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以真实世界数据驱动医保治理变革
Sou Hu Cai Jing· 2025-09-30 10:32
Core Insights - Real World Data (RWD) is becoming a crucial engine for reshaping healthcare decision-making and promoting high-quality development in the medical industry [1][2] Summary by Sections RWD as a Policy Basis - Traditional healthcare policy relies on Randomized Controlled Trials (RCTs), which have limitations in population coverage and fail to reflect the multidimensional value of drugs. RWD addresses these issues by providing comprehensive data from various sources, including electronic health records and insurance claims [2] - RWD has three core advantages: broad population coverage, rich data dimensions, and continuous time span, allowing for dynamic tracking of patient treatment trajectories and long-term safety data [2] Empowering the Healthcare Industry - RWD can resolve challenges such as stalled drug development for rare diseases and inefficient chronic disease treatment plans due to lack of data support. It enhances the entire healthcare process by breaking down data barriers and providing real-world insights [5] - In drug development, RWD allows pharmaceutical companies to gather data on drug effectiveness and safety across diverse populations, accelerating the drug development process and increasing success rates [5][6] Clinical Application and Payment Decision - RWD aids in identifying clinical gaps and standardizing services, enabling healthcare institutions to improve treatment processes and service quality [6] - In payment decision-making, RWD quantifies the real value of drugs and services, serving as a scientific benchmark for healthcare funding allocation and optimizing resource distribution [6] Releasing Maximum Value from RWD - To fully leverage RWD, efforts must focus on data governance and the establishment of evaluation systems. A unified healthcare information platform has been created, but further development of a real-world database and standardization of data is necessary [8] - An evaluation mechanism centered on RWD should be established, covering three key stages: pre-market comprehensive value assessment, post-market entry evaluation, and ongoing re-evaluation of drugs within the healthcare system [9] Current Status and Future Directions - While significant progress has been made in applying RWD in healthcare decision-making, challenges remain, including data sharing mechanisms, analytical capabilities, and privacy concerns. Continuous efforts are needed to build a robust RWD-based decision support system [9][10]