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·药事管理·
中成药医保准入的影响因素分析
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曹世欢 1, 2, 3* ,梁婉娴 1, 2, 3 ,张丽宁 1, 2, 3 ,官海静 ,金雪晶 1, 2, 3 # (1.北京中医药大学中医学院,北京 100029;2.北京
中医药大学循证医学中心,北京 100029;3.北京中医药大学国际循证中医药研究院,北京 100029;4.首都医
科大学附属北京天坛医院药学部,北京 100070)
中图分类号 R95 文献标志码 A 文章编号 1001-0408(2024)22-2709-07
DOI 10.6039/j.issn.1001-0408.2024.22.01
摘 要 目的 分析影响中成药在国家医保目录准入的因素,助力中成药在医保准入中充分体现实际价值。方法 从国家医保局
官网获取2021-2023年通过形式审查的目录外中成药的申报材料,包括药品的基本信息、安全性、有效性、创新与传承信息,并参
考药典和药智网等进行补充;经济性信息和企业信息通过药智网等网站获取。对药品的首次申报信息和准入结果进行单因素分
析、多因素Logistic回归分析和逐步回归分析;并将在不同年份进行多次申报的药品均作为独立样本进行敏感性分析。结果与结论
2021-2023年通过形式审查的目录外中成药有27个,涉及37次申报。单因素分析结果显示,药品说明书中适应证/功能主治描述
中含有中医证型、有明确的特殊人群用药方案调整信息、上市时间短、注册类型为1~6类中成药或Ⅰ类中药创新药/Ⅲ类古代经典名
方中药复方制剂、生产企业申报当年在“中国医药工业百强企业榜单”的中成药更有可能进入国家医保目录(P<0.05);多因素Logistic
回归分析结果显示差异暂不显著,逐步回归与单因素分析的结果显示出较好的一致性。敏感性分析结果与基础分析呈现出相同趋
势。建议中成药企业进一步明确对产品说明书内容的描述,增强创新能力,传承发展古代经典名方,并及时完善临床试验证据。
关键词 中成药;国家医保目录;影响因素
Analysis of influencing factors on the inclusion of Chinese patent medicines in the national reimbursement
drug list
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CAO Shihuan 1, 2, 3 ,LIANG Wanxian 1, 2, 3 ,ZHANG Lining 1, 2, 3 ,GUAN Haijing ,JIN Xuejing 1, 2, 3 (1. School of
Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;2. Center for
Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;3.
International Institute of Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing
100029, China;4. Dept. of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070,
China)
ABSTRACT OBJECTIVE To analyze the factors affecting the inclusion of Chinese patent medicines in China’s National
reimbursement drug list (NRDL), and assist these medicines in fully reflecting their actual value in the reimbursement admission
process. METHODS From the official website of the China’s National Healthcare Security Administration, the application
materials of Chinese patent medicines outside the list that passed the formal review from 2021 to 2023 were obtained, including
basic information on the medicines, safety, efficacy, innovation and heritage information, and supplemented with references from
the pharmacopeia and the Yaozhi Database. Economic information and enterprise information were obtained through websites such
as the Yaozhi Database. Univariate analysis, multivariate Logistic regression analysis and stepwise regression analysis were
conducted on the initial application information and admission outcomes of the medicines. Sensitivity analysis was also performed
on medicines that applied multiple times in different years as independent samples. RESULTS & CONCLUSIONS There were 27
Chinese patent medicines that passed the formal review from 2021 to 2023, involving 37 applications. The univariate analysis
results showed that medicines with descriptions of traditional Chinese medicine (TCM) syndrome types, clear adjustment
information for medication plans for specific population groups, short time to market in the indications of the package insert,
registered as Class 1 to 6 following or class Ⅰ innovative
Δ 基金项目 中央高校基本科研业务费专项(No.2022-JYB-JBRW-
TCM/class Ⅲ ancient classic prescription compound TCM
003);北京市科技新星计划项目(No.Z211100002121060) registered, and those produced by enterprises listed in the
*第一作者 硕士研究生。研究方向:中医药药物经济学。E-
mail:shcbucm@163.com “Top 100 Chinese Pharmaceutical Industry Enterprises” list for
# 通信作者 教授,博士生导师。研究方向:卫生技术评估与药物 the current year were more likely to be included in the NRDL
经 济 学 评 价 ,健 康 偏 好 与 效 用 测 量 、估 值 研 究 。 E-mail: (P<0.05). The results of the multivariate Logistic regression
jinxuejing2018@163.com analysis were not statistically significant, but the stepwise
中国药房 2024年第35卷第22期 China Pharmacy 2024 Vol. 35 No. 22 · 2709 ·