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·药物经济学·
我国非免费抗HIV药品及用药方案的价格与可负担性分析 Δ
王旋辉 ，宫春博（山东中医药大学药学院，济南 250300）
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中图分类号 R956；R512.91 文献标志码 A 文章编号 1001-0408（2022）21-2638-05
DOI 10.6039/j.issn.1001-0408.2022.21.14
摘 要 目的 为促进我国艾滋病用药的经济性提供建议和参考。方法 根据《中国艾滋病诊疗指南（2021版）》和《国家免费艾滋
病抗病毒药物治疗手册（第4版）》筛选非免费抗人类免疫缺陷病毒（HIV）药品及用药方案，搜集国内外药品价格数据，通过标准调
查法，使用中位价格比值（MPR）法和药品可负担性研究法分析非免费抗HIV药品及用药方案的价格和可负担性。结果 共筛选
得到18种非免费抗HIV药品（以药品名称计），其中5种药品仅有国产药，11种仅有进口药，2种兼有国产药和进口药，8种被列入
《基本医疗保险目录（2021版）》。18种药品的MPR中位值为0.504，在医保报销前可负担性小于1的药品占药品总数的55%，医保
报销后这一数据提升为75%。10种单片复方制剂报销后的可负担性中位值为0.625，其中被指南推荐可单独使用的4种单片复方
制剂的可负担性均小于1。用药方案中的推荐方案和替代方案在医保报销前后以及报销后两方案之间的可负担性差异均无统计
学意义（P＞0.05）。结论 我国非免费抗HIV药品的单品可负担性良好，联合用药方案的可负担性差；单片复方制剂相较传统治疗
方案的可负担性优势显著。政府和企业应以研发创新药品、加强药品价格管制为重点，建立健全针对HIV/艾滋病群体的非免费
药品保障体系，使其可选择药品更多样、用药更经济。
关键词 艾滋病；抗人类免疫缺陷病毒；药品价格；可负担性
Price and affordability analysis of non-free anti-HIV drugs and therapeutic regimen in China
WANG Xuanhui，GONG Chunbo（School of Pharmacy，Shandong University of Traditional Chinese Medicine，
Jinan 250300，China）
ABSTRACT OBJECTIVE To provide suggestions and references for promoting the economic efficiency of anti-AIDS drug use
in China. METHODS According to the Chinese Guidelines for the Diagnosis and Treatment of AIDS （2021 Edition） and the
National Free HIV Antiretroviral Drug Treatment Manual（4th Edition），non-free anti-HIV drugs and therapeutic regimens were
screened；the data on domestic and foreign drug prices were collected，and the price and affordability of non-free anti-HIV drugs
and drug regimens were analyzed with the median price ratio （MPR） method and drug affordability study method by standard
survey method. RESULTS A total of 18 non-free anti-HIV drugs（based on drug names）were screened，of which 5 drugs were
only domestically produced，11 were only imported，and 2 were both domestic and imported drugs；eight types were listed in the
Basic Medical Insurance Catalogue（2021 Edition）. The median MPR for 18 drugs was 0.504，and drugs with affordability of less
than 1 accounted for 55% of the total number of drugs before medicare reimbursement，and this figure increased to 75% after
medicare reimbursement. The median affordability after reimbursement of 10 single-tablet combinations was 0.625，of which the
affordability of the four single-tablet combinations recommended by the guidelines for use alone was less than 1. There was no
statistically significant difference in the affordability of two regimens before and after medicare reimbursement and between
recommended regimens and alternatives after reimbursement（P＞0.05）. CONCLUSIONS The affordability of single non-free anti-
HIV drugs in China is good，but the affordability of combination drugs is poor. The affordability advantages of single-tablet
combination formulations over conventional therapeutic regimens are significant. The government and enterprises should focus on
the research and development of innovative drugs and strengthen drug price control，and establish and improve the non-free drug
protection system for HIV/AIDS groups，so that they can choose more drugs and use drugs more economically.
KEYWORDS AIDS；HIV；drug price；affordability
Δ 基金项目 山东省研究生教育质量提升计划项目（No.SDYKC- 艾滋病即获得性免疫缺陷综合征（acquired immune
21053） deficiency syndrome，AIDS），由人类免疫缺陷病毒（hu‐
＊ 第一作者 硕 士 研 究 生 。 研 究 方 向 ：药 事 管 理 。 E-mail： man immunodeficiency virus，HIV）引起，是世界重大传
2575072721@qq.com
染病之一，也是我国法定乙类传染病。根据我国疾控中
# 通信作者 副教授，硕士生导师，硕士。研究方向：药事管理、健
康经济学与医疗保障。E-mail：gongchunbo168@163.com 心的统计，截至2020年10月底，我国HIV携带者和艾滋
·2638· China Pharmacy 2022 Vol. 33 No. 21 中国药房 2022年第33卷第21期
