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              當前位置:首頁 > 資訊中心 > 行業動態

              藥品價格繼續下降將成趨勢

              更新時間:2017-01-09 20:14:00      點擊次數:4636次


              近日了解到,醫保藥品支付標準制定規則正在醞釀中,或將在今年12月底同新版醫保藥品目錄一起出臺。據了解,不同于過往的按比例報銷方式,未來醫保支付標準將使醫療機構更有動力主動壓低藥品價格,這一政策一方面可以逐步緩解醫保基金的支付壓力,另一方面也將對多數藥品價格構成巨大影響。

              醫保目錄 + 醫保支付標準將出臺

                 醫保支付標準是指三大基本醫保的參保人員在使用醫保目錄內藥品時,醫保基金支付藥品費用的基準。醫保基金根據藥品的支付標準及醫保支付規定向基本醫療保險定點醫療機構、定點零售藥店(合稱定點機構)支付藥品費用。

                  近日,安徽省衛計委重新調整了基本醫療保險藥品的醫保支付參考價。128日,安徽省衛計委、藥監局等機構聯合下發《安徽省基本醫療保險藥品醫保支付參考價調整實施辦法的通知》(以下簡稱通知),擬對《2015年安徽省基本醫療保險藥品限價(醫保支付參考價)目錄》(以下簡稱目錄)內的藥品進行價格調整。根據通知要求,質量層次倒掛品種要調平。按通知要求,“醫保支付參考價調整后,通用名、劑型、規格、包裝材質,不同質量類型的藥品,出現價格倒掛的一律作調平處理”,這意味著較低質量層次的藥品價格不得高于較高質量層次的藥品價格。

                  業內人士分析,安徽此規則若全國推開,可以推測未來省平臺很有可能不再開始招標,現有的招標價格可能會成為省平臺沿用的“門檻價”。同時,醫保支付價將成為各省藥品控費的主要手段,這一手段會在2017年全面開花,通過采購金額的總額限制來使企業服從醫保支付標準情況的可能會越來越多。

                  事實上,在國家層面,“醫保目錄 + 醫保支付標準”聯袂出臺的可能性也非常大。中國醫藥企業管理協會會長于明德近日表示,“醫保支付標準將與醫保目錄一起出臺,人社部等部委制定規則,省級政府制定具體政策,統籌地區制定支付方法。”人社部新聞發言人李忠曾表示:“在國際上,醫保支付標準有很多比較成熟的經驗,我國一些地區也先行進行了這方面探索。人社部在總結經驗做法的基礎上,已經起草了基本醫療保險藥品支付標準制定的實行規則,并在一定范圍內征求了意見。”

              同類價格比較或將被引入

              一份人力資源和社會保障部辦公廳、國家衛生計生委辦公廳《關于基本醫療保險藥品支付標準制定規則的指導意見(征求意見稿)》(以下簡稱《意見》)近日在業內傳播。如果說此前的醫保支付注重支付方式的調整,比如說總額預付,那么此次調整則更注重支付制度的改革,比如說支付原則、范圍等。

              按照這一版本的《意見》內容,已通過一致性評價或者質量差異較小的藥品,原則上按通用名制定支付標準。同一通用名稱(相同劑型、規格)的藥品,按最小劑量單位制定該通用名稱藥品統一的支付標準,逐步通過選取代表藥品并計算差價比價的方式,確定同一通用名稱下不同劑型、規格的藥品的支付標準,有關規則可參照藥品差比價規則執行,僅限于兒童使用的藥品應單列代表品。基本醫療保險目錄中專利、獨家藥品,談判確定支付標準。

              支付標準主要依據藥品實際市場交易價格、數量等因素制定,也可以探索引入同類藥品價格比較、其他地區價格參考、藥物經濟學評價等因素和辦法,通過加權平均、中位數或者分位數等方式計算相應品規的平均價格,并以此為基礎確定支付標準。支付標準要根據藥品實際市場交易價格、藥品實際供應及使用情況等因素實行動態調整,原則上每兩年調整一次。國家衛計委衛生發展研究中心顧雪非對《經濟參考報》記者表示,醫保藥品支付標準也稱“基準價”,有的國家稱之為“參考價”。醫保支付標準是根據藥物在治療效果上的等效性和臨床上的替代性,將具有可替代的藥品進行分組,按照某個基準價確定各組藥品的醫保補償水平。

              “嚴格意義上說,醫保支付標準不是一個定價系統,而是一種補償機制,它是一種通過限制醫保補償水平實現對藥品費用進行控制的政策,通過減少對高價藥品的需求(從需方)和刺激藥品生產者主動降價 (從供方)兩方面來降低參考定價制度所涉及的藥品價格。”顧雪非表示。

              藥價繼續下降將成未來趨勢

              對于業內尤其關注的支付標準的使用,《意見》將其分成以下三種情況:一是定點醫療機構藥品實際銷售的價格等于支付標準的,醫保基金和參保人員均以支付標準為基礎支付費用;二是定點醫療機構藥品實際銷售的價格低于支付標準的,醫保基金以支付標準為基礎支付費用,參保人員以實際銷售價格為基礎支付費用。三是按藥品通用名制定支付標準的情況下,定點醫療機構向參保人員出售藥品的價格高于支付標準的,醫保基金仍以支付標準為基準支付費用,在臨床必需、患者知情同意的前提下,參保人員以實際銷售價格為基準,按照醫保規定的個人分擔比例支付費用。

              “如果真如征求意見稿所言,那么不管政府是否允許二次議價,醫療機構一定會進行議價。因為每議下來的一分錢,都將是醫療機構的收入。同時,價格高于醫保支付標準的藥品也將難以實現院內銷售。”中國醫藥企業管理協會副會長牛正乾直言,上述規定可以通過一組正向激勵措施,鼓勵醫療機構采用物美價廉的藥物,以促進藥品在市場上的價格形成,同時實現合理用藥。這意味著藥品價格繼續下降會是未來的趨勢。

              人力資源和社會保障部社保中心醫療服務管理處處長段政明表示:支付標準不是價格,藥品價格是市場交易形成的,醫保部門只能通過制定支付標準,間接影響藥品價格形成。”他說,“實際市場交易價格并不等于中標價。我們會要求醫療機構報送藥品銷售實際情況,包括品名、規格、數量、價格等。”段政明說,“至于一些創新藥物,我們會參照其在我國香港、臺灣地區以及日本的具體銷售情況和銷售價格。”

              業內人士表示,《意見》最終目標是要有利于逐步建立以市場為主導的藥品價格形成機制,減少政府對藥品價格的直接干預;要有利于醫保、集中采購等政策的銜接配合,要調動定點機構主動降低藥品采購價格的積極性;要有利于促進公立醫院改革, 完善各項體制機制。
              ?

              福安藥業(集團)股份有限公司 ? 2007 - 2018

              金福彩票

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