·30·第36卷第3期2023年3月医学与社会MedicineandSocietyVol.36No.3Mar.2023多层次视角下国内外罕见病用药保障支持体系研究曾淑金1,吴良淼2,翁开源1,31广东药科大学药学院,广东广州,510006;2暨南大学第一临床医学院,广东广州,510632;3广东药科大学国家药品监督管理局药物警戒技术重点实验室,广东广州,510006摘要本文通过文献研究和政策梳理的方法,分别从罕见病的政策支持体系、资金支持体系和医疗服务支持体系等不同维度,分析和总结国内外罕见病政策保障和用药保障的模式与经验。建议我国应结合自身国情和经济实力,创建“引入+自研”双轨并行的创新格局;统筹医保保障,建立多方支付机制;完善医疗服务体系,积极开展罕见病分级诊疗和远程会诊,解决罕见病“诊断难”“治疗难”等问题,从而在罕见病的立法、资金支付、医疗资源配置上整合多种用药保障模式,精准化解决罕见病患者用药难题。关键词药品管理;罕见病;罕用药中图分类号:R199文献标识码:ADOI:10.13723/j.yxysh.2023.03.006文章编号:1006-5563(2023)03-0030-06AnalysisofDomesticandForeignDrugSupportSystemforRareDiseasesfromtheMulti-levelPerspectiveZENGShujinetalSchoolofPharmacy,GuangdongPharmaceuticalUniversity,Guangzhou,Guangdong,510006,ChinaAbstractThroughthemethodofliteratureresearchandpolicyreview,thisstudyanalyzesandsummarizesthemodeandex-perienceofmedicationguaranteeforrarediseasesathomeandabroadfromdifferentdimensionssuchasthepolicysupportsystem,financialsupportsystemandmedicalservicesupportsystemforrarediseases.Itissuggestedthatourcountryshouldcombineitsownnationalconditionsandeconomicstrengthtocreateadual-trackinnovationpatternof"introduction+self-research",coordinatemedicalinsurancecoverageandestablishamulti-partypaymentmechanism.Weshouldimprovethemedicalservicesystem,andactivelycarryoutgradeddiagnosisandtreatmentofrarediseasesandremoteconsultation,whichsolvetheproblemsofrarediseasessuchas“difficultyindiagnosis”and“difficultyintreatment”.Asaresult,avarietyofmedicationguaranteemodelsareintegratedinthelegislation,capitalpayment,andmedicalresourceallocationofrarediseases,whichaccuratelysolvetheproblemofdruguseinpatientswithrar...