国家医保药品目录价格谈判对中国肺癌靶向药物定价、市场渗透和支出的影响

doi:10.5246/jcps.2025.06.041

中国药学(英文版) ›› 2025, Vol. 34 ›› Issue (6): 543-555.DOI: 10.5246/jcps.2025.06.041

国家医保药品目录价格谈判对中国肺癌靶向药物定价、市场渗透和支出的影响

王成¹, 易洪彬², 韩晟¹^,², 史录文¹^,²^,^*()

^1. 北京大学药学院药事管理与临床药学系, 北京 100191
^2. 北京大学医药管理国际研究中心, 北京 100191

收稿日期:2025-01-04 修回日期:2025-03-20 接受日期:2025-03-23 出版日期:2025-07-03 发布日期:2025-07-03
通讯作者: 史录文

Effects of NRDL price negotiations on the pricing, market penetration, and spending of targeted lung cancer medications in China

Cheng Wang¹, Hongbin Yi², Sheng Han¹^,², Luwen Shi¹^,²^,^*()

¹ Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
² International Research Center for Medicinal Administration, Peking University, Beijing 100191, China

Received:2025-01-04 Revised:2025-03-20 Accepted:2025-03-23 Online:2025-07-03 Published:2025-07-03
Contact: Luwen Shi
Supported by:
Research on Innovative Method of Drug Rational Use Supervision Decision Based on Big Data of Medical Insurance (Grant No. 82273899).

摘要/Abstract

摘要：

2016年至2024年, 中国政府通过价格谈判将多款创新药纳入国家医保药品目录(NRDL)。这些谈判导致价格大幅下降, 进而刺激了销售额的增长。本研究旨在评估该政策对NRDL中包含的靶向肺癌治疗的定价、利用和总体支出的影响。本研究对来自698家医疗机构的采购数据进行了间断时间序列分析, 评估了即时和长期影响。在即时效果方面, 价格谈判导致所有靶向治疗的限定日剂量成本(DDDc)显著下降(P < 0.05)。就长期趋势而言, 仅在吉非替尼、埃克替尼和恩沙替尼的定价轨迹中观察到显著变化(P < 0.05)。在对药物利用的即时影响方面, 除吉非替尼和埃克替尼外, 所有靶向药物的用量均大幅增加(P < 0.05)。从长期来看, 所有靶向治疗的使用量均呈显著上升趋势(P < 0.05)。在支出方面, 纳入NRDL的直接影响导致阿法替尼、克唑替尼、奥希替尼、阿来替尼和恩沙替尼的支出显著增加(P < 0.05)。随着时间的推移, 除厄洛替尼外, 靶向药物的总支出显著增加(P < 0.05)。总体而言, 国家医保药品目录的价格谈判成功地减轻了肺癌患者的经济负担, 提高了中国靶向治疗的可及性和可负担性。

关键词: 肺癌, 靶向药物, 国家医保药品目录, 价格谈判

Abstract:

Between 2016 and 2024, the Chinese government incorporated several innovative drugs into the National Reimbursement Drug List (NRDL) through price negotiations. These negotiations led to significant price reductions, which in turn stimulated an increase in sales. This study aimed to assess the impact of this policy on the pricing, utilization, and overall expenditure of targeted lung cancer therapies included in the NRDL. Using an interrupted time series analysis of procurement data from 698 healthcare institutions, the study evaluated both immediate and long-term effects. In terms of immediate effects, price negotiations resulted in a significant decline in the defined daily dose cost (DDDc) for all targeted therapies (P < 0.05). Regarding long-term trends, a significant shift was observed only in the pricing trajectory of Gefitinib, Icotinib, and Ensartinib (P < 0.05). In terms of immediate effects on drug utilization, all targeted medicines experienced a substantial increase in volume (P < 0.05), except for Gefitinib and Icotinib. Over the long term, the usage of all targeted therapies exhibited a significant upward trend (P < 0.05). With respect to expenditure, the immediate impact of NRDL inclusion resulted in a significant increase in spending on Afatinib, Crizotinib, Osimertinib, Alectinib, and Ensartinib (P < 0.05). Over time, total spending on targeted medicines showed a significant increase (P < 0.05), except for Erlotinib. Overall, NRDL price negotiations successfully reduced the economic burden on lung cancer patients, improving both accessibility and affordability of targeted therapies in China.

Key words: Lung cancer, Targeted medicine, National Reimbursement Drug List, Price negotiation

Supporting:

王成, 易洪彬, 韩晟, 史录文. 国家医保药品目录价格谈判对中国肺癌靶向药物定价、市场渗透和支出的影响[J]. 中国药学(英文版), 2025, 34(6): 543-555.

Cheng Wang, Hongbin Yi, Sheng Han, Luwen Shi. Effects of NRDL price negotiations on the pricing, market penetration, and spending of targeted lung cancer medications in China[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(6): 543-555.

图/表 7

Table 1. Basic information of the target drugs.

Table 2. ITSA results for the DDDc of target drugs.

Figure 1. Changes in DDDc of target drugs before and after policy implementation.

Table 3. ITSA results for the volume of target drugs (thousands of DDDs).

Figure 2. Changes in the volume of target drugs before and after policy implementation.

Table 4. ITSA results for the spending of target drugs (millions of CNY).

Figure 3. Changes in the spending of target drugs before and after policy implementation.

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国家医保药品目录价格谈判对中国肺癌靶向药物定价、市场渗透和支出的影响

Effects of NRDL price negotiations on the pricing, market penetration, and spending of targeted lung cancer medications in China

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