创新抗癌药物医保覆盖对癌症用药可及性与经济性的影响：价值视角下的政策评估与优化研究

创新抗癌药物价格高昂，阻碍了药品公平可及，造成沉重经济负担。为提高癌症用药的可及性，我国政府采取价格谈判将创新抗癌药物纳入医保覆盖。然而，各地区不同的政策操作方式，导致实际效果存在差异，需实证研究支撑。我国医保药品管理由“低水平广覆盖”快速跨越到纳入众多高价创新抗癌药物的阶段，面临着如何优化资源投入和效果产出的挑战。因此，以可及性与经济性为切入点，从微观视角对创新抗癌药物医保覆盖政策效果进行跟踪评估意义凸显。本项目拟在价值医疗视角下，通过政策实施前后基于典型病种的医保覆盖与未覆盖的抗癌药物比较，评估政策对不同地区药品可获得性、价格、费用、患者卫生服务利用、健康结局及用药公平的影响，并基于全社会视角，跟踪评价政策实施前后创新抗癌药物的成本和效果指标变化趋势，分析政策对癌症用药经济性的影响，为进一步优化相关政策提供实证依据。研究结果对促进创新抗癌药物公平获得、优化药物资源合理配置具有积极意义。

The high price of innovative anti-cancer drugs has hindered the equitable access to medicines, which leads to a heavy economic burden in the society. In order to increase the accessibility of cancer medicines, the Chinese government has adopted the measure of price negotiations to cover the innovative anti-cancer medicines in basic health insurance. However, the local governments in different regions implement different operating methods of the policies, which leads to differences in actual policy effects. It is necessary to conduct empirical research to evaluate the policy effects. Meanwhile, in China, the assigned drugs of medical insurance has rapidly transformed from the stage of "low level and wide coverage" to the stage of incorporating numerous high-price innovative anti-cancer drugs. It should face the challenge of how to optimize resource input and effect output. Therefore, using accessibility and cost-benefit of drugs as the entry point, it is of great significance to track and evaluate the effect of innovative anti-cancer drug health insurance coverage policy from a micro perspective. Based on value-based healthcare, the objectives of this study are to evaluate and compare the impacts of insurance coverage policy on availability, price, costs, equitable access to innovative anti-cancer drug, health service utilization and health outcomes of cancer patients in different regions. This study aims to evaluate the effects of the policy through comparing health insurance covered and uncovered anti-cancer drugs of typical diseases before and after the implementation of the policy. This study also will evaluate the changes in the cost and effectiveness of innovative anti-cancer drugs before and after the policy implementation, and analyze the impact of the policy on the cost-effectiveness of drug use from the perspective of the whole society. It aims to provide an empirical evidence for further optimization of related policies. The research results will be of value for promoting equitable access to innovative anti-cancer drugs and optimizing the rational allocation of drug resources.