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日本儿童药定价及价格激励政策对我国的启示 Δ
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张 宸 ,凡 馨,金秋晨,陈永法(中国药科大学国际医药商学院,南京 211198)
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中图分类号 R951 文献标志码 A 文章编号 1001-0408(2021)23-2822-06
DOI 10.6039/j.issn.1001-0408.2021.23.02
摘 要 目的:借鉴日本儿童药定价及价格激励政策,为我国儿童药价格体系的完善提供参考。方法:分析日本药品定价策略,总
结日本儿童药价格激励政策及其实施现状与效果,提出完善我国儿童药价格体系的建议。结果与结论:日本医保药品定价策略包
括医保目录准入定价和医保目录内药品价格调整两种类型,其中儿童药价格激励政策主要包括儿童新药初次定价补正加算、目录
内新增儿童适应证加算和其他措施(如符合条件的药品可获得间接价格补偿、卫生技术评估时要考虑儿童因素等)等。整体而言
这些措施加快了日本儿童药研发上市、有效推动了日本儿童药发展。笔者建议我国应开展体现儿童药特殊性的卫生技术评估,对
儿童药医保支付价格予以适当的直接价格激励,并合理制定儿童适用的药品品规的价格并给予价格激励,以促进我国儿童药的
发展。
关键词 儿童药;定价机制;价格激励政策;加算;日本
Pediatric Drug Pricing and Price Incentive Policy in Japan and Its Enlightenment to China
ZHANG Chen,FAN Xin,JIN Qiuchen,CHEN Yongfa(School of International Pharmaceutical Business,China
Pharmaceutical University,Nanjing 211198,China)
ABSTRACT OBJECTIVE:To learn from pediatric drug pricing and price incentive policy in Japan,and to provide reference for
the improvement of pediatric drug price system in China. METHODS:The drug pricing strategy of Japan was analyzed,and price
incentive policy of pediatric drugs in Japan and its implementation status and effect were summarized. The suggestions of perfecting
the price system of pediatric drugs in China were put forward. RESULTS & CONCLUSIONS:The pricing strategy of medical
insurance drugs in Japan included two types,such as access pricing of medical insurance list and price adjustment of drugs in
medical insurance list. Among them,price incentive policy for pediatric drugs mainly included the premium for initial pricing of
new pediatric drugs,the premium for drugs with newly added pediatric indication included in medical insurance list and other
measures(such as eligible drugs could obtain indirect price compensation,and children’s factors could be considered in health
technology assessment). Overall,these measures accelerated the R&D and marketing of Japanese pediatric drugs,and effectively
promoted the development of pediatric drugs in Japan. The author suggests that our country should carry out health technology
assessment which reflects the particularity of pediatric drugs,give appropriate direct price incentives to the payment price of
pediatric drugs,and reasonably set the price of drug specification suitable for children and give price incentives so as to promote
the development of pediatric drugs in China.
KEYWORDS Pediatric drugs;Pricing mechanism;Price incentive policy;Premium;Japan
儿童与成人在药物的吸收、分布、代谢和排泄方面 童药临床试验难开展等原因外,儿童药的研发、生产投
存在许多差异,故药物不能以成人剂量简单折算后供 入高,相对成人药而言盈利较少,也是企业研发儿童药
[1]
儿童使用 。目前,儿童药存在儿童专用剂型少、规格 积极性不高的另一重要原因 。目前,世界各国儿童药
[2]
少、品种匮乏,药品包装说明书中关于儿童剂量、疗效、 激励政策主要集中在药品注册环节,如延长儿童药专利
安全性等信息不充分,以及超说明书用药等问题,儿 期、儿童药优先审评等,但在能直接激励儿童药生产企
童 甚至被称为“临床治疗意义上的孤儿(therapeutic 业的医保准入定价环节却鲜有政策涉及 [3-4] 。考虑到成
orphan)”。 本-效益问题,如果能在定价环节也给予儿童药价格方
[2]
除了儿童受试者招募困难和存在伦理问题导致儿 面的支持,将进一步推动儿童药的发展。
Δ 基金项目:2020 年江苏省研究生科研创新计划(No.KYCX20_ 为鼓励儿童药研发、上市,日本除出台了与欧美类
0697)
似的延长儿童药专利期等措施外,其独特的药品定价制
*硕士研究生。研究方向:医药政策与药物经济学评价。E-mail:
度更是对儿童药产生了直接价格激励,获得了很好的成
zc_cpu@163.com
效。为此,本文对日本儿童药定价及价格激励政策进行
# 通信作者:教授,博士生导师,博士。研究方向:国内外药事法
规与药品评价。E-mail:cyf990@163.com 分析,旨在为我国儿童药价格体系的完善提供参考。
·2822 · China Pharmacy 2021 Vol. 32 No. 23 中国药房 2021年第32卷第23期