Page 21 - 《中国药房》2022年3期

国家医保谈判抗肿瘤药品支付限定条件的循证医学证据变迁 Δ

1 #b
2
1
3 #a
藕顺龙 ，罗 静 ，刘 辉 ，狄 进 ，蒋 倩 （1.四川省肿瘤医院·研究所/四川省癌症防治中心/电子科
1＊
技大学医学院，成都 610041；2.电子科技大学医学院，成都 610041；3.成都市医疗保障局事务中心，成都
610041）
中图分类号 R956；R979.1 文献标志码 A 文章编号 1001-0408（2022）03-0271-04
DOI 10.6039/j.issn.1001-0408.2022.03.03

摘 要 目的 研究国家医保谈判（简称“国谈”）抗肿瘤药品医保支付限定条件和对应的中国临床肿瘤学会（CSCO）历年肿瘤诊疗
指南推荐意见变迁情况，以期为国谈工作提供参考。 方法 整理汇总各年度国谈抗肿瘤药品目录，检索国谈抗肿瘤药品医保支付
限定条件提及肿瘤类型对应的 CSCO 诊疗指南，定量分析国谈抗肿瘤药品医保支付限定条件与 CSCO 诊疗指南的证据衍变。
结果与结论 在纳入分析的46个协议期内抗肿瘤药品品种中，医保支付限定条件发生改变的有7个，医保支付限定条件、药品说明
书和CSCO诊疗指南推荐意见之间存在差异的有13个，不同年度CSCO诊疗指南推荐意见/证据强度/推荐等级存在变化的有28
个，各癌种CSCO诊疗指南推荐药品品种数有较大差异。国谈抗肿瘤药品医保支付限定条件逐渐扩大，对应的临床诊疗指南推荐
意见、证据强度及推荐等级不断提升，但多数药品的医保支付限定条件仅限于药品说明书适应证、包括食管癌和鼻咽癌在内的部
分癌种治疗药物缺乏。
关键词 国家医保谈判；医保支付限定条件；抗肿瘤药品；诊疗指南；循证证据

Evidence-based medical evidence change of the payment limitation of antitumor drugs in national
medical-insurance negotiation
OU Shunlong ，LUO Jing ，LIU Hui ，DI Jin ，JIANG Qian（1. Sichuan Cancer Hospital & Institute/Sichuan
3
1
1
2
1
Cancer Center/School of Medicine， University of Electronic Science and Technology of China， Chengdu
610041，China；2. School of Medicine，University of Electronic Science and Technology of China，Chengdu
610041，China；3. Chengdu Healthcare Security Administration Affairs Center，Chengdu 610041，China）
ABSTRACT OBJECTIVE To study the changes in medical-insurance payment limitations of antitumor drugs in national medical-
insurance negotiation（hereinafter referred to as“national negotiation”）and recommendations of diagnosis and treatment guidelines
corresponding to tumor issued by Chinese Society of Clinical Oncology（CSCO），so as to provide reference for the performance of
national negotiation. METHODS The annual list of antitumor drugs in national negotiation were summarized；CSCO diagnosis and
treatment guidelines were searched according to the tumor types restricted by the medical-insurance payment limitations of
antitumor drugs in national negotiation；the evidence evolution of the payment limitations of medical insurance for antitumor drugs
and CSCO diagnosis and treatment guidelines were analyzed quantitatively. RESULTS & CONCLUSIONS Finally，46 antitumor
drugs in the agreement period were included；seven of their payment limitations of medical insurance had changed；and there were
differences among the payment limitation of medical insurance，drug labels and recommendations of CSCO diagnosis and treatment
guidelines for 13 varieties；the recommendations，strength of evidence，recommendation level of CSCO diagnosis and treatment
guidelines were changing for 28 varieties antitumor drugs in different years；the number of antitumor drugs recommended by CSCO
diagnosis and treatment guidelines differed significantly among different cancer varieties. The medical insurance payment limitations
of antitumor drugs in national negotiation have been gradually expanded，and the corresponding recommendations，strength of
evidence， recommendation level in guidelines have been
Δ 基金项目：北京医卫健康公益基金会项目（No.B20021CS）；白
constantly improved. However， the payment limitation of
求 恩 公 益 基 金 会“ 白 求 恩·求 索 - 药 学 科 研 能 力 建 设 ”项 目（No.
medical insurance for most drugs are limited to the indications
B-19-H-20200622）
＊ 药 师 ，硕 士 研 究 生 。 研 究 方 向 ：临 床 药 学 。 电 话 ：028- of drug labels and drugs for some cancers are scarce，such as
85420393。E-mail：oushunlong@sohu.com esophageal cancer and nasopharyngeal carcinoma.
#a 通 信 作 者 ：副 局 级 。 研 究 方 向 ：医 保 管 理 。 电 话 ：028- KEYWORDS national medical-insurance negotiation；
87706738。E-mail：2541424772@qq.com payment limitations of medical insurance；antitumor drugs；
#b 通信作者：副主任药师，博士。研究方向：药事管理学研究与 diagnosis and treatment guidelines；evidence-based medical
实践、循证决策与管理。电话：028-85420393。E-mail：jiangqian_3805.
evidence
student@sina.com

中国药房 2022年第33卷第3期 China Pharmacy 2022 Vol. 33 No. 3 ·271 ·