目的：基于医保支付方的角度，预测假设白蛋白紫杉醇进入国家基本医保目录后，未来5年对医保基金可能产生的影响。方法：依据中国乳腺癌流行病学数据界定目标人群，基于紫杉醇类化疗药品费用、不良反应治疗费用、住院床位等其他费用来确定患者治疗费用。依据中国乳腺癌药品市场销售数据及专家意见，确定相应替代药品及其替代关系，以此构建预算影响分析模型。结果：如果白蛋白紫杉醇进入医保，2016-2020年医保基金支出将分别增加5241、6536、7872、9229、10628万元，并对结果进行了敏感性分析。结论：白蛋白紫杉醇具有更高的疗效和安全性、不需助溶剂预处理、输液时间大大缩短等优势，由于其价格的影响会增加一定医保基金的支出，适当降低价格或者提高门诊化疗率可显著降低医保基金的支出。%Objective:To estimate the potential influence of healthcare insurance fund in the next five years from health insurance payer perspective, assuming albumin paclitaxel is listed in NRDL. Method:Study population was draw from the breast cancer epidemiology data of China. The average treatment cost was calculated based on drug cost, adverse events management cost and other healthcare source usage including drug delivery time. Based upon market data of China and expert opinions, a budget impact model was established. Result:in two scenarios, healthcare insurance fund expenditure would be increased by ¥52.41 million, ¥65.36 million, ¥78.72 million, ¥92.29 million and ¥106.28 million, respectively, during the period of 2016-2020, and the sensitivity analysis of the results was carried out. Conclusion:albumin paclitaxel has the advantages of high efficacy and safety, without the need of solvent pretreatment, while with short infusion time and saving the use of medical resources. Because it will increase the expenditure of health insurance funds, appropriately reducing the price or improving outpatient chemotherapy can significantly reduce the cost of health insurance funds.
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