Page 6 - 2019年11月第30卷第21期

·药事管理·

台州市降糖类基本药物全额保障政策经济性评价研究 Δ

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郭志刚 1，2＊ ，周簪荣 ，翟琛琛 ，管晓东 ，史录文 ，郑利光 （1.北京大学口腔医学院·口腔医院药剂科，北京
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100081；2.北京大学医药管理国际研究中心，北京 100191；3.浙江省疾病预防控制中心，杭州 310051；4.北京
大学药学院，北京 100191）
中图分类号 R956 文献标志码 A 文章编号 1001-0408（2019）21-2881-05
DOI 10.6039/j.issn.1001-0408.2019.21.01

摘 要 目的：评价台州市降糖类基本药物全额保障政策的经济性，为改善我国药品可及性、完善国家基本药物制度提供参考。
方法：提取台州市2009－2016年各区县糖尿病患者电子健康档案和财政投入数据，采用队列研究设计，以各区县各自政策实施时
间作为间断点，将逐年记录的数据取均值处理为年度数据，形成政策实施前1年（基线年）和实施后3年的队列数据。根据政策实
施后是否选择使用免费药物分为政策组和对照组，使用倾向性得分匹配法控制两组基线差异，形成最终研究样本，借鉴双重差分
法模型进行分析，计算政策的实施成本和收益。结果：经匹配后两组各纳入研究14 744人，政策实施期间台州市年人均财政投入
为263.8元，与基线年比较，因政策实施引起的年人均药品费用减少了649.2元、年人均住院医疗费用减少了624.7元，投入-产出比
为1 ∶ 4.8。结论：台州市基本药物全额保障政策有利于降低患者费用负担，政策具有经济性，通过结合相关政策进行科学设计，具
备可推广性和持续性。
关键词 台州市；降糖药物；基本药物；全额保障政策；免费药物；经济性评估；费用负担

Economic Evaluation on the Full Coverage Policy for Hypoglycemic Essential Medicines in Taizhou City
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GUO Zhigang ，ZHOU Zanrong ，ZHAI Chenchen ，GUAN Xiaodong ，SHI Luwen ，ZHENG Liguang 1
（1.Dept. of Pharmacy， Peking University School and Hospital of Stomatology， Beijing 100081， China；
2.International Research Center for Medicinal Administration， Peking University， Beijing 100191， China；
3.Zhejiang Provincial Center for Disease Control and Prevention， Hangzhou 310051， China；4.School of
Pharmaceutical Sciences，Peking University，Beijing 100191，China）
ABSTRACT OBJECTIVE：To evaluate the economics of the full coverage policy for hypoglycemic essential medicines in
Taizhou city，and to provide reference for improving medicine accessibility and essential medicine system in China. METHODS：
The electronic health records and financial input data of diabetic patients were extracted from different districts and counties of
Taizhou city during 2009-2016. In cohort study design，taking the implementation time of each district and county’s policies as the
breakpoint，the data recorded annually were processed as annual data，forming the cohort data for 1 year before（baseline year）
and 3 years after the implementation of the policies. According to the choice of free medicines after the implementation of the
policy，they were divided into policy group and control group. Propensity score matching was used to balance the differences
between two groups to get the final sample， and then the economics of the policy was evaluated with the methods of
difference-in-differences. The cost and benefit of implementation policy were calculated. RESULTS：Totally 14 744 people of each
group were got by propensity score matching. The mean annual financial expenses on free medicine per capita were 263.8 yuan.
Compared with baseline year，mean annual medicine expenses per capita reduced by the policy were 649.2 yuan，and mean annual
hospitalization expenses per capita were 624.7 yuan. Thus the input-output ratio of the policy was 1 ∶ 4.8. CONCLUSIONS：The
implementation of the policy is beneficial to reduce the cost burden of patients and economical. It can be popularized and sustained
through scientific design combined with relevant policies.
KEYWORDS Taizhou city；Hypoglycemic medicine；Essential medicine；Full coverage policy；Free medicine；Economic
evaluation；Cost burden

糖尿病作为全球主要慢病之一，患病率高、病程长、
Δ 基金项目：国家自然科学基金资助项目（No.71774005）
＊主管药师，博士。研究方向：药事管理与临床药学。电话： 并发症多，对医疗资源需求巨大，个人负担较重 [1-2] 。因
010-82195126。E-mail：guozhigang0909@163.com
药品费用负担带来的药品可及性不足，增加了在控制糖
# 通信作者：主任药师。研究方向：药事管理与临床药学。电话：
010-82195126。E-mail：zhenglg1103@163.com 尿病进展、改善糖尿病患者用药依从性和疾病效果上的

中国药房 2019年第30卷第21期 China Pharmacy 2019 Vol. 30 No. 21 ·2881 ·