CHINA PH ARMACY Volume 33，Number 10，May 30，2022 Semimonthly Table of Contents Effect evaluation of comprehensive drug cost control in China based on the entropy method-cluster analysis / 中国药房

OBJECTIVE To evaluate th e effects of comprehensive drug cost control in China ，and to provide reference for further improving the effects of cost control. METHODS Entropy method was used to establish a comprehensive evaluation index system of the comprehensive drug cost control effect from the respective of drug price control ability ，drug cost control ability and patient affordability. The comprehensively evaluate the effects of drug cost control in 31 provinces （autonomous regions and municipalities）during 2016-2020. The k-means cluster method was used to analyze the effects of comprehensive drug cost control in various provinces. RESULTS & CONCLUSIONS During the period of 2016-2020，the total score of comprehensive drug cost control effect of 31 provinces were 14.64，16.71，17.58，17.57，17.88，respectively. The results of cluster analysis were similar to the ranking of entropy method. Medical and health system reform policy had entered a stable period after achieving phased results ； the effects of comprehensive drug cost control was characterized by regional steps in 31 provinces；the effects of comprehensive drug cost control were better in developed coastal areas and some provinces and cities of western regions ，followed by provinces and cities in central China ；however，comprehensive drug cost control in 3 provinces of northeast China showed poor effect. The effects of comprehensive drug cost control in pilot cities of comprehensive medical reform were significantly improved. It is suggested that the successful experience of pilot cities of comprehensive medical reform should be promoted nationwide ，and policies such as volume-based drug procurement ，medical insurance drug price negotiation ，and diagnosis-related groups / diagnosis-intervention packet payment method reform should be further deepened.

Study on disabled grade assessment scale for long-term care / 重庆医学

Objective To explore the establishment of disabled grade assessment scale for long-term care insurance (LTC).Methods Based on the results of literature review and long-term care needs survey,an initial scale of disabled grade assessment was formulated,then the Delphi method was combined to conduct the consultation on 22 specialists.Results After two rounds of expert consultation,the unanimous disabled grade assessment scale included four first-class indexes of sensation perception,daily activity ability,recognition ability and emotion behavior,the importance mean (M) was 4.64-5.00 points,which ≥4.0 points,the variable coefficient (CV) was 0.00 ％-13.86 ％,which ≤25 ％,the full mark rate (Fr) was 72.73 ％-100.00 ％,which ≥50 ％,recognition rate (Ar) was 90.91％-100.00％,which ≥80％,which indicated that the experts reached a consensus opinion.Among the 22 second-class indexes,the M was 4.27-4.95 points,which ≥4.0 points,CV was 4.20％-25.62％,Fr was 63.64％-95.46％,Ar was 77.27 ％-100.00 ％.The two items of touch sense and getting up from sitting position were newly added,the transferring of table and chair,recent memory and procedural memory were modified into sitting down on the bench and chair,immediate memory and short term memory,the experts reached the consistent opinion.Conclusion The replenished and modified disabled grade assessment scale for LTC has higher authority and expert consistency,which can provide a theoretical reference for the disabled grade assessment work of LTC.

Supervision System on Drug Post-marketing Research in America and Its Enlightenments to China / 中国药房

OBJECTIVE:To put forward suggestions for improving the supervision of phase Ⅳ clinical trials in China. METH-ODS:According to summarizing the post-marketing research in America,FDA's supervision(including key elements,supervision flow,auxiliary supervision system and enforcement measures)for drug post-marketing research in America was analyzed,and sug-gestions for the supervision of phaseⅣclinical trials in China was put forward. RESULTS&CONCLUSIONS:The drug post-mar-keting research in America included post-marketing commitment research(PMR)and post-marketing requirement research(PMC). The key elements included supervision subjects(dealt by Office of New Drugs affiliated to Drug Evaluation and Research Center), key document (including the documents helping FDA and applicants reached a research agreement,and documents for process tracking and supervision in identified studies)and important time node. The supervision flow included developing drafts and review-ing reports. FDA had established PMC/PMR database,which was used as auxiliary supervision system,and relevant enforcement measures were respectively developed for PMC and PMR. Relevant supervision departments in China should converse the supervi-sion ideas,give full play to the government's guidance and supervision,enhance the connection of supervision between pre- and post-marketing,specially develop phase Ⅳ clinical program,establish system for phase Ⅳ clinical trial data,enhance whole pro-cess supervision,draw lessons from"pre-process plan,dynamic tracking in the process,and post-process decision according to law"of FDA to improve the supervision of phaseⅣclinical trials in China.

Empirical Research on Influencing Factors of the Inpatient’ Actual Reimbursement Rate under the Urban Employee Basic Medical Insurance / 中国卫生经济

To discover factors affecting the inpatient’ actual reimbursement rate of urban resident basic medical insurance ( URBMI ) . Methods: Using the method of correlation analysis and multiple stepwise regression modeling to identify the influencing factors. Results: The per capita funding criteria, rate of inpatient out of pocket payment over resident annual per capita disposable income and per capita hospitalization rate have significant effect on the actual reimbursement rate of URBMI. Conclusion: It is needed to establish a sustainable steady financing mechanisms for URBMI, improve the evaluation system of reimbursement policy and gradually raise the level of actual reimbursement.

Evaluating the Compensation Level of Urban Basic Medical Insurance in Jiangsu / 中国卫生经济

Objective: To evaluate the compensation level of the Urban Employee Basic Medical Insurance ( UEBMI ) and Urban Resident Basic Medical Insurance ( URBMI ) in Jiangsu province . Methods: Take catastrophic health expense as the bottom line of compensation ratio for the basic medical insurance, the benefit of hospitalization expenses of those joining the insurance as the actual line of compensation ratio, and quartile division was used to comparatively analyze the differences between the bottom line of compensation ratio and the actual line of compensation ratio. Results: Take 10%as the critical value of catastrophic health expense, the actual line of compensation level is higher than the bottom line of compensation level in UEBMI, and there is reverse in URBMI. Conclusion: In some extent, the compensation level of UEBMI has relieved the economic burden of the poor jointed group because of sickness, while limited compensation level of UEBMI is in need of further improvement.