引用本文: 王美凤,王海银,符雨嫣,等.日本、韩国及我国台湾地区多适应证药物医保准入与支付策略研究及启示[J].中国卫生经济,2022,41(11):91-96.[点击复制] WANG Mei-feng,WANG Hai-yin,FU Yu-yan,et al.Research and Enlightenment on Medical Insurance Access and Payment Strategy of Multi-indication Drugs in Japan, South Korea and Taiwan, China[J].CHINESE HEALTH ECONOMICS,2022,41(11):91-96.[点击复制]
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日本、韩国及我国台湾地区多适应证药物医保准入与支付策略研究及启示
王美凤,王海银,符雨嫣,程文迪,覃肖潇,金春林
0
(上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所) 上海 200040)
摘要:
在梳理与我国医疗保险制度相似的日本、韩国及我国台湾地区的多适应证药物医保准入管理、支付标准制定、 续增适应证规则等具体做法的基础上,得到如下启示:(1)应积极探索建立应用风险分担协议机制;(2)应加强医保机构内设的卫生技术评估队伍建设;(3)应积极探索比较成本与奖励溢价的定价模式。
关键词:  多适应证药物  免疫检查点抑制剂药物  医保准入  支付标准  日本  韩国  中国台湾
DOI:
基金项目:
Research and Enlightenment on Medical Insurance Access and Payment Strategy of Multi-indication Drugs in Japan, South Korea and Taiwan, China
WANG Mei-feng,WANG Hai-yin,FU Yu-yan,CHENG yu-yan,TAN xiao-xiao,JIN chun-lin
(Shanghai Health Development Research Center (Shanghai Institute of Medical Science and Technology Information), Shanghai, 200040 , China)
Abstract:
As with similar to China's medical insurance system, it has important reference value to take Japan, South Korea and Taiwan, China as the research object. By learning from the specific practices such as the management of medical insurance access, the formulation of payment standards and the continuation of indication rules for multi-indication drugs in these areas, it proposes to actively explore the pricing model of comparative cost and reward premium, explore the establishment and application of RSA(Risk-Sharing Agreement) mechanism, and strengthen the construction of health technology evaluation team in medical insurance institutions.
Key words:  multiple indicationdrugs  immune tumor drug  medical insurance access  payment standard  Japan  South Korea  Taiwan  China

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