英国癌症药物基金改革及对医保创新药支付政策的启示

目的:通过对英国癌症药物基金(Cancer Drugs Fund, CDF)的形成背景、运行机制及改革中优化管理策略进行批判借鉴研究,为中国创新药准入及管理政策的制定提供参考。方法:文献梳理、政策分析。结果:CDF在解决癌症患者创新药的可及性、可负担性方面具有积极意义,但同时存在较大争议。CDF通过不断改革完善、优化基金管理办法,在药品准入和退出机制、审批流程规范化、预算管理风险分摊协议等方面做出优化调整。结论和建议:CDF在癌症创新药快速准入方面的经验及教训值得我国批判借鉴。中国的创新药支付政策方面,建议可成立多元化筹资的癌症药物基金,建立药物准入及退出机制,关注真实世界数据在支付决策中的作用,探索合理超支分担科学管理的预算协议。

Reform strategy of the British Cancer Drug Fund and its enlightenment on innovative drug payment policy in medical insurance

Objective: To conduct a critical study on the formation background, operating mechanisms and optimized management strategies of the Cancer Drugs Fund (CDF) in the UK, aiming at providing reference for the formulation of China''s innovative drug accession and management policies. Methods: Literature review and policy analysis. Results: CDF has great significance in solving the problems associated with the accessibility and affordability of innovative drugs for cancer patients, but at the same time, controversies have become more and more. Through continuous reform and improvement, CDF has made adjustments in of the optimization of drug-access and withdrawal mechanisms, approval process standardization, and risk management and mitigation agreements for budget management. Conclusions and Recommendations: The experience and lessons of CDF in the rapid access to innovative cancer drugs is worthy of reference for China. In light of China''s innovative drug payment policy, it is suggested to create a multi-segment fund for cancer drugs, establish drug-access and withdrawal mechanisms, focus more on the role of real-world data in payment decision-making, and explore a reasonable budget management model under scientific risk-sharing principles.