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目的:通过对赫赛汀进行预算影响分析,为药品报销目录的遴选决策、药品降价谈判及确立医保支付价格提供科学依据。方法:构建预算影响分析模型,比较国家医保目录内辅助化疗治疗方案,测算赫赛汀在中国上市并进入医保目录对医保支出的预期影响。结果:如果2016年赫赛汀进入医保目录,到2020年HER-2阳性乳腺癌患者医保预算总费用增幅分别为135.30%、141.93%、142.25%、142.27%和143.82%。结论:将赫赛汀纳入城镇医保将较大增加医保预算费用,增幅和各变量呈线性相关,建议进一步发挥国家有关部门集中谈判优势,在“带量降价”基础上,根据各地经济、医保状况,将赫赛汀纳入医保合理报销范围。
OBJECTIVE: To provide a scientific basis for Herceptin’s budgetary impact analysis, decision-making on drug reimbursement catalogs, drug price bargaining and the establishment of medical insurance payment prices. Methods: Constructing a budget impact analysis model, comparing the treatment plans of adjuvant chemotherapy in the national health insurance catalog, and calculating the expected impact of Herceptin on health insurance expenditure when listed in China and entering the medical insurance catalog. Results: If Herceptin enters the medical insurance catalog in 2016, the total medical insurance budget for HER-2-positive breast cancer will increase by 135.30%, 141.93%, 142.25%, 142.27% and 143.82% respectively by 2020. Conclusion: The inclusion of Herceptin in urban medical insurance will greatly increase the cost of medical insurance, the increase rate is linearly correlated with each variable, and it is suggested that the relevant state departments should give full play to the advantage of centralized negotiation. On the basis of “carrying quantity and price reduction ”, Medicare status, the Herzen Ting into the medical insurance reasonable reimbursement.