美国药品调剂服务收费制度研究及其对我国的启示

廖诗语; 伍琳; 陈永法

doi:10.6039/j.issn.1001-0408.2026.07.03

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美国药品调剂服务收费制度研究及其对我国的启示

药事管理 | 更新时间：2026-07-16

- 美国药品调剂服务收费制度研究及其对我国的启示
- Study on pharmacy dispensing fee system in the United States and its implications for China
- 中国药房 2026年37卷第7期页码：842-847
- 作者机构：
  
  中国药科大学国际医药商学院，南京　211198
- 作者简介：
  
  硕士研究生。研究方向：医药卫生政策与法规。 E-mail：15343289302@163.com
  教授，博士生导师，博士。研究方向：医药卫生政策与法规。E-mail：cyf9906@163.com
- 基金信息：
  
  国家自然科学基金青年基金项目(72404280);中国药科大学国家执业药师发展研究中心立项课题(ndrplc202301;NRCLPD202502)
- DOI：10.6039/j.issn.1001-0408.2026.07.03
  中图分类号： R95
- 收稿：2025-11-12，
  
  修回：2026-03-15，
  
  录用：2026-03-16，
  
  纸质出版：2026-04-15
- 稿件说明：
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廖诗语,伍琳,陈永法.美国药品调剂服务收费制度研究及其对我国的启示 [J].中国药房,2026,37(07):842-847.

LIAO Shiyu,WU Lin,CHEN Yongfa.Study on pharmacy dispensing fee system in the United States and its implications for China[J].ZHONGGUO YAOFANG,2026,37(07):842-847.
廖诗语,伍琳,陈永法.美国药品调剂服务收费制度研究及其对我国的启示 [J].中国药房,2026,37(07):842-847. DOI： 10.6039/j.issn.1001-0408.2026.07.03.

LIAO Shiyu,WU Lin,CHEN Yongfa.Study on pharmacy dispensing fee system in the United States and its implications for China[J].ZHONGGUO YAOFANG,2026,37(07):842-847. DOI： 10.6039/j.issn.1001-0408.2026.07.03.

摘要

目的

借鉴美国药品调剂服务收费实践经验，为我国药品调剂服务收费方案设计提供参考。

方法

检索相关文献及官方网站，系统梳理美国药品调剂服务的收费历程、不同医疗保险计划的收费方式及标准、收费考量因素，总结其收费特点，对我国完善相关工作提出建议。

结果与结论

美国药品调剂服务收费制度历经理念萌芽、模式探索、制度建立与专业化发展4个阶段，逐步形成独立于药品价格、以处方为单元的收费方式。各类医疗保险计划在联邦政府的统一框架下，依据真实调剂成本并结合药品类别、药房类型、处方量及政策目标等因素制定差异化调剂收费方案，以体现药师专业价值并保障调剂服务可持续供给。我国虽已在国家层面认可药品调剂服务收费，但仍面临价值认知不足与医疗保险支付压力双重落地障碍。建议借鉴美国经验，结合我国国情，加强药品调剂服务价值评估实证研究助力医疗保险决策；统一药品调剂服务成本测算口径，并结合药师专业技术价值与公共利益，明确收费标准制定依据；以省份为统筹、以处方为单元探索差异化收费方案，注重突出专业技术、调剂风险等；辅以持续强化药师专业能力建设，从而实现药品调剂服务收费政策的科学制定与合理落地。

Abstract

OBJECTIVE

To draw upon the United States’ experience in charging for drug dispensing services and provide reference for designing China’s fee scheme for such services.

METHODS

Relevant literature and official websites were reviewed to systematically summarize the evolution of dispensing fees in the U.S.， charging methods and standards across different health insurance plans， and factors influencing fee determination. The key characteristics of the U.S. fee system were summarized. Recommendations for improving China’s related practices were then proposed.

RESULTS CONCLUSIONS

The U.S. dispensing fee system has undergone four stages of conceptual emergence， model exploration， system establishment， and professional development， forming a prescription-based charging model independent of drug prices. Under a unified federal framework， health insurance programs set a differentiated dispensing fee system based on actual costs and factors such as drug category， pharmacy type， prescription volume， and policy objectives， reflecting pharmacists’ professional value and ensuring sustainable service provision. Although China has recognized dispensing fees at the national level， implementation still faces barriers including insufficient value recognition and pressure on medical insurance payment. Drawing on U.S. experience and considering China’s national context， it is recommended to strengthen empirical research on the value assessment of dispensing services to support medical insurance decision-making； standardize the methodology for dispensing cost measurement and clarify the basis for fee setting by incorporating pharmacists’ professional and technical value as well as public interests； explore differentiated charging models at the provincial level with prescriptions as the basic unit， with emphasis on professional expertise and dispensing risks， and continuously strengthen pharmacists’ professional capacity to facilitate the scientific formulation and effective implementation of dispensing service fee policies.

关键词

Keywords

references

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