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        價值醫療視角下國家藥品集中帶量采購在某公立醫院的實施效果評價
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        篇名: 價值醫療視角下國家藥品集中帶量采購在某公立醫院的實施效果評價
        TITLE:
        摘要:
        目的評價某公立醫院對國家藥品集中帶量采購以下簡稱國采”)政策的執行情況以期為推進以價值醫療為導向的國采政策提供參考方法對重慶市某公立醫院涉及的國采中選的抗菌藥物共計6個品種12個品規進行具體分析調取該醫院國 采實施前12019420-2020419和實施后12020420-2021419的藥品使用數據析其價格變化仿制藥替代率日均費用DDDc)、實際節省費用等指標提出問題及建議并評估國采政策實施效果是否體現價值醫療的核心內涵結果國采實施后該醫院中選抗菌藥物價格平均降幅為63.44原研藥價格平均降幅為27.38仿制藥替代率平均為25.59該醫院中選抗菌藥物的DDDc均有不同程度下降其中4種藥物的降幅在10~40鹽酸莫西沙星片降幅達80.146種抗菌藥物相較國采前共節省約52.13萬元其中進口藥鹽酸莫西沙星片和鹽酸莫西沙星氯化鈉注射液共節省49.53 萬元占抗菌藥物總節省費用的94.97)。結論基于價值醫療角度的國采政策的價值主要體現在藥品雙通道管理機制提高了藥品可獲得性可以有效控制醫療費用不合理增長減少醫保基金支出有助于進一步減輕患者用藥負擔而目前國采政策實施面臨的困難還包括藥品價格需回歸合理區間外企需改變策略尋求突破中選仿制藥與原研藥之間的質量差異會導致療效 差異等為此筆者認為醫藥市場結構應正向轉變以價值醫療助力醫保調控優化一致性評價體系從而進一步提高患者健康 水平
        ABSTRACT:
        OBJECTIVETo evaluate the implementation of national drug centralized volume-based procurement called VBPfor shortin a public hospitalso as to provide reference for promoting VBP policy guided by value-based healthcare. METHODSA total of 6 varieties and 12 specifications of antibiotics included in VBP in a public hospital in Chongqing were analyzed. The drug use data of the hospital one year before the implementation of VBPi.e. April 202019- April 192020and one year after the implementationi.e. April 202020-April 192021were collected and analyzed in respects of price changegeneric drug substitution rateaverage daily costDDDc),actual cost savings and other indicators. The problems and suggestions were put forwardand the effects of VBP policy implementation whether reflects the core connotation of value-based healthcare were evaluated. RESULTSAfter the implementation of VBPdrug prices fell by an average of 63.44the average price drop of
        original drugs was 27.38and substitution rate of generic drugs was 25.59. DDDc of selected antibiotics in the hospital
        decreased in varying degreesof which the decline of four drugs was 10-40and that of Moxifloxacin hydrochloride tablets
        was 80.14. Compared with bef VBP6 kinds of antibiotics saved about 521 300 yuanof which the imported Moxifloxacin
        hydrochloride tablets and Moxifloxacin hydrochloride sodium chloride injection saved 495 300 yuanaccounting for 94.97of the total cost savings of antibiotics. CONCLUSIONSThe value of VBP based on the perspective of value-based healthcare is mainly reflected in the dual channel management mechanism of drugswhich improves the availability of drugseffectively controls the unreasonable growth of medical expensesreduces the expenditure of medical insurance fundand helps to further reduce the drug burden of patients. At presentthe implementation of VBP still faces difficultiesincluding the need for drug prices to return to a reasonable rangethe need for foreign enterprises to change strategies to seek a breakthroughand different therapeutic efficacy due to the difference in quality between the selected generic drugs and the original drugs. Thereforethe author believes that the pharmaceutical market structure should be transformed positivelyvalue-based healthcare should help the regulation of medical insuranceand the consistency evaluation system should be optimizedso as to further improve the health level of patients.
        期刊: 2021年第32卷第19期
        作者: 趙 潔,李 巍,王皋俊
        AUTHORS: ZHAO Jie,LI Wei,WANG Gaojun
        關鍵字: 藥品;國家藥品集中帶量采購;價值醫療;實施效果
        KEYWORDS: Drug;National drug centralized volume-based procurement;Value-based healthcare;Implementation effect
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