制度供给释放医疗创新活力

国家医保局不久前印发通知，试行医疗服务价格项目预立项制度，新技术、新产品在获得批准之前先进行储备，待正式获批后可迅速进入收费范围。该措施缩减了落地空窗期，稳定了产业预期，使群众更早得到优质的诊疗服务。其意义不仅在于价格管理环节，更在于用制度供给回应创新需求，打通科技惠民的“最后一公里”。

价格预立项是医疗新技术领域机制创新的一个缩影，通过政策前置、规则重塑、流程再造把支持节点前移，把不确定性降下去、转化效率提上来。近年来，我国持续推进医疗领域改革，不断完善医疗新技术审批、准入、应用等配套政策，医疗创新转化效率持续提高。但从整体而言，医疗新技术制度创新还存在碎片化、滞后化的现象。研发、审批、定价、临床应用各阶段的政策衔接不畅，缺少全周期、系统化的支撑机制。一些前沿技术研发周期长、投入大、不确定性高，企业及医疗机构存在创新投入回报不明的问题，一定程度上也影响了医疗创新活力的充分释放。

好技术等不起，患者更等不起。未来，应多措并举，利用系统集成的制度创新打通堵点。

强化协同。建立跨部门、跨领域前置服务机制，使医保、价格、审评、伦理、采购等政策工具尽早介入创新链条。对突破性疗法、急需器械等进行分类评价、清单管理，促进数据共享、结果互认。价格预立项的一大启示就是政策不能等到产品完全成熟后再排队，而是要提前研究、储备，给出稳定的预期，降低制度性交易成本，使有临床价值的医疗创新少走弯路。

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完善激励。医疗新技术若要用得起、用得上，就需解决医院是否敢用、医生是否愿用、患者能否承受的问题。可健全创新技术成本补偿和绩效评价机制，完善医保支付、商业保险、风险分担等安排，探索首台(套)、首批次应用支持政策。对于临床价值明显的技术，可依托真实数据动态调整价格和支付标准，形成合理的回报预期。

厚植生态。医疗新技术的行稳致远要依靠数据、人才、平台和审慎监管。可推进伦理审查互认、临床数据规范共享、科技成果转化收益分配等改革，建设一批概念验证、中试熟化和临床研究平台。监管上，坚持包容审慎和动态退出并重，给创新留出空间的同时守住安全底线。区域间加强协同，防止重复建设、一哄而上，推动成熟技术向基层规范推广。