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首页> 外文期刊>Frontiers in Public Health >Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study
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Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study

机译：国家医疗保险覆盖政策对我国创新抗癌药物利用和可用性的影响：中断时间序列研究

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Objective: The study aimed to evaluate the impact of the National Health Insurance Coverage (NHIC) policy on the utilisation and accessibility of innovative anti-cancer medicines in Nanjing, China. Methods: We used the adjusted World Health Organisation and Health Action International methodology to calculate the price and availability of 15 innovative anti-cancer medicines included in the National Health Insurance drug list in 20 tertiary hospitals and six secondary hospitals in Nanjing before and after NHIC policy implementation. Interrupted time-series regression was used to analyse the changes in the utilisation of the study medicines. Results: The price reduction rates of innovative anti-cancer medicines ranged between 34 and 65%. The mean availability rate was 27.44% before policy implementation and increased to 47.33% after policy implementation. The utilisation of anti-cancer medicines suddenly increased with a slope of 33.19–2,628.39 when the policy was implemented. Moreover, the usage rate of bevacizumab, bortezomib, and apatinib significantly increased ( p 0.001, p = 0.009, and p 0.001, respectively) after policy implementation. With regard to price reduction and medical insurance reimbursement, the medicines became more affordable after policy implementation (0.06–1.90 times the per capita annual disposable income for urban patients and 0.13–4.46 times the per capita annual disposable income for rural patients). Conclusion: The NHIC policy, which was released by the central government, effectively improved the utilisation and affordability of innovative anti-cancer medicines. However, the availability of innovative anti-cancer medicines in hospitals remained low and the utilisation of innovative anti-cancer medicines was affected by some factors, including the incidence of cancer, limitation of indications within the insurance program, and the rational use of innovative anti-cancer medicines. It is necessary to improve relevant supporting policies to promote the affordability of patients. The government should speed up the process of price negotiation to include more innovative anti-cancer medicines in the medical insurance coverage, consider including both medical examinations and adjuvant chemotherapy in the medical insurance, and increase investment in health care.
机译：目的：该研究旨在评估国家健康保险范围（NHIC）政策对中国南京创新抗癌药物利用和可用性的影响。方法：我们使用了调整后的世界卫生组织和健康行动国际方法论，计算南京的20个高级医院和六次中学医院的国家医疗保险药品名单中包含15个创新抗癌药物的价格和可用性执行。中断的时间序列回归用于分析研究药物利用的变化。结果：创新抗癌药物的降价率在34％至65％之间。在政策实施之前，平均可用性率为27.44％，并在政策实施后增加至47.33％。抗癌药物的利用突然在实施政策时突然增加了33.19-2,628.39。此外，在政策实施之后，Bevacizumab，Bortezomib和Apatinib的使用率显着增加（P <0.001，P <0.009，P <0.001分别）。关于降价和医疗保险报销，药品在政策执行后更加实惠（城市患者的人均年一次性收入0.06-1.90倍，农村患者人均年一次性收入的0.13-4.46倍）。结论：中央政府释放的NHIC政策有效改善了创新抗癌药物的利用和可负担性。然而，医院的创新抗癌药物的可用性仍然很低，利用创新的抗癌药物受到一些因素的影响，包括癌症的发生率，保险计划内的适应症的限制以及创新抗的合理使用 - 癌症药物。有必要改善相关的支持政策以促进患者的负担能力。政府应加快价格谈判的过程，包括在医疗保险中的更具创新性的抗癌药物，考虑在医疗保险中包括医学检查和辅助化疗，并增加对医疗保健的投资。

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