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·药事管理·
澳大利亚PBS药品上市后再审查制度介绍及对我国的启示
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李大双 ,颜建周,邵 蓉(中国药科大学国家药物政策与医药产业经济研究中心,南京 211198)
中图分类号 R95 文献标志码 A 文章编号 1001-0408(2023)15-1793-05
DOI 10.6039/j.issn.1001-0408.2023.15.01
摘 要 目的 为加强我国医保目录内药品的准入后管理提供参考。方法 介绍澳大利亚药品福利计划(PBS)上市后再审查
(PMR)制度的基本情况、开展流程和实施成效,同时对我国医保目录类药品的准入后管理提出建议。结果与结论 PMR制度体现
了澳大利亚对PBS目录内药品进行全生命周期管理的理念,作为管理PBS药品的准入和调整的一种机制,可实现对PBS目录内药
品的持续评估。其流程主要包括PBS药品审查启动前流程和PBS药品审查流程2种,涉及药品遴选、审查范围确定、实施管理等
步骤。通过PMR,澳大利亚共完成了PBS目录内糖尿病、儿童哮喘、阿尔茨海默病等9个治疗领域的多个药品的审查。笔者建议
我国可在制度层面完善药品准入后审查(明确审查对象的遴选标准和方法、主要程序和责任主体、保证审查过程公开透明);明
确国家医疗保障局或委托第三方机构,直至成立专门的技术机构负责这一工作;与此同时,进一步完善数据收集和监测系统的
建设。
关键词 医保准入;上市后再审查;澳大利亚药品福利计划
Introduction of Australian post-market reviews of pharmaceutical benefits scheme subsidized medicines
and its implication to China
LI Dashuang,YAN Jianzhou,SHAO Rong(Research Center of National Drug Policy & Ecosystem, China
Pharmaceutical University, Nanjing 211198, China)
ABSTRACT OBJECTIVE To provide a reference for strengthening the post-admission management of drugs on the medicare
formulary in China. METHODS The basic situation, implementation process and effect of post-market reviews (PMR) were
introduced after marketing approval of the Australian pharmaceutical benefits scheme (PBS) subsidized medicines. The suggestions
were put forward for post-admission management of medicare formulary drugs in China. RESULTS & CONCLUSIONS PMR
system exemplified Australia’s concept of life-cycle management of medicines on the PBS catalogue; as a mechanism for managing
the admission and adjustment of PBS medicines, it provided a continuous evaluation of medicines in the PBS catalogue; the
process mainly included two types: the pre-initiation process of PBS drug review and the PBS drug review process, involving steps
such as drug selection, determination of review scope, and implementation management. Through PMR, Australia had completed
the review of multiple medicines in nine treatment areas including diabetes, childhood asthma and Alzheimer’s disease in the PBS
catalogue. The author suggests that China can improve the post-admission review of medicines at the institutional level (clarifying
the selection criteria and methods of the review object, main procedures and responsible parties, and ensuring the transparency of
the review process); specify the National Healthcare Security Administration or the third-party organization until a special technical
organization is established to take charge of this work; at the same time, further improve the construction of data collection and
monitoring systems.
KEYWORDS medicare admission; post-market reviews; Australian pharmaceutical benefits scheme
2017 年,在人力资源和社会保障部的组织实施下, 录,自此开始探索建立我国创新药医保谈判准入制度。
我国首次通过谈判准入方式将高值创新药纳入医保目 经过多年的发展和完善,医保谈判准入制度已成为医药
Δ 基金项目 国家自然科学基金面上项目(No.72274217) 卫生领域极为重要的制度设计之一,在降低患者负担、
*第一作者 硕士研究生。研究方向:医药政策与法规。E-mail: 提高药品可及性的同时,该制度也通过创新药医保准入
lds0024@153.com
速度的加快而提高了医药企业创新的积极性 。近年
[1]
# 通信作者 教授,博士生导师,博士。研究方向:医药政策与法
规。电话:025-86185188。E-mail:shaorong118@163.com 来,随着创新药医保准入速度加快、数量增多,各类高值
中国药房 2023年第34卷第15期 China Pharmacy 2023 Vol. 34 No. 15 · 1793 ·