Research on the Economic Accessibility of Innovative Anti-MDR-TB Drugs in Hospitals Under the DRG Payment System
Objective:The paper analyzes the economic accessibility of bedaquinoline,an innovative drug for the treatment of multidrug resistant tuberculosis (MDR-TB) in clinical prescriptions under the DRG payment system,so as to provide evidence for improving the reform policy of medical insurance payment. Methods:Taking the DRG payment model city B of National Healthcare Security Administration as the research site,the medical cost information of respiratory tuberculosis inpatients in the sample hospital was retrospectively collected,the patient distribution and resource consumption of MDR-TB-related DRG were analyzed. The hospital-level drug budgets for the patient were compared with the single-drug budgets of bedaquinoline,based on the medical insurance reimbursement criteria. Results:Nine hospitals were included in this study,and hospitalized patients with respiratory tuberculosis had a higher proportion of medical technology and drug costs in the DRG groups of ES11 and ES15. Under ideal circumstance,the elastic intervals of average drug cost per case for each sample hospital were[4690.98,9998.85]yuan and[1418.71,7731.09]yuan,respectively,while the realistic cost intervals of using bedaquiline for MDR-TB patients were[9800,19600]yuan and[8400,16800]yuan,respectively. Only one hospital had economic accessibility to prescribe bedaquiline under the payment of ES11 group. Conclusion:After the implementation of DRG payment system,hospitals are required to enhance communication with the medical insurance department and design appropriate policies to improve the economic accessibility of innovative drugs for MDR-TB in clinical applications. The medical insurance department needs to pay attention to the synergistic effect of relevant policies and improve the synergy of policy implementation.
万方数据
维普
