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医保目录调整对医院罕见病用药的影响研究
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| 篇名： | 医保目录调整对医院罕见病用药的影响研究 |
| TITLE： | Research on the impact of the adjustment of National Reimbursement Drug List on drug use of rare disease in hospitals |
| 摘要： | 目的 探究医保目录调整对医院罕见病用药的影响，为提高我国罕见病患者用药保障水平提供参考。方法从全国医药经济信息网中提取2016年1月－2018年12月有连续数据的789家医疗机构的罕见病用药的月度采购数据，采用单组间断时间序列模型对医保目录调整前后的罕见病用药品种、采购金额、平均限定日费用（DDDc）和用药频度（DDDs）进行比较。结果2017年医保目录共新增9个罕见病用药，包括吡非尼酮、左旋多巴/卡比多巴、利鲁唑、罗匹尼罗、屈昔多巴、依折麦布、依维莫司、重组人凝血因子Ⅸ和重组人凝血因子Ⅶa。医保目录调整后，9个罕见病用药的平均DDDc显著降低，DDDs和采购金额的上升趋势显著增大（P＜0.001）。结论我国医保目录中新增的罕见病用药数量不断增多，医疗保障覆盖范围不断扩大，罕见病用药价格显著降低，患者经济负担进一步降低，罕见病用药的用量显著增加，惠及了更多的罕见病患者，但同时也会增加医院的罕见病用药的采购金额。国家医疗保障部门需要充分考虑如何权衡医保基金承受能力与罕见病用药覆盖需求。 |
| ABSTRACT： | OBJECTIVE To explore the impact of the adjustment of the national reimbursement drug list on rare disease drugs in hospitals， and to provide reference for improving the drug security of patients with rare diseases in China.METHODS The monthly procurement data of rare disease drugs from 789 medical institutions that continuously reported data from January 2016 to December 2018 were extracted from the Chinese Medicine Economic Information. The single-group interrupted time series model was used to compare drug varieties， procurement amount， average defined daily cost （DDDc） and defined daily doses （DDDs） of rare disease drugs before and after the adjustment of national reimbursement drug list. RESULTS In 2017， a total of 9 rare disease drugs were newly included in the national reimbursement drug list， including pirfenidone， carbidopa/levodopa， riluzole， ropinirole， droxidopa， ezetimibe， everolimus， coagulation factor Ⅸ human recombinant and coagulation factor Ⅶa human recombinant. After the adjustment of the national reimbursement drug list， the average DDDc of 9 rare disease drugs was significantly decreased， the upward trend of DDDs and the procurement amount was significantly increased （P＜0.001）. CONCLUSIONS The number of newly included rare disease drugs in national reimbursement drug list keeps increasing， the coverage of medical security keeps expanding， the price of rare disease drugs is significantly decreased， the economic burden of patients is further decreased， and the consumption of rare disease drugs is significantly increased， benefiting more patients with rare diseases； but at the same time， it also increases the procurement amount of rare disease drugs in hospitals. National medical security departments need to fully consider how to balance the affordability of medical insurance funds with the demand for rare disease drug coverage. |
| 期刊： | 2022年第33卷第24期 |
| 作者： | 易洪彬，石丰豪，蒯丽萍，邢花 |
| AUTHORS： | YI Hongbin，SHI Fenghao，KUAI Liping，XING Hua |
| 关键字： | 医保目录；罕见病；间断时间序列分析；限定日费用；用药频度 |
| KEYWORDS： | national reimbursement drug list； rare disease； interrupted time series analysis； defined daily dose cost； defined |
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