[1]贾宇飞,于保荣.商业健康保险在医药费用支付中的作用及国际经验[J].卫生经济研究,2020,(05):8-12.
　JIA Yu-fei,YU Bao-rong.Research on the Role of Commercial Health Insurance in Drug Expense Payment and International Experience[J].Journal Press of Health Economics Research,2020,(05):8-12.
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商业健康保险在医药费用支付中的作用及国际经验
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
期数:
2020年05期
页码:
8-12
栏目:
专题研究
出版日期:
2020-04-29

文章信息/Info

Title:
Research on the Role of Commercial Health Insurance in Drug Expense Payment and International Experience
作者:
贾宇飞1; 于保荣1
1.对外经济贸易大学保险学院 ，北京100029
Author(s):
JIA Yu-fei; YU Bao-rong
School of Insurance and Economics，University of International Business and Economics，Beijing 100029，China
关键词:
商业健康保险; 药品费用支付; 国际经验
Keywords:
commercial health insurance; payment of pharmaceutical costs; international experience
分类号:
R19
文献标志码:
A
摘要:
当前商业健康保险是行业发展的热点，各家寿险公司纷纷布局健康险业务，但整体来看在药品费用支付中的占比十分有限。本文选取了典型商业险模式的美国、全民医保模式的英国和典型社会保险模式的德国作为研究对象，通过分析其商业健康保险在药品费用支付中的作用，明晰中国商业健康险的角色，提出经营策略调整方向、建立控费机制、与医疗服务体系及药品流通体系整合等建议。
Abstract:
At present，commercial health insurance is a hotspot in the development of the industry，and various life insurance companies have laid out health insurance businesses，but the overall proportion of pharmaceutical insurance payments is very limited. This article selects the typical commercial insurance model in the United States，the universal health insurance model in the United Kingdom，and the typical social insurance model in Germany as the research objects. By analyzing the role of commercial health insurance in the payment of pharmaceutical costs，it clarifies the role of commercial health insurance in China and proposes suggestions on strategy adjustment，establishment of fee control mechanism，and integration with medical service system and drug circulation system.

参考文献/References:

[1] 赵雯. 药品福利管理（PBM）在我国医疗保险和商业健康保险中的运用[D].西南财经大学,2014.
[2] 沈晨光，等. 世界新型家庭医生服务系统与国民联合健康保障体系构建[Ｍ].北京：中国书籍出版社，2018:18.
[3] 郝育德. 慢性疾病导致的企业员工劳动力健康损失测量[D]. 陕西：第四军医大学,2017:13
[4] 仇雨临,王昭茜.城乡居民基本医疗保险制度整合发展评析[J] .中国医疗保险,2018(2):16-20.
[5] 崔泽敏.多层次医疗保障体系下商业健康保险发展的制度基础研究[D] .首都经济贸易大学，2018.
[6] 中保协：商业健康险尚处于发展初期，2020年市场规模将超1万亿[EB/OL].（2018-07-27）.http://finance.ifeng.com/a/20180727/16410029_0.shtml.
[7] 美国健康险的发展之路[EB/OL]. （2019-09-27）.https://www.iyiou.com/p/113869.html.
[8] “保险+健康管理”成为商业健康险的重要领域 [EB/OL].（2017-11-27）.http://invest.10jqka.com.cn/20171127/c601785377.shtml.
[9] Juliette Cubanski, Matthew Rae,et al.How does prescription drug spending and use compare across large employer plans, Medicare Part D, and Medicaid? [EB/OL].（2019-05-20）.https://www.healthsystemtracker.org/chart-collection.
[10] Just Landed Health insurance-How to cover your medical expenses in Germany [EB/OL].https://www.justlanded.com/english/Germany/Germany-Guide/Health/Health-insurance.

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更新日期/Last Update: 2020-04-29