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目的:分析国家基本药物基层免费供应的可行性。方法:以上海市65岁以上老人基层用药现状为基础,测算实行国家基本药物基层免费供应后财政、医保和个人的负担,并结合当前政治、经济、技术和社会因素分析其可行性。结果:2013年上海市基层若实施65岁以上老年人国家基本药物免费供应需要10.25亿~33.18亿元,其中医保负担6.74亿~29.9亿元,财政负担1.02亿~11.31亿元。结论:国家基本药物基层免费供应具备政治和技术上的可行性,财政和医保能够共同从经济上保障该政策的实施,有助于进一步巩固和完善国家基本药物制度。但需加强系统研究,从筹资、支付、组织、监管和行为等层面共同推进国家基本药物制度,保障居民用药需求。
Objective: To analyze the feasibility of providing a free supply of basic essential medicines at national level. Methods: Based on the current situation of grassroots drug use among the elderly over 65 in Shanghai, the financial, medical insurance and personal burden after the implementation of the free supply of the national essential drug base were measured. Based on the current political, economic, technical and social factors, the feasibility was analyzed. Results: In 2013, the grass-roots units in Shanghai need to spend 1.025 billion yuan to 3.318 billion yuan to provide free supplies of essential medicines for the elderly over 65 years of age, of which the medical insurance burden is 674 million yuan to 2.99 billion yuan and the financial burden is 102 million yuan to 1.131 billion yuan. Conclusion: The free supply of the national essential medicines at the grassroots level is politically and technically feasible. Both the financial and medical insurance can jointly guarantee the implementation of this policy economically and help to further consolidate and improve the national essential drug system. However, it is necessary to strengthen systematic research and jointly promote the national essential drug system from the aspects of financing, payment, organization, supervision and behavior so as to guarantee the residents’ medication needs.