Ապահովագրությանշրջանակներումդեղերիփոխհատուցմանհիմնականսխեմաներիհամեմատականվերլուծություն/比较分析的主要药物报销在保险计划

L. Karapetyan, Arsen Petrosyan, Tatevik Vardanyan, Tigran Mikayelyan, G. Hakobyan
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引用次数: 0

摘要

医疗保险系统的一个组成部分是药品保险,它为处方药的费用提供全部或部分报销。药品支出在保健总费用中占很大比例。定期向人们分发数量充足、质量有保证的药品是每个国家政府面临的最大挑战之一。发达国家和发展中国家在以药品报销计划为基础的基本保险方面都有丰富的经验,因此评估这些计划的关键特征至关重要。亚美尼亚共和国尚未实施所需的医疗保险制度及其基本组成部分——药品报销计划,因此这是一个值得研究的重要而相关的问题。作者对选定国家的药品报销方案进行了研究和比较,讨论了药品报销标准、报销清单编制的特点,提出了药品报销领域价格政策制定的主要途径。该研究还分析了在RA经营的药物的主要报销机制、报销框架中包括的人口群体和疾病。研究审查了《药品补助制度》中药品报销的主要机制,以及报销框架所涵盖的人口群体和疾病。研究结果表明,缺乏一种通用的药物报销模式。相反,发达国家和经济状况相似的国家发展了自己的公共卫生保护模式。这些模型虽然在非组织性方面有所不同,但包含了共同的组成部分,包括人口类别、报销清单、报销中心、价格调节系统和其他组成部分,这些组成部分应在RA中创建药品保险模型时作为指南。
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Ապահովագրության շրջանակներում դեղերի փոխհատուցման հիմնական սխեմաների համեմատական վերլուծություն / Comparative Analysis of the Main Drug Reimbursement Schemes in Insurance
One component of the health insurance system is drug insurance, which provides full or partial reimbursement for the cost of prescription drugs. Expenditures on pharmaceuticals account for a large proportion of total health care costs. The regular distribution of drugs to people in adequate quantities and with guaranteed quality presents one of the largest challenges for the government of every country. Both developed and developing countries have an extensive experience with the primary insurance based on drug reimbursement programs, making it crucial to evaluate the key characteristics of these programs. The required medical insurance system and its essential component, the drug reimbursement program, have not yet been implemented in the Republic of Armenia, making it a significant and pertinent issue for study. The authors studied and compared the drug reimbursement schemes in selected countries, discussed the criteria for drug reimbursement, the features of the compilation of reimbursement lists, and presented the main approaches to the price policy development in the field of drug reimbursement. The study also analyses the main mechanisms of reimbursement of medicines operating in the RA, population groups and diseases included in the framework of reimbursement. The research examines the primary mechanisms of drug reimbursement in the RA, as well as population groups and diseases covered by the framework of reimbursement. The findings of the study demonstrate the lack of a universal model for drug reimbursement. Instead, developed nations and those with similar economies develop their own public health protection models. These models, while differ in organizational aspects, contain common components including population categories, reimbursement lists, reimbursement rates, price regulation systems, and other components that should serve as a guide when creating the drug insurance model in the RA.
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