美国药品调剂服务收费制度研究及其对我国的启示

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中图分类号R95 文献标志码A 文章编号 1001-0408（2026）07-0842-06

DOI 10.6039/j.issn.1001-0408.2026.07.03

Study on pharmacy dispensing fee system in the United States and its implications for China LIAO Shiyu，WU Lin，CHEN Yongfa（School of International Pharmaceutical Business，China Pharmaceutical University，Nanjing ，China）

ABSTRACTOBJECTIVETodraw upontheUnited States’experience incharging fordrug dispensing servicesand provide referencefordesigning China’sfe schemeforsuchservices.METHODSRelevantliteratureandoficial websiteswerereviewed to systematicallysummarizetheevolutionofdispensingfeesintheU.S.，chargingmethodsandstandardsacrossdifferenthealth insuranceplans，andfactorsinfluencingfeedetermination.ThekeycharactersicsoftheU.S.feesystemweresummarized. Recommendations for improving China's related practices were then proposed. RESULTS & CONCLUSIONS The U.S.dispensing feesystemhasundergonefourstagesofconceptualemergence，modelexploration，systemestablishment，andprofessional development，formingaprescription-basedcharging modelindependentofdrug prices.Underaunified federalframework，health insuranceprogramssetadiferentiateddispensingfeesystembasedonactualcostsandfactorssuchasdrugcategory，pharmacy type，prescriptionvolume，andpolicyobjectives，reflectingpharmacists’profesionalvalueandensuringsustainableservice provision.AlthoughChinahasrecognizeddispensingfesatthenationallevel，implementationstillfacesbarrersincluding insuficientvaluerecognitionand presureonmedical insurance payment.Drawingon U.S.experienceandconsidering China’s nationalcontext，itisrecommendedtostrengthenempiricalresearchonthevalueasssmentofdispensingservicestosupport medicalisurance decision-making；standardizethe methodologyfordispensingcostmeasurementandclarifythebasis forfee setingbyincorporatingpharmacists’profesionalandtechicalvalueasellaspublicinterests；exploredierentiatedchaging modelsattheprovinciallevelwithprescriptionsasthebasicuit，withemphasisonprofesionalexpertiseanddispesings，and continuouslystrengthenpharmacists’professonalcapacitytofacilitatethescientificformulationandefectiveimplementationof dispensing service fee policies.

KEYWORDSdrug dispensing；dispensing fees；value assessment； charging system； pharmaceutical services

2023年9月，《全国医疗服务项目技术规范（2023年版）》（以下简称《项目技术规范》首次纳入药师门诊诊察、处方/医嘱药品调剂、住院患者个性化用药监护3项药学服务项目，从国家层面正式认可和补偿药学服务价值。（剩余13131字）