摘要
目的 评估化湿败毒颗粒续约《国家基本医疗保险、工伤保险和生育保险药品目录》(以下简称"药品目录")对医保基金支出可能产生的影响.方法 基于国际药物经济学与结果研究协会公布的《预算影响分析指南》,采用Excel软件构建化湿败毒颗粒治疗时疫的预算影响分析模型,模型模拟时间范围设定为 3 年(2024-2026 年),对化湿败毒颗粒续约药品目录报销后医保基金的支出进行估算.结果 假设化湿败毒颗粒续约药品目录乙类,每年分别替代奈玛特韦片/利托那韦片、阿兹夫定片、宣肺败毒颗粒、奥司他韦胶囊(国产)、奥司他韦胶囊(原研)、奥司他韦颗粒、帕拉米韦氯化钠注射液治疗时疫0.41%、0.30%、0.05%、1.34%、0.62%、3.64%、0.64%的市场份额,预计2024-2026年在治疗流行性感冒和新型冠状病毒肺炎中,累计因化湿败毒颗粒纳入国家医疗保险乙类目录而增加的医保基金支出分别为-1 524万元,-3 034万元和-4 532万元,增加的医保基金支出累计占流行性感冒和新型冠状病毒肺炎中的医保基金支出的-4.05%,-8.30%和-12.78%.敏感性分析显示预算影响分析结果较稳定,将参数范围上下浮动 10%后仍可节约医保基金.结论 在本研究假定参数下,化湿败毒颗粒续约药品目录乙类,每年分别替代奈玛特韦片/利托那韦片、阿兹夫定片、宣肺败毒颗粒、奥司他韦胶囊(国产)、奥司他韦胶囊(原研)、奥司他韦颗粒、帕拉米韦氯化钠注射液治疗时疫0.41%、0.30%、0.05%、1.34%、0.62%、3.64%、0.64%的市场份额,以当前中标价格作为 2024-2026 年药品价格,将减少医保基金的支出,并且随着化湿败毒颗粒市场份额的增大,将会节约更多的医保基金.
Abstract
Objective To evaluate the possible impact of Huashi Baidu granules on the expenditure of medical insurance fund when it is included in Drug Catalogue of National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance(hereinafter referred to as the"drug catalogue").Methods Based on the budget impact analysis guidelines published by the International Association for Pharmacoeconomics and Results Research,the budget impact analysis model of Huashi Baidu granules in the treatment of epidemic was established by Excel software.The simulation time range of the model was set to 3 years(2024-2026).The possible impact of Huashi Baidu granules on the expenditure of medical insurance fund was evaluated.Results Assuming that Huashi Baidu granules are renewed in the directory,on the basis of the existing market share,it could respectively replace the market share of Nirmatrelvir Tablets/Ritonavir Tablets 0.41%,Azvudine Tablets 0.30%,Xuanfei Baidu Granules 0.05%,Oseltamivir Capsules(domestically produced)1.34%,Oseltamivir Capsules(originator)0.62%,Oseltamivir Granules 3.64%and Peramivir Sodium Chloride Injection 0.64%.It was estimated that from 2024 to 2026,in the treatment of influenza and COVID-19,the increase in medical insurance fund expenditures due to the inclusion of Huashi Baidu granules in the drug catalogue class B will be-15.24 million yuan,-30.34 million yuan,and-45.32 million yuan,respectively.These increased medical insurance fund expenditures will account for-4.05%,-8.30%,and-12.78%of the medical insurance fund expenditures in the treatment of influenza and COVID-19.Sensitivity analysis indicates that the budgetary impact analysis results are relatively stable,as even with a 10%fluctuation in parameter ranges,savings in the medical insurance fund can still be achieved.Conclusion Under the assumed parameters of this study,if Huashi Baidu granules are renewed in the drug catalogue,it will respectively replace the market share of Nirmatrelvir Tablets/Ritonavir Tablets 0.41%,Azvudine Tablets 0.30%,Xuanfei Baidu Granules 0.05%,Oseltamivir Capsules(domestically produced)1.34%,Oseltamivir Capsules(originator)0.62%,Oseltamivir Granules 3.64%and Peramivir Sodium Chloride Injection 0.64%.Taking the current bid price as the drug price from 2024 to 2026,it will be able to reduce the expenditure of the medical insurance fund,and as the market share of Huashi Baidu Granules increases,more medical insurance fund will be saved.
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