(biāo)準(zhǔn)化具有重要的意義,進(jìn)而推進(jìn)我國醫(yī)保藥品價(jià)格政策改革更加符合中國實(shí)際醫(yī)藥市場情況,有效地緩解醫(yī)�；饓毫�,保障參�；颊叩臋�(quán)益。
[Abstract]:China's current government pricing, centralized bidding and procurement, hospital drug addition control, these three regulatory policies, there are "false high drug prices", "difficult to see a doctor," "expensive" "cheap drugs to die." in view of this, in May 2015, Seven ministries and commissions, including the National Development and Reform Commission, jointly issued the Circular on issuing opinions on promoting Drug Price Reform, and decided that "the vast majority of drug government pricing shall be abolished from June 1. The actual transaction prices of drugs are mainly competitive in the market." And the document says, "Medicines paid by the health care fund, The medical insurance department, together with the relevant departments, shall formulate the standards for the payment of medical care drugs and explore the establishment of a mechanism to guide the rational formation of drug prices. "the concept of" drug payment standards "mainly comes from the implementation of the social medical insurance system in Germany and Japan. Countries and regions such as Taiwan, China, and other countries and regions. They regard the "standard of medical insurance payment" as the core of drug price management, which conforms to the inherent logic of their medical system. Since the public health care system has caused changes in the nature and behavior of the drug demand side, The drug price management should take the standard of medical insurance payment as the core and restrict the formation of the drug price through the reimbursement policy to ensure the effective operation of the public medical insurance system. The scope of payment standards in China includes all Chinese and western medicines in the medical insurance catalogue, but there are differences in the use principles, clinical indications, ingredients, sources of raw materials, and so on. It is worth exploring how to make reasonable payment standard and supporting policy in the later period according to the particularity of Chinese patent medicine. Although foreign advanced theories and experience show that the drug price reference system is the most reasonable and widely used at present, A more mature payment policy, but some of which can not be fully applicable to the guidance of traditional Chinese medicine theory, the components are complex, How to draw lessons from the relatively mature medical insurance payment system abroad and Taiwan and its theoretical mechanism and practical experience to pay for the Chinese patent medicine which occupies about 19% of the medical market in our country. It is worth paying attention to and pondering whether it is suitable for the situation of Chinese traditional medicine market and whether we can find a satisfactory answer from the policy theory and experience of other countries and advanced regions. Drawing lessons from foreign and advanced regional drug payment standards to explore the payment standards and supporting policies of proprietary Chinese medicines, and at the same time inheriting the characteristics of proprietary Chinese medicines, To study the standard of medical insurance payment for Chinese patent medicine with the characteristics of traditional Chinese medicine. On the one hand, it is helpful to guide the price of Chinese patent medicine to return to the market. Promoting enterprises to enhance the power to improve the quality of medicines, thus occupying more market share, effectively improving the quality of medicines, on the other hand, promoting the standardization of the quality of proprietary Chinese medicine is of great significance. Furthermore, the reform of medical insurance drug price policy in China is more in line with the actual medical market situation, which can effectively relieve the pressure of medical insurance fund and protect the rights and interests of insured patients.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.1

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