战略性延迟和谈判澳大利亚药物公共保险覆盖
Jing Jing Li1, Anthony Harris1
1Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia.
Health economics
|March 13, 2026
概括
澳大利亚的药品定价谈判表明,延迟是战略性的,而不是程序性的. 协议的时间反映了预期的健康益处和机会成本之间的平衡,受成本效益和临床需要等因素的影响.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 卫生技术评估 卫生技术评估
背景情况:
- 药品的公共资金涉及制造商和机构之间的复杂谈判.
- 关于这些药品定价谈判的经济结构和时间的实证研究是有限的.
研究的目的:
- 分析谈判时间如何反映药品定价协议的经济结构.
- 评估观察到的延迟和协议是否与不完整信息下的动态讨价还价理论保持一致.
主要方法:
- 利用一个持续时间模型来分析2005年至2018年的澳大利亚制药谈判数据.
- 审查了400种疗法的634份提交,重点是谈判时间和协议率.
主要成果:
- 协议的中位数是16个月,71%的谈判回合没有立即达成协议.
- 感知价值较低的疗法 (每QALY成本较高,预算影响,证据不确定性) 面临更长的延迟和更低的协议率.
- 具有高临床重要性,感知需要或公共利益的疗法被列出得更快.
结论:
- 观察到的谈判模式表明,如果预期的健康益处证明了机会成本,治疗就会获得资金的系统规则.
- 药品定价协议的时间表反映了在不确定性下进行的战略谈判,而不是仅仅是程序性延迟.
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