Health technology assessment, international reference pricing, and budget control tools from China's perspective: what are the current developments and future considerations?

摘要

Background: China is investing considerably in health care reforms to address issues in its health care system. An example is access to innovative drugs, which remains challenging because it is largely dependent on patient self-pay. Recognizing this, the government has invested considerably in its basic medical insurance. As health care expenditure increases, there are growing concerns on budget control. Several health policy tools have been discussed recently such as health technology assessment, international reference pricing, and hospital budget control tools, which can be viewed as addressing the affordability concerns of the government budget. China has also listed her health outcomes goals in "Healthy China 2020" initiative. Objectives: This article aimed to discuss the "fit-for-purpose" of these tools to address budget concerns and support China in reaching her health outcomes goals. Methods: The findings are informed by a panel discussion at ISPOR Asia Pacific 2014, literature review, and authors' experience. This review looks at the current developments in China and the considerations and implications for using these tools by drawing experiences from countries where they are used. Results: These tools are generally used in countries with advanced health care systems. China's health care spending is still below that of countries with advanced health care systems and below World Health Organization recommendation. Conclusions: China has not yet reached the "critical mass" necessary for the effective use of these tools. As China continues its health care reforms, increase in health care spending to balance the health needs of the population would be key.