Page 20 - 《中国药房》2026年7期

美国药品调剂服务收费制度研究及其对我国的启示
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廖诗语 ，伍 琳，陈永法（中国药科大学国际医药商学院，南京 211198）
中图分类号 R95 文献标志码 A 文章编号 1001-0408（2026）07-0842-06
DOI 10.6039/j.issn.1001-0408.2026.07.03

摘 要 目的 借鉴美国药品调剂服务收费实践经验，为我国药品调剂服务收费方案设计提供参考。方法 检索相关文献及官方
网站，系统梳理美国药品调剂服务的收费历程、不同医疗保险计划的收费方式及标准、收费考量因素，总结其收费特点，对我国完
善相关工作提出建议。结果与结论 美国药品调剂服务收费制度历经理念萌芽、模式探索、制度建立与专业化发展4个阶段，逐步
形成独立于药品价格、以处方为单元的收费方式。各类医疗保险计划在联邦政府的统一框架下，依据真实调剂成本并结合药品类
别、药房类型、处方量及政策目标等因素制定差异化调剂收费方案，以体现药师专业价值并保障调剂服务可持续供给。我国虽已
在国家层面认可药品调剂服务收费，但仍面临价值认知不足与医疗保险支付压力双重落地障碍。建议借鉴美国经验，结合我国国
情，加强药品调剂服务价值评估实证研究助力医疗保险决策；统一药品调剂服务成本测算口径，并结合药师专业技术价值与公共
利益，明确收费标准制定依据；以省份为统筹、以处方为单元探索差异化收费方案，注重突出专业技术、调剂风险等；辅以持续强化
药师专业能力建设，从而实现药品调剂服务收费政策的科学制定与合理落地。
关键词 药品调剂；调剂费；价值评估；收费制度；药学服务

Study on pharmacy dispensing fee system in the United States and its implications for China
LIAO Shiyu，WU Lin，CHEN Yongfa（School of International Pharmaceutical Business，China Pharmaceutical
University， Nanjing 211198， China）

ABSTRACT OBJECTIVE To draw upon the United States’ experience in charging for drug dispensing services and provide
reference for designing China’s fee scheme for such services. METHODS Relevant literature and official websites were reviewed to
systematically summarize the evolution of dispensing fees in the U. S.， charging methods and standards across different health
insurance plans， and factors influencing fee determination. The key characteristics of the U. S. fee system were summarized.
Recommendations for improving China’s related practices were then proposed. RESULTS & CONCLUSIONS The U.S. dispensing
fee system has undergone four stages of conceptual emergence， model exploration， system establishment， and professional
development， forming a prescription-based charging model independent of drug prices. Under a unified federal framework， health
insurance programs set a differentiated dispensing fee system based on actual costs and factors such as drug category， pharmacy
type， prescription volume， and policy objectives， reflecting pharmacists’ professional value and ensuring sustainable service
provision. Although China has recognized dispensing fees at the national level， implementation still faces barriers including
insufficient value recognition and pressure on medical insurance payment. Drawing on U. S. experience and considering China’s
national context， it is recommended to strengthen empirical research on the value assessment of dispensing services to support
medical insurance decision-making； standardize the methodology for dispensing cost measurement and clarify the basis for fee
setting by incorporating pharmacists’ professional and technical value as well as public interests； explore differentiated charging
models at the provincial level with prescriptions as the basic unit， with emphasis on professional expertise and dispensing risks， and
continuously strengthen pharmacists’ professional capacity to facilitate the scientific formulation and effective implementation of
dispensing service fee policies.
KEYWORDS drug dispensing； dispensing fees； value assessment； charging system； pharmaceutical services

2023年9月，《全国医疗服务项目技术规范（2023年 药学服务项目，从国家层面正式认可和补偿药学服务价
版）》（以下简称《项目技术规范》）首次纳入药师门诊诊 值。然而，在各地后续发布的药学类医疗服务项目中，
察、处方/医嘱药品调剂、住院患者个性化用药监护 3 项 均未见药品调剂服务费（以下简称“调剂费”）相关举措，

Δ 基金项目 国家自然科学基金青年基金项目（No.72404280）；中 这提示《项目技术规范》在全国范围内落地不畅。药品
国药科大学国家执业药师发展研究中心立项课题（No.ndrplc202301， 调剂作为药师日常工作的核心，若不能实现合理收费，
No.NRCLPD202502） 不仅会使药师的价值无法得到真正体现，而且会严重影
＊第一作者 硕士研究生。研究方向：医药卫生政策与法规。
响药师的积极性与服务质量，最终影响患者获益 。因
[1]
E-mail：15343289302@163.com
此，需尽快推动我国药品调剂服务收费政策落地，激发
# 通信作者 教授，博士生导师，博士。研究方向：医药卫生政策与
法规。E-mail：cyf9906@163.com 药师积极性，从而更好地服务患者。

· 842 · China Pharmacy 2026 Vol. 37 No. 7 中国药房 2026年第37卷第7期