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本文概述了世界主要发达国家药品价格制度、保险偿还和病人负担的情况，并着重介绍了德国为遏制药费持续增长而采用的参照价格制度。参照价格制度虽然一时性遏制了德国药费增加的趋势，但实际上只起到最高限价的作用，不利于市场自由竞争，并未取得预期的效果。并且在制订参照价格时药品归类未必合理，确定有效成分平均日用量极其困难，从而使参照价格不可能正确反映药品效能与价格的关系。
This article provides an overview of the drug pricing system, insurance reimbursement and patient burden in the world’s major developed countries and highlights the reference price system used by Germany to curb the continued growth of drug prices. Although the price system temporarily contained the trend of increasing drug fees in Germany, it actually played the role of the ceiling price and was not conducive to free competition in the market and did not achieve the expected result. And when formulating the reference price, the drug classification may not be reasonable. It is extremely difficult to determine the average daily dosage of the active ingredients, so that the reference price can not correctly reflect the relationship between the drug efficacy and the price.