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改善抗生素处方开具——关于资助和定价政策以促进即时检验使用的建议

Improving antibiotic prescribing - Recommendations for funding and pricing policies to enhance use of point-of-care tests.

作者信息

Vogler Sabine, Steigenberger Caroline, Windisch Friederike

机构信息

WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich GmbH (GÖG/Austrian National Public Health Institute), Stubenring 6, 1010 Vienna, Austria.

Department of Health Care Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany.

出版信息

Health Policy Open. 2024 Sep 28;7:100129. doi: 10.1016/j.hpopen.2024.100129. eCollection 2024 Dec 15.

Abstract

INTRODUCTION

Diagnostics can contribute to the improved quality of antibiotic prescribing. However, there is potential to enhance the use of point-of-care tests (POCTs) in general practice. This paper presents fit-for-purpose policy recommendations related to funding and pricing for POCTs applied for community-acquired acute respiratory tract infections (CA-ARTIs).

METHODS

The development of the recommendations was informed by an analysis of the current status of funding and pricing policy frameworks for CA-ARTI POCTs in European countries, and an identification of barriers and facilitators for their uptake. Draft recommendations were developed and subsequently revised based on written and verbal feedback from meetings with experts.

RESULTS

The proposal includes four recommendations for policy interventions related to funding and three recommendations regarding pricing policies. Two of the funding policy-related recommendations concern physicians' remuneration, and two relate to product-specific reimbursement (public coverage) of the CA-ARTI POCTs. The pricing-related recommendations include a proposal to explore the introduction of price regulation, to pilot subscription-fee procurement models and to enhance more strategic approaches in public procurement of CA-ARTI POCTs.

CONCLUSIONS

Optimised pricing and funding policies could make a difference in enhancing uptake of CA-ARTI POCTs. It is crucial for the successful implementation of policies to consider country settings. Additionally, supportive policy action is recommended, including the systematic use of health technology assessment, stakeholder communication, and monitoring and evaluation.

摘要

引言

诊断有助于提高抗生素处方的质量。然而,在全科医疗中,即时检验(POCT)的使用仍有提升空间。本文提出了与用于社区获得性急性呼吸道感染(CA-ARTIs)的POCT资金和定价相关的适用政策建议。

方法

通过分析欧洲国家CA-ARTI POCT资金和定价政策框架的现状,并确定其采用的障碍和促进因素,为建议的制定提供了依据。制定了建议草案,随后根据与专家会议的书面和口头反馈进行了修订。

结果

该提案包括四项与资金相关的政策干预建议和三项关于定价政策的建议。两项与资金政策相关的建议涉及医生薪酬,另外两项涉及CA-ARTI POCT的特定产品报销(公共覆盖)。与定价相关的建议包括探索引入价格监管、试点订阅费采购模式以及在CA-ARTI POCT的公共采购中加强更具战略性的方法的提议。

结论

优化的定价和资金政策可能会在提高CA-ARTI POCT的采用率方面产生影响。考虑国家背景对于政策的成功实施至关重要。此外,建议采取支持性政策行动,包括系统使用卫生技术评估、与利益相关者沟通以及监测和评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04bb/11488418/4dc575ea69c9/ga1.jpg

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