[1]姜 来,贾宇飞,孔维政,等.普惠险特药目录的制定与管理经验研究[J].卫生经济研究,2022,39(2):10-13,18.
　JIANG Lai,JIA Yu-fei,KONG Wei-zheng,et al.Research on the Design and Management Experience of Special Drug Catalog in Inclusive Health Insurance[J].Journal Press of Health Economics Research,2022,39(2):10-13,18.
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普惠险特药目录的制定与管理经验研究
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
39
期数:
2022年2期
页码:
10-13,18
栏目:
医疗保障
出版日期:
2022-01-27

文章信息/Info

Title:
Research on the Design and Management Experience of Special Drug Catalog in Inclusive Health Insurance
作者:
姜 来1; 贾宇飞1; 孔维政1; 于保荣1
1.对外经济贸易大学保险学院，北京 100029
Author(s):
JIANG Lai;  JIA Yu-fei;  KONG Wei-zheng;  YU Bao-rong
School of Insurance, University of International Business and Economics, Beijing 100029, China
关键词:
普惠险; 特药目录; 药品遴选; 基本医保目录
Keywords:
inclusive insurance;  special drug catalog;  drug selection;  basic medical insurance list
分类号:
R19
文献标志码:
A
摘要:
普惠险特药目录的制定可根据政府参与程度，分为纯商业运作、政府指导下的商业运作、纯政府承办三种类型。特药遴选应遵循临床价值、药物经济学价值、基金可承担以及城市定制性等原则，并根据投保情况、基金运行情况、与医保目录的紧密性等因素，不断调整普惠险特药目录。整体而言，为促进普惠险特药保障责任，在平衡产品保障效率与可持续性的同时，多方利益主体应加强药品、保险产品以及信息技术等方面的交流与合作。
Abstract:
According to the degree of government participation, the design of the special drug catalog in inclusive health insurance can be divided into three types: commercial operation, commercial operation under the guidance of the government, and government operation. The selection of special drugs should follow the principles of clinical value, economic value, insurance funds affordability, and city-oriented customization. In addition, this catalog should be constantly adjusted according to insurance coverage, fund operation, and closeness to the medical insurance catalog. As a whole, in order to improve the security of special drugs in inclusive health insurance, it is important to balance the efficiency and sustainability of security. In addition, stakeholders should strengthen the exchange and cooperation between medicines, insurance products, and information technology.

参考文献/References:

[1] 最新公布！“浙丽保”两个清单正式推出，哪些能报哪些不能报？[EB/OL].（2020-12-30）.https://mp.weixin.qq.com/s/5kcXg2wWDJgIg-V4UKnsrg.

相似文献/References:

[1]于保荣,孔维政,王 庆.普惠险药品准入机制与评估体系研究[J].卫生经济研究,2022,39(8):1.
　YU Baorong,KONG Weizheng,WANG Qing.Research on Access Mechanism and Evaluation System of Inclusive Insurance Drugs[J].Journal Press of Health Economics Research,2022,39(2):1.
[2]赵 静,史彦龙,卢凌美,等.普惠险购买意愿与购买行为的影响因素研究 ——以宁波市为例[J].卫生经济研究,2023,40(4):19.
　ZHAO Jing,SHI Yanlong,LU Lingmei,et al.Research on Influencing Factors of the Purchase Intention and Purchase Behavior of Inclusive Health Insurance ——Taking Ningbo City as an Example[J].Journal Press of Health Economics Research,2023,40(2):19.

更新日期/Last Update: 2022-01-27