[1]谭清立,李永盈,崔洪瑞.创新药医保谈判的博弈分析[J].卫生经济研究,2024,41(06):5-9,15.
　TAN Qingli,LI Yongying,CUI Hongrui.Game Analysis of Health Insurance Negotiation for Innovative Drug[J].Journal Press of Health Economics Research,2024,41(06):5-9,15.
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创新药医保谈判的博弈分析

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
41
期数:
2024年06期
页码:
5-9,15
栏目:
专题研究
出版日期:
2024-05-30

文章信息/Info

Title:
Game Analysis of Health Insurance Negotiation for Innovative Drug
作者:
谭清立1; 2; 李永盈1; 崔洪瑞1
1.广东药科大学医药商学院，广东 中山 528453
2.广东药科大学卫生经济与健康促进研究中心，广东 广州 510308
Author(s):
TAN Qingli;  LI Yongying;  CUI Hongrui
School of Medical Business, Guangdong Pharmaceutical University, Zhongshan Guangdong 528453, China
关键词:
创新药; 国家基本医保药品目录; 医保谈判; 博弈论
Keywords:
innovative drugs;  national basic health insurance drug catalog;  health insurance negotiation;  game theory
分类号:
R19
文献标志码:
A
摘要:
博弈分析发现，随着国家基本医保药品目录调整常态化，医保谈判规则逐渐明晰，医保部门与医药企业之间的博弈不断“升级”。医保谈判药品存在量价不平衡现象，导致医药企业对创新药进入医保的积极性降低。为此，要增加医保基金对高值药品的支出，减少额外的资源配置成本；通过构建有效的激励约束机制、多方共同参与的监督约束机制，提高医保谈判决策的科学性，推动医保谈判药品成功落地。
Abstract:
With the normalization of the adjustment of the national basic health insurance drug catalog, the rules of health insurance negotiation are gradually clarified, and the game between the health insurance department and the pharmaceutical enterprises is constantly "upgraded". There is an imbalance between the quantity and price of medicines negotiated by the health insurance, which leads to a decrease in the enthusiasm of pharmaceutical companies for innovative drugs to enter health insurance. In this regard, it is necessary to increase the expenditure of the health insurance fund on high-value medicines, reduce the additional resource allocation costs, improve the scientific nature of the decision-making of the health insurance negotiation through the construction of an effective incentive and constraint mechanism and the supervision and constraint mechanism with the participation of many parties, so as to promote the successful landing of the negotiated medicines.

参考文献/References:

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[6] 谭清立，郭润镒，孙慧琳，等.药品集中带量采购与医保谈判政策的协同作用[J].中国药房，2021，32（15）：1793-1799.
[7] Luo Z H,Gyawali B,Han S,et al.Can locally developed me-too drugs aid price negotiation?An example of cancer therapies from China[J].Seminars in Oncology,2021,48(02): 141-144.

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更新日期/Last Update: 2024-05-30