Page 7 - 《中国药房》2021年8期

·药事管理·

我国罕见病药品价格水平和可负担性研究 Δ

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朱楚玉 ，孙维阳，常 峰，路 云（中国药科大学国际医药商学院，南京 211198）
中图分类号 R95 文献标志码 A 文章编号 1001-0408（2021）08-0897-07
DOI 10.6039/j.issn.1001-0408.2021.08.01

摘 要 目的：评估我国罕见病药品价格水平及可负担性情况，提出改善罕见病治疗药品可负担性的政策建议，以期为政府主管
部门的相关决策提供依据。方法：基于《第一批罕见病目录》和《罕见病诊疗指南（2019年版）》选择罕见病药品，采用中位价格比
值法（MPR）评估药品价格水平，用药品年治疗费用和城乡居民年均可支配收入的倍数评估药品可负担性以及价格管理政策对药
品价格和可负担性的影响。结果与结论：共纳入罕见病药品71种，其MPR中位数为0.83，其中原研药的MPR中位数为1.13、仿制
药的MPR中位数为0.37。71种罕见病药品年均费用相当于2020年我国城镇居民年均收入的0.001～178.43倍，农村居民年均收
入的0.003～456.57倍，分别有21和28种药品年均费用超过城镇和农村居民年均收入。对其中14种罕见病药品实施医保准入谈
判或集中带量采购后，相关药品的MPR中位数从1.71下降到0.46，费用超过城镇居民年收入的药品数由8种降为0种，农村居民
由10种降为5种。总体上，我国罕见病药品价格水平略低于国际参考价格，但原研药价格水平整体高于国际参考价格，部分药品
费用远超过居民支付能力。建议加强原研药价格管理，促进优质仿制药临床替代，建立健全高负担罕见病药品支付保障体系。
关键词 罕见病药品；药品价格；中位价格比；可负担性

Study on the Price and Affordability of Rare Disease Drugs in China
ZHU Chuyu，SUN Weiyang，CHANG Feng，LU Yun（School of International Pharmaceutical Business，China
Pharmaceutical University，Nanjing 211198，China）

ABSTRACT OBJECTIVE：To evaluate the price and affordability of rare disease drugs in China and provide the suggestions for
the improvement of rare disease drug affordability in order to provide reference for the relevant decision-making of government
departments. METHODS：According to the List of the First Batch of Rare Diseasesand Diagnosis and Treatment Guideline for Rare
Diseases（2019 edition），rare disease drugs were selected. The median price ratio（MPR）was used to evaluate the drug price level，
and the ratio of the annual drug costs to the annual disposable income of urban or rural residents was used to evaluate the
affordability，and the impact of price management policieson drug prices and affordability. RESULTS and CONCLUSIONS：A total
of 71 kinds of rare disease drugs were included，and the median MPR of them was 0.83；among them，the median MPR of the
original drugs was 1.13，and the median MPR of the generic drugs was 0.37. The annual cost of 71 rare disease drugs was
0.001-178.43 times the average annual income of urban residents，and 0.003-456.57 times the average annual income of rural
residents. There were 21 and 28 drugs whose annual cost exceeded the annual income of urban and rural residents.After the
implementation of national medical insurance negotiation or volume based procurement of 14 drugs，the median MPR of these
drugs decreased from 1.71 to 0.46. For urban residents，the number of unaffordable drugs had been reduced from 8 to 0；for rural
residents，it had been reduced from 10 to 5. In summary，the price level of orphan drugs in China was slightly lower than
international reference price，but the price level of original drugs was higher than the international reference price，and the cost of
some drugs far exceeded the residents’ability to pay. It is suggested that the government should strengthen the price management of
original drugs，promote the substitution of high-quality generic drugs for original drugs，and improve the payment system for
high-value rare disease drugs.
KEYWORDS Rare disease drugs；Drug price；Median price ratio；Affordability

Δ 基金项目：国家卫生健康委购买服务合同项目 罕见病即患病率极低、患者数量极少的疾病，各国
＊硕士研究生。研究方向：医药卫生政策、药品价格。E-mail： 多将罕见病界定为患病率在5/10万～80/10万之间的疾
15850651251@163.com [1]
病 。全球已知的罕见病约有6 000余种，其中约72％由
# 通信作者：教授，博士生导师，博士。研究方向：药物经济学、医
基因缺陷导致，约 70％在儿童时期发病，且多数病情严
药 政 策 与 医 疗 保 险 、药 品 价 格 。 电 话 ：025-86185188。 E-mail：
luyuncpu@163.com 重、易危及生命、需长期治疗，患者疾病负担沉重 [1－2] 。

中国药房 2021年第32卷第8期 China Pharmacy 2021 Vol. 32 No. 8 ·897 ·