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亚太地区的政府药品定价策略:概述

Government pharmaceutical pricing strategies in the Asia-Pacific region: an overview.

作者信息

Verghese Naina R, Barrenetxea Jon, Bhargava Yukti, Agrawal Sagun, Finkelstein Eric Andrew

机构信息

Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.

HTA and Pricing, APAC, Roche Singapore Pte Ltd, Singapore, Singapore.

出版信息

J Mark Access Health Policy. 2019 Apr 11;7(1):1601060. doi: 10.1080/20016689.2019.1601060. eCollection 2019.

Abstract

: Governments in Asia Pacific (APAC) are increasingly using pharmaceutical pricing strategies to contain rising healthcare costs. The objective of this narrative review is to discuss formal pricing strategies for reimbursed prescription medication in APAC, supported by relevant examples of implementation differences across countries. In the discussion section, we examine key advantages and disadvantages of each strategy. : A narrative review of the peer-reviewed and grey literature was undertaken to retrieve information, including strategy definitions, practising countries, country-specific implementation considerations, and merits and demerits of each strategy. : Seven strategies (Internal Reference Pricing, External Reference Pricing, Special Pricing Agreements, Pharmacoeconomic Evaluation, Cost plus pricing, Price Maintenance Premium, and Tendering and negotiations) were identified as most commonly practised in APAC through the review process. Most countries use multiple strategies that differ in how they are implemented. : APAC countries use multiple strategies simultaneously with varying implementation methods, including different formulae and sub-types of medication that a strategy applies to, whether the strategy is a mandate or guideline, and the extent of negotiations and transparency. Strategies are instituted partly with the aim of cost containment, and may also promote price stability, innovation, and increased access in the short and longer term. APAC - Asia Pacific; WHO - World Health Organisation; IRP - Internal Reference Pricing; ERP - External Reference Pricing; SPA - Special Pricing Agreement; MES - Managed Entry Scheme; PVA - Price-Volume Agreement; RSA - Risk Sharing Agreement; NHIS - National Health Insurance System; PE - Pharmacoeconomic Evaluation; CEA - Cost-Effectiveness Analysis; QALY - Quality-adjusted Life Year; BIA - Budget Impact Analysis; PMP - Price Maintenance Premium; R&D - Research & Development.

摘要

亚太地区各国政府越来越多地采用药品定价策略来控制不断上涨的医疗成本。本叙述性综述的目的是讨论亚太地区报销处方药物的正式定价策略,并辅以各国实施差异的相关实例。在讨论部分,我们将审视每种策略的主要优缺点。

通过对同行评审文献和灰色文献进行叙述性综述来获取信息,包括策略定义、实施国家、各国具体实施考量以及每种策略的优缺点。

通过综述过程,确定了七种在亚太地区最常用的策略(内部参考定价、外部参考定价、特殊定价协议、药物经济学评估、成本加成定价、价格维持溢价以及招标与谈判)。大多数国家采用多种实施方式不同的策略。

亚太地区各国同时使用多种策略,实施方式各不相同,包括策略所适用药物的不同公式和子类型、该策略是指令性还是指导性的、谈判程度以及透明度。制定这些策略部分是为了控制成本,从短期和长期来看,还可能促进价格稳定、创新并增加可及性。

亚太地区(APAC);世界卫生组织(WHO);内部参考定价(IRP);外部参考定价(ERP);特殊定价协议(SPA);管理进入计划(MES);价格-数量协议(PVA);风险分担协议(RSA);国家医疗保险系统(NHIS);药物经济学评估(PE);成本效益分析(CEA);质量调整生命年(QALY);预算影响分析(BIA);价格维持溢价(PMP);研发(R&D)

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