Abstract Because there is only part of the cost should be bear in the relationship of insurance, or because of the lack of understanding to drugs, patients usually do not have enough motivation or ability to seek economical drug with excellent effects during drug selections. Secondly, if the income of physicians is linked up with the expenses of drugs, it is possible for physicians to induce the need of drugs and it is also possible to overspend drugs. China's government have taken lots of actions to deal with the increasing of health care expenses, and the most notable one is that the prices of drugs have been forcibly reduced for 23 times since 1997. But, this kind of forcible reduction to drug price has not achieved the purpose of control to health expense. A new approach to control the increasing of health expense is quite needed to China. The concept of Pharmacoeconomics has been imported in dealing with this problem in some other counties all over the world. In a nutshell, Pharmacoeconomics is an approach to put Economic principles and methods into the filed of Pharmaceutics. Pharmacoeconomics evaluation is to evaluate the value of drug itself. It is not the method to make a price of drugs only based on its cost, but to set a reasonable price which is accompany with its value for the drug based on more factors such as effects, effectiveness, and benefits etc. Some countries have imported the principles of Pharmacoeconomics, with the purpose of setting a reasonable price for drug at the very beginning of the price setting, and of evaluating and adjusting the price of drug with the methods of Pharmacoeconomics in the coming process of price accommodation. After the Pharmacoeconomics evaluation had been firstly used in the price setting and expense system in Australia in 1993, more and more countries have noticed the functions of this kind of evaluation during the progresses of price setting, expense system and accommodation step to drug. Because of the lack of unitive standard during the Pharmacoeconomics evaluation, there usually are some errors in the methods selection and data statistics. Thus, every country has set the guide to Pharmacoeconomics evaluation as the guidance of price setting, expense system and accommodation progress. And, these guides are beneficial to the share of Pharmacoeconomics information. The concept of Pharmacoeconomics has been imported into China for more than ten years, but in the field of using, it is only used in case study by physicians, but not widely used. For the development of Pharmacoeconomics all over the world, and for its effects which have been appeared in the price setting, expense system and accommodation progress of drug, China's government has actively develop the research of Pharmacoeconomics, and has claimed to set the guide of Pharmacoeconomics evaluation, *China' Guide to Pharmacoeconomics Evaluation*, for itself on 2006. Because that the understanding of China to Pharmacoeconomics are limited, the study and reference are still quite needed to China. This thesis prepares to give out some suggestions to the improvement of the guide of China about Pharmacoeconomics through the understanding and introduction to Pharmacoeconomics itself and the guide of some other countries. Key words: Pharmacoeconomics, Price setting, Expense, Industry development

摘要: 世界各國醫療服務費用都在不斷增加，給各國政府帶來了極大的經濟負擔。中國政府也不例外，同樣面臨著醫療服務費用的連年上漲。導致服務費用增長的主要原因之一是由於藥品市場在定價、支付，以及在價格調整過程中中未盡完善。首先患者在使用藥物時，或由於保險關係僅承擔部分的成本，或出於對藥物缺乏瞭解，導致患者在選擇藥物時沒有足夠的動機或知識尋找效果好且經濟的藥物。其次，如果醫師收入與藥品消費有某種程度的掛鉤，就可能出現藥物過度使用和醫師誘導需求等現象。 中國政府在解決醫療服務費用增長的問題上採取了很多措施，其中力度最大的是自1997年以來先後進行的23次藥品價格強制降價。但是政府的強制降價措施並沒有達到控制醫療費用增長的目的。相反地，在這一系列的降價過程中反而嚴重打擊了整個製藥行業的積極性。因此本研究認為中國需要尋覓一新的方法來控制醫療服務費用的增長。 比較其他國家在處理類似問題時，往往引入了藥物經濟學的概念。簡單來說，藥物經濟學是將經濟學的原理和方法運用到藥物領域來。藥物經濟學的實質是針對藥品的自身價值進行評估。它不單是通過藥品成本這一單一因素對藥品進行定價，還要通過對藥物的效果、效用、效益等方面的評估分析。以此為基礎，給藥品訂定一個符合其自身價值的合理價格。 藥物經濟學除了協助相關部門制定藥品價格，並在日後的價格調整過程中扮演積極的角色外，並隨著1993年澳大利亞政府首先將藥物經濟學用於定價和支付機制開始，越來越多的國家注意到藥物經濟學評估在藥品定價、支付及價格調整過程中可發揮的作用，紛紛將藥物經濟學的方法引入其現行的定價、支付機制，並對機制進行補充和完善。然而，若在進行藥物經濟學評估過程中沒有統一的標準，往往會在方法選擇或是資料上以及最後的結果出現誤差。所以各國紛紛建立了藥物經濟學評估指南作為規範藥品的定價、支付及價格調整的指引，同時也有利於各國家和地區之間的藥物經濟學資料資源的共用。 藥物經濟學這一概念進入中國也有十年的時間了，但在其使用上，往往都是隨臨床醫師對某一藥品或治療進行個案的分析，並沒有廣泛的應用。鑒於全球藥物經濟學發展的趨勢以及在藥品定價、支付及價格調整中所凸現出的作用，中國政府也積極開展藥物經濟學研究，並於2006年，制定了自己的藥物經濟學定價指南即《中國藥物經濟學評估指南》。由於中國對藥物經濟學仍處於初級階段，很多方面的內容還需要學習和借鑑。本文通過對藥物經濟學及國外藥物經濟學評估指南的介紹，對建立及推行中國藥物經濟學評估指南提供建議 關鍵字：藥物經濟學，定價，支付，產業發展