CAJ | 학술논문

目的探究适应于中国国情的罕见病医疗保险模式.方法以6大疾病系统的11类罕见疾病、35种治疗药品为研究对象,对比分析了这些罕见病和罕用药在我国不同基本医疗保险体系中的覆盖现况.结果 35种罕用药,在我国的基本药物目录2009版和2012版中覆盖率分别为0和37.1％；在国家基本医疗保险目录中覆盖率为54.3％(19种),8个省份新型农村合作医疗药品目录中的平均覆盖率约为33.6％.总体上,我国基本医保纳入的罕见病种类过少.结论我国罕见病患者总体的基本医疗保障水平较低,应提高罕用药保险报销目录覆盖率,建立罕见病及罕用药的专项报销计划,完善我国罕见病医疗救助机制,着手提高罕见病患者的医疗保障水平,减轻其经济负担.
목적 탐구괄응우중국국정적한견병의료보험모식.방법 이6대질병계통적11류한견질병、35충치료약품위연구대상,대비분석료저사한견병화한용약재아국불동기본의료보험체계중적복개현황.결과 35충한용약,재아국적기본약물목록2009판화2012판중복개솔분별위0화37.1％；재국가기본의료보험목록중복개솔위54.3％(19충),8개성빈신형농촌합작의료약품목록중적평균복개솔약위33.6％.총체상,아국기본의보납입적한견병충류과소.결론 아국한견병환자총체적기본의료보장수평교저,응제고한용약보험보소목록복개솔,건립한견병급한용약적전항보소계화,완선아국한견병의료구조궤제,착수제고한견병환자적의료보장수평,감경기경제부담.
Objective To explore a medical insurance model for rare diseases and orphan drugs applicable in China.Methods Eleven rare diseases from six disease systems and thirty-five orphan drugs covered were pinpointed for comparative analysis of their present coverage in various medical insurance systems in China.Results The coverage of 35 orphan drugs in the national essential drug list(2009)and the national essential drug list(2012)is 0 and 37.1％ respectively; the coverage in the national essential insurance medicine list is 54.3％ (19 types),and the average coverage in the medicine list for the New Rural Cooperative Medical Insurance Scheme is 33.6％.The study found insufficient rare diseases included in the Basic Medical Insurance Schemes in general.Conclusion The coverage of basic medical insurance for rare disease patients is low in China.In this regard,such measures should be taken to mitigate the economic burden for these patients,namely expanding the coverage of reimbursement list of orphan drugs,building the special reimbursement system of rare diseases and orphan drugs and improving the medical rescue system for rare diseases in China and their medical care level.