Research on the impact of the adjustment of National Reimbursement Drug List on drug use of rare disease in hospitals

YI Hongbin; SHI Fenghao; KUAI Liping; XING Hua

doi:10.6039/j.issn.1001-0408.2022.24.02

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Research on the impact of the adjustment of National Reimbursement Drug List on drug use of rare disease in hospitals

更新时间：2023-02-22

- Research on the impact of the adjustment of National Reimbursement Drug List on drug use of rare disease in hospitals
- ZHONGGUO YAOFANG Vol. 33, Issue 24, Pages: 2952-2956(2022)
- 作者机构：
  
  1.沈阳药科大学工商管理学院，沈阳　110016
  2.北京大学医药管理国际研究中心，北京　100191
  3.中国药学会科技开发中心，北京　100022
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2022.24.02
  CLC： R95
- Published：30 December 2022，
  
  Received：12 August 2022，
  
  Revised：07 November 2022，
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易洪彬,石丰豪,蒯丽萍等.医保目录调整对医院罕见病用药的影响研究 ^Δ[J].中国药房,2022,33(24):2952-2956.

YI Hongbin,SHI Fenghao,KUAI Liping,et al.Research on the impact of the adjustment of National Reimbursement Drug List on drug use of rare disease in hospitals[J].ZHONGGUO YAOFANG,2022,33(24):2952-2956.
易洪彬,石丰豪,蒯丽萍等.医保目录调整对医院罕见病用药的影响研究 ^Δ[J].中国药房,2022,33(24):2952-2956. DOI： 10.6039/j.issn.1001-0408.2022.24.02.

YI Hongbin,SHI Fenghao,KUAI Liping,et al.Research on the impact of the adjustment of National Reimbursement Drug List on drug use of rare disease in hospitals[J].ZHONGGUO YAOFANG,2022,33(24):2952-2956. DOI： 10.6039/j.issn.1001-0408.2022.24.02.

摘要

目的

探究医保目录调整对医院罕见病用药的影响，为提高我国罕见病患者用药保障水平提供参考。

方法

从全国医药经济信息网中提取2016年1月－2018年12月有连续数据的789家医疗机构的罕见病用药的月度采购数据，采用单组间断时间序列模型对医保目录调整前后的罕见病用药品种、采购金额、平均限定日费用（DDDc）和用药频度（DDDs）进行比较。

结果

2017年医保目录共新增9个罕见病用药，包括吡非尼酮、左旋多巴/卡比多巴、利鲁唑、罗匹尼罗、屈昔多巴、依折麦布、依维莫司、重组人凝血因子Ⅸ和重组人凝血因子Ⅶa。医保目录调整后，9个罕见病用药的平均DDDc显著降低，DDDs和采购金额的上升趋势显著增大（

＜0.001）。

结论

我国医保目录中新增的罕见病用药数量不断增多，医疗保障覆盖范围不断扩大，罕见病用药价格显著降低，患者经济负担进一步降低，罕见病用药的用量显著增加，惠及了更多的罕见病患者，但同时也会增加医院的罕见病用药的采购金额。国家医疗保障部门需要充分考虑如何权衡医保基金承受能力与罕见病用药覆盖需求。

Abstract

OBJECTIVE

To explore the impact of the adjustment of the national reimbursement drug list on rare disease drugs in hospitals， and to provide reference for improving the drug security of patients with rare diseases in China.

METHODS

The monthly procurement data of rare disease drugs from 789 medical institutions that continuously reported data from January 2016 to December 2018 were extracted from the Chinese Medicine Economic Information. The single-group interrupted time series model was used to compare drug varieties， procurement amount， average defined daily cost （DDDc） and defined daily doses （DDDs） of rare disease drugs before and after the adjustment of national reimbursement drug list.

RESULTS

In 2017， a total of 9 rare disease drugs were newly included in the national reimbursement drug list， including pirfenidone， carbidopa/levodopa， riluzole， ropinirole， droxidopa， ezetimibe， everolimus， coagulation factor Ⅸ human recombinant and coagulation factor Ⅶa human recombinant. After the adjustment of the national reimbursement drug list， the average DDDc of 9 rare disease drugs was significantly decreased， the upward trend of DDDs and the procurement amount was significantly increased （

＜0.001）.

CONCLUSIONS

The number of newly included rare disease drugs in national reimbursement drug list keeps increasing， the coverage of medical security keeps expanding， the price of rare disease drugs is significantly decreased， the economic burden of patients is further decreased， and the consumption of rare disease drugs is significantly increased， benefiting more patients with rare diseases； but at the same time， it also increases the procurement amount of rare disease drugs in hospitals. National medical security departments need to fully consider how to balance the affordability of medical insurance funds with the demand for rare disease drug coverage.

关键词

医保目录罕见病间断时间序列分析限定日费用用药频度

Keywords

rare diseaseinterrupted time series analysisdefined daily dose costdefined daily doses

references

丁若溪，张蕾，赵艺皓，等. 罕见病流行现状：一个极弱势人口的健康危机[J]. 人口与发展，2018，24（1）：72-84.

人民网.《中国罕见病定义研究报告2021》发布[EB/OL].（2021-09-13）[2022-07-24].http：//health.people.com.cn/n1/2021/0913/c14739-32225468.htmlhttp://health.people.com.cn/n1/2021/0913/c14739-32225468.html.

FERREIRA C R. The burden of rare diseases[J]. Am J Med Genet A，2019，179（6）：885-892.

王雪，赵聪，许淑红，等. 我国罕见病用药可及性现状分析[J]. 中国临床药理学杂志，2021，37（8）：1026-1032.

信枭雄，管晓东，史录文. 基于5种罕见病可负担性评价的我国罕见病保障机制研究[J]. 中国药房，2014，25（5）：404-407.

牟燕，宋奎勐，吴敏，等. 基于政策工具视角的我国罕见病领域政策文本分析[J]. 中国卫生政策研究，2021，14（1）：17-23.

朱楚玉，孙维阳，常峰，等. 我国罕见病药品价格水平和可负担性研究[J]. 中国药房，2021，32（8）：897-903.

人力资源社会保障部.人力资源社会保障部关于印发国家基本医疗保险、工伤保险和生育保险药品目录（2017年版）的通知[EB/OL].（2017-02-21）[2022-07-24].http：//www.mohrss.gov.cn/SYrlzyhshbzb/shehuibaozhang/zcwj/yiliao/201702/t20170223_266775.htmlhttp://www.mohrss.gov.cn/SYrlzyhshbzb/shehuibaozhang/zcwj/yiliao/201702/t20170223_266775.html.

JANDOC R，BURDEN A M，MAMDANI M，et al. Interrupted time series analysis in drug utilization research is increasing：systematic review and recommendations[J]. J Clin Epidemiol，2015，68（8）：950-956.

PENFOLD R B，ZHANG F. Use of interrupted time series analysis in evaluating health care quality improvements[J]. Acad Pediatr，2013，13（6 Suppl）：S38-S44.

FRETHEIM A，TOMIC O. Statistical process control and interrupted time series：a golden opportunity for impact evaluation in quality improvement[J]. BMJ Qual Saf，2015，24（12）：748-752.

OGRINC G，MOONEY S E，ESTRADA C，et al. The SQUIRE（standards for quality improvement reporting excellence）guidelines for quality improvement reporting：explanation and elaboration[J]. Qual Saf Health Care，2008，17（Suppl 1）：i13-i32.

LINDEN A. Conducting interrupted time-series analysis for single- and multiple-group comparisons[J]. Stata J，2015，15（2）：480-500.

NEWEY W K，WEST K D. A simple，positive semi-definite，heteroskedasticity and autocorrelation consistent covariance matrix[J]. Econometrica，1987，55（3）：703.

中共中央，国务院.中共中央国务院关于深化医疗保障制度改革的意见[EB/OL].（2020-03-05）[2022-11-07]. http：//www.gov.cn/zhengce/2020-03/05/content_5487407.htmhttp://www.gov.cn/zhengce/2020-03/05/content_5487407.htm.

国家医疗保障局.2022年国家基本医疗保险、工伤保险和生育保险药品目录调整通过初步形式审查的申报药品信息[EB/OL].（2022-09-06）[2022-11-01].http：//www.nhsa.gov.cn/art/2022/9/6/art_152_8853.htmlhttp://www.nhsa.gov.cn/art/2022/9/6/art_152_8853.html.

赵守明. 药品费用控制中药物经济学的重要作用[J]. 当代经济，2012（14）：142-143.

李艳，丁庆明. 限定日剂量在药物利用研究中的应用[J]. 中国执业药师，2010，7（9）：6-8，16.

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