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瑞士创新药医保准入及定价政策的分析与启示

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目的:满足人民群众优医优药的需求,为我国创新药医保准入与定价程序优化提供参考.方法:从决策机构、决策流程、决策标准三个维度系统梳理瑞士的创新药准入与定价政策,对标我国当前的政策现状,分析存在的问题与不足.结果:瑞士通过以"WWZ"为核心的卫生技术评估程序严格审查申请准入的药品,在定价方面也综合了内部和外部参考价格保证价格的合理性,并且为鼓励创新,创新药还可获得高于对照药品的"创新溢价".结论:完善药品卫生技术评估制度,结合评估结果给予不同创新程度的药品差异化的价格或者报销水平,同时更加注重与多方利益相关者的沟通,促进其参与到相关的决策之中,保证评审工作的公开透明.
Analysis and Enlightenment of Swiss Medical Insurance Access and Pricing Policy for Innovative Drugs
Objective:To meet the people's demand for excellent medicine,the paper provides reference for the optimization of medical insurance access and pricing procedures for innovative drugs in China.Methods:This paper systematically summarizes the access and pricing policies of innovative drugs in Switzerland from three dimensions:decision-making institutions,processes and standards,and analyzes the problems and shortcomings of the current policy in China.Results:Switzerland strictly examines the drugs applying for access through the health technology assessment procedure with"WWZ"as the core,and integrates the internal and external reference prices to ensure the rationality of the price.In order to encourage innovation,innovative drugs can also get an"innovation premium"higher than the reference drugs.Conclusion:We should improve the drug health technology assessment system,and give different prices or reimbursement rates to drugs with different degrees of innovation according to the evaluation results.At the same time,we should pay attention to the communication with multiple stakeholders,promote their participation in decision-making,and ensure the openness and transparency of the evaluation.

Switzerlandinnovative drugsmedical insurance accessdrug pricing

宋源源、李雨畅、杜昕昱、刘远立

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北京协和医学院卫生健康管理政策学院 北京 100730

瑞士 创新药 医保准入 药品定价

医疗卫生系统价值医疗体系研究项目

WH10022023001

2024

中国医疗保险
中国医疗保险研究会

中国医疗保险

影响因子:0.492
ISSN:1674-3830
年,卷(期):2024.(3)
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