目的 本研究以国产创新药物埃克替尼为例,探讨及时纳入医疗保险对国产创新药物使用的影响。方法 研究选取将埃克替尼纳入医疗保险时间差异较大的X省和Z省,使用全国医药经济信息网数据库中覆盖两个省份的样本医院2013~2018年间季度采购数据,对比分析3个同样用于治疗非小细胞肺癌的靶向药(吉非替尼、厄洛替尼、埃克替尼)的价格和用量与费用份额的变化情况。结果 Z省2013年将埃克替尼纳入基本医保,其用量和费用市场份额在被纳入医保后迅速增加,并在较长的一段时间内维持在85%左右,占据市场主导地位;而X省2016年将埃克替尼纳入医保,埃克替尼的市场份额在被纳入医保后最高时也仅占8%;两省中埃克替尼日费用长期为样本药品中最低,3个样本药品日费用在两省间无明显差异;国家医保谈判后,3个药品日费用降幅在60%~79%之间,并于2018年后期趋于一致。结论 及时将优质国产创新药物纳入医保报销范围能够有效促进创新药物使用,相比国外同治疗类别药品可以在一定程度上节约费用,真正使患者受益。
Abstract
OBJECTIVE To explore the impact of timely inclusion of medical insurance on the use of high-quality domestic innovative drugs, using the domestic innovative drug, icotinib, as an example. METHODS Province X and province Z with large difference on the timing to include icotinib in medical insurance were selected as sample provinces to compare and analyze the price, volume and expenditure changes of three targeted drugs (gefitinib, erlotinib and icotinib) for non-small cell lung cancer (NSCLC), using the sample hospital procurement data covering two provinces from 2013 to 2018 in the China Medical Economic Information Network (CMEI) database. RESULTS In two sample provinces, icotinib′s daily cost had been the lowest among three sample drug′s for a long time. Province Z has included icotinib in the basic health insurance since 2013. After that, the market shares of icotinib′s volume and expenditure had increased rapidly from 0, and remained at about 85% for a long period of time, occupying the dominant position in province Z′s market. However, province X has not included icotinib until 2016. The highest market share of icotinib′s volume was only 8% in province X′s market. There was little difference of sample drugs′ daily cost between two provinces. After the national health insurance negotiation, the daily cost of sample drugs decreased significantly, with an overall decrease between 60% to 79%. By the second half of 2018, the daily cost of sample drugs was almost the same. CONCLUSION Timely inclusion of high-quality domestic innovative drugs in the scope of medical insurance reimbursement can greatly promote the use of high-quality domestic innovative drugs. Compared with foreign drugs with same indications, high-quality domestic innovative drugs can save money for patients, which will greatly benefit them.
关键词
医疗保险 /
创新药物 /
埃克替尼
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Key words
medical insurance /
innovative drug /
icotinib
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中图分类号：
R95
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