This paper used comparative method to analyze the evaluation principles of the selection of orphan drug of medical insurance sys-tem in UK, Canada and Australia.The medical insurance system of UK, Canada and Australia not only focuses on the economic and evidence-based evaluation principles of orphan drugs, but also considers some new ideas during the evaluation process of orphan drugs, such as risk-sha-ring agreement, social solidarity, stakeholder participation, and so on.Based on the good experiences from three medical insurance systems, it is very crucial for the evaluation principles of orphan drugs'selection that we should consider the cost of orphan drugs and also care for the treatment value and therapeutic uniqueness and society needs of the orphan drugs in China.%采用对比研究方法,分析英国、加拿大和澳大利亚医疗保险制度中罕用药保险覆盖遴选的评价原则. 研究发现3个国家医保药物评价机构罕用药遴选的评价原则不仅考虑药物的经济学及循证医学评价证据,而且还引入新的评价理念,如风险分担、社会团结,利益相关者参与等. 建议我国罕用药遴选评价,不仅要考虑罕用药的成本,更要综合考虑罕用药的治疗价值、唯一性和社会需要.
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