Page 57 - 《中国药房》2023年2期

基于价值的多适应证药品医保准入与定价方法研究
Δ

1， 2 #
王樱澄 1， 2＊ ，吴 尧 ，杨 岚 ，芮明军 ，李洪超 （1.中国药科大学国际医药商学院，南京 211198；2.中国
1， 2
1， 2
1， 2
药科大学药物经济学评价研究中心，南京 211198）
中图分类号 R956 文献标志码 A 文章编号 1001-0408（2023）02-0179-06
DOI 10.6039/j.issn.1001-0408.2023.02.10

摘 要 目的 探讨多适应证药品的医保准入与定价方法。方法 梳理我国多适应证药品在历年医保谈判中的准入情况，参考基
于价值定价的经济学理论和其他国家的相关经验，总结3类共5种在我国可能适用的多适应证药品定价方法。以头孢他啶-阿维
巴坦为例，针对该药的不同适应证开展成本-效用分析，并探讨该药合适的定价方法。结果与结论 目前我国多适应证药品均为单
一定价。可探索的定价方法包括基于产品的单一定价方法（如基于低价值适应证的单一定价和混合/加权的单一定价）、基于适应
证的定价方法（如按适应证协议不同折扣的单一定价和根据不同适应证以不同商品名上市并分别定价），以及补偿准入限制的定
价方法。每种定价方式各有优势和局限性。通过头孢他啶-阿维巴坦的案例分析可知，多适应证药品首先要对各个适应证分别开
展价值评估，再基于价值综合考量合适的准入情况与定价方法。单一的定价方法虽然简单，但是难以完全反映价值；而基于适应
证的定价方法和补偿准入限制依赖于完善的信息系统和多部门的配合。我国应逐步应用基于价值的多适应证药品的定价方法，
不断探索合理的准入方式，提高整体社会福利。
关键词 多适应证药品；价值定价；定价方法；医保准入

Study on value-based medical insurance access and pricing methods of multi-indication drugs
WANG Yingcheng ，WU Yao ，YANG Lan ，RUI Mingjun ，LI Hongchao （1. School of International
1， 2
1， 2
1， 2
1， 2
1， 2
Pharmaceutical Business， China Pharmaceutical University， Nanjing 211198， China；2. Pharmacoeconomics
Evaluation Research Center， China Pharmaceutical University， Nanjing 211198， China）
ABSTRACT OBJECTIVE To discuss medical insurance access and pricing methods for multi-indication drugs. METHODS The
access situation of multi-indication drugs in China’s medical insurance negotiation over the years was sorted out. Referring to the
economic theory of value-based pricing and the relevant experience of other countries， five applicable pricing methods of 3
categories for multi-indication drug in China were summarized. Taking ceftazidime-avibactam（CAZ-AVI） as an example， cost-
utility analyses were performed for different indications， and appropriate pricing methods were applied. RESULTS &
CONCLUSIONS All multi-indication drugs in China adopted a single pricing method. The pricing methods that could be explored
include product-based pricing， such as single pricing based on the lower-value indication or mixed/weighted single pricing；
indication-based pricing， such as developing a new agreement for single pricing under different discounts and listing with different
brands and pricing of the same medicine for different indications； and compensation for access restrictions. Each method has its
advantages and limitations. The case of CAZ-AVI showed that it is necessary to estimate the value of each indication for multi-
indication drugs， and comprehensively consider appropriate access conditions and pricing methods based on value. Although single
pricing is simple to operate， it is different to reflect the value entirely. The indication-based pricing and compensation for access
restrictions all depend on the information collection system and the cooperation of multiple departments. China is supposed to carry
out the value-based pricing of multi-indication drugs and constantly explore reasonable access methods to improve overall social
welfare.
KEYWORDS multi-indication drugs； value-based pricing； pricing methods； medical insurance access

Δ 基金项目 江苏省研究生科研与实践创新计划（No.SJCX20_
0219） 多适应证药品（multi-indication drugs）是指同一有
＊第一作者 硕士研究生。研究方向：药物经济学、卫生经济与政 效成分可以用于多种不同适应证（包括用于不同类型的
策。E-mail：suisui1909@163.com
疾病、用于不同线的药物治疗或联合用药以及用于同一
# 通信作者 副教授，硕士生导师，博士。研究方向：药物经济学、
卫生经济与政策。E-mail：lihongchao@cpu.edu.cn 疾病不同特征的亚组患者等情况）的药品。近年来，随

中国药房 2023年第34卷第2期 China Pharmacy 2023 Vol. 34 No. 2 · 179 ·