PDF(Pubmed)
Abstract：
OBJECTIVE: Multiple reforms aimed at improving the Chinese population\'s health have been introduced in recent years, including several designed to improve access to innovative drugs. We sought to review current factors affecting access to innovative drugs in China and to anticipate future trends.
METHODS: Targeted reviews of published literature and statistics on the Chinese healthcare system, medical insurance and reimbursement processes were conducted, as well as interviews with five Chinese experts involved in the reimbursement of innovative drugs.
RESULTS: Drug reimbursement in China is becoming increasingly centralized due to the removal of provincial pathways, the establishment of the National Healthcare Security Administration and the implementation of the National Reimbursement Drug List (NRDL), which is now the main route for drug reimbursement in China. There is also an increasing number of other channels via which patients may access innovative treatments, including various types of commercial insurance and special access. Health technology assessment (HTA) and health economic evidence are becoming pivotal elements of the NRDL decision-making process. Alongside the optimization of HTA decision making, innovative risk-sharing agreements are anticipated to be increasingly leveraged in the future to optimize access to highly specialized technologies and encourage innovation while safeguarding limited healthcare funds.
CONCLUSIONS: Drug public reimbursement in China continues to align more closely with approaches widely used in Europe in terms of HTA, health economics and pricing. Centralization of decision-making processes for public reimbursement of innovative drugs allows consistency in assessment and access, which optimizes the improvement of the Chinese population\'s health.
METHODS: Targeted reviews of published literature and statistics on the Chinese healthcare system, medical insurance and reimbursement processes were conducted, as well as interviews with five Chinese experts involved in the reimbursement of innovative drugs.
RESULTS: Drug reimbursement in China is becoming increasingly centralized due to the removal of provincial pathways, the establishment of the National Healthcare Security Administration and the implementation of the National Reimbursement Drug List (NRDL), which is now the main route for drug reimbursement in China. There is also an increasing number of other channels via which patients may access innovative treatments, including various types of commercial insurance and special access. Health technology assessment (HTA) and health economic evidence are becoming pivotal elements of the NRDL decision-making process. Alongside the optimization of HTA decision making, innovative risk-sharing agreements are anticipated to be increasingly leveraged in the future to optimize access to highly specialized technologies and encourage innovation while safeguarding limited healthcare funds.
CONCLUSIONS: Drug public reimbursement in China continues to align more closely with approaches widely used in Europe in terms of HTA, health economics and pricing. Centralization of decision-making processes for public reimbursement of innovative drugs allows consistency in assessment and access, which optimizes the improvement of the Chinese population\'s health.
摘要：
目的：近年来推行了多项旨在改善中国人口健康的改革，包括几个旨在改善创新药物的获取。我们试图回顾影响中国创新药物获取的当前因素，并预测未来趋势。
方法：有针对性地回顾已发表的有关中国医疗保健系统的文献和统计数据，进行了医疗保险和报销流程，以及对参与创新药报销的五名中国专家的采访。
结果：由于取消了省级途径，中国的药品报销越来越集中，国家医疗保障局的成立和国家报销药品目录（NRDL）的实施，现在是中国药品报销的主要途径。还有越来越多的其他渠道，患者可以通过这些渠道获得创新的治疗，包括各类商业保险和特殊准入。卫生技术评估（HTA）和卫生经济证据正在成为NRDL决策过程的关键要素。除了优化HTA决策，预计未来将越来越多地利用创新的风险分担协议，以优化对高度专业化技术的获取，并鼓励创新，同时保护有限的医疗保健基金。
结论：中国的药品公共报销继续与欧洲在HTA方面广泛使用的方法更加紧密地保持一致，卫生经济学和定价。创新药公共报销的决策过程的集中化使得评估和获取的一致性,这优化了中国人口健康的改善。
方法：有针对性地回顾已发表的有关中国医疗保健系统的文献和统计数据，进行了医疗保险和报销流程，以及对参与创新药报销的五名中国专家的采访。
结果：由于取消了省级途径，中国的药品报销越来越集中，国家医疗保障局的成立和国家报销药品目录（NRDL）的实施，现在是中国药品报销的主要途径。还有越来越多的其他渠道，患者可以通过这些渠道获得创新的治疗，包括各类商业保险和特殊准入。卫生技术评估（HTA）和卫生经济证据正在成为NRDL决策过程的关键要素。除了优化HTA决策，预计未来将越来越多地利用创新的风险分担协议，以优化对高度专业化技术的获取，并鼓励创新，同时保护有限的医疗保健基金。
结论：中国的药品公共报销继续与欧洲在HTA方面广泛使用的方法更加紧密地保持一致，卫生经济学和定价。创新药公共报销的决策过程的集中化使得评估和获取的一致性,这优化了中国人口健康的改善。
