药品患者援助项目的模式梳理与“共建式慈善”路径综述

A review of patient assistance program models toward a collaborative philanthropy pathway

摘要

当前我国疾病负担加重，医保保障能力有限，药品慈善救助已成为多层次医疗保障关键补充。文章梳理了国内外药品患者援助项目的发展与典型模式，在分析美国多品种打包援助、英国国家医疗服务体系下患者支持、德国法定医保下的企业补充服务及澳大利亚全民药品福利计划等国际经验基础上，归纳了我国共助、全额免费与资金援助三类主流模式的实施特点。进一步聚焦国内药品捐赠中“慈善”与“促销”边界模糊的现实困境，揭示其制度与操作层面的深层矛盾。提出以“共建式慈善”作为协同治理的创新路径，通过推动多方联合捐赠、构建药品资源池及完善政策支持体系，提升药品可及性，强化公益属性，为我国药品慈善体系的优化与创新提供理论参考。

Abstract

With the rising disease burden in China and limited medical insurance coverage, the patient assistance program (PAP) has become a crucial supplement to the multi-level medical security system. This paper systematically reviews the development and typical models of patient assistance programs (PAPs) domestically and globally. Building on analyses of international experiences, including the U.S. multi-product bundled assistance, patient support under the UK’s National Health Service (NHS) system, corporate supplementary services under Germany’s statutory health insurance, and Australia’s Pharmaceutical Benefits Scheme (PBS), the paper summarizes the implementation characteristics of three mainstream models in China: co-assistance, free drugs, and financial aid. The paper further examines the practical dilemma in domestic drug donations of blurred boundaries between charitable intent and marketing objectives, revealing underlying contradictions at both institutional and operational levels. Accordingly, the paper proposes collaborative philanthropy as an innovative path for collaborative governance. By promoting multi-source joint donations, establishing a centralized drug pool, and improving the supporting policy system, the approach aims to enhance drug accessibility and strengthen the public interest attributes of PAPs, thus providing a theoretical reference for the optimization and innovation of China’s pharmaceutical charity system.

关键词

药品 / 患者援助项目 / 慈善赠药 / 共建式慈善

Key words

drug / patient assistance program / charitable donations / collaborative philanthropy

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基金资助

安徽省高校哲学社科优秀科研创新团队“基层健康协同治理研究”(2023AH010036)

安徽医科大学医院管理研究所“国医科技”开放项目(2023jykj06)