作为国家医改的重要内容,政府有关部门和社会各界都在积极探索解决中国药品流通环节过多、药价虚高等问题。然而历经数年,诸多相关问题至今并未得到有效解决。相反,社会对这些问题的反应似乎越来越强烈。在中国药品流通环节中,药品生产、经营基本由市场决定,而药品流通终端则涉及较多的垄断和非市场化干预,公立医疗机构销售了市场85%的药品。在这样的流通格局下,政府出台多项相关政策,特别是药品集中招标采购政策和医疗机构药品加价政策,试图推进药品流通体制改革,旨在解决药价虚高带来的过度用药、以药养医、医疗费用过高等问题。本文从经济激励机制的分析视角,基于中国当前药品市场的实际状况,对药品流通的相关政策及其影响进行系统分析,希望为政府决策部门进一步改革和完善相关工作提供科学依据。
<<As an important content of national health care reform,the relevant government departments and different sectors of the society actively explore the solution to solve the problems such as there are too many intermediate links in China’s drug circulation and drugs have illusory high prices. After several years,however,many related problems so far have not been solved effectively. On the contrary,the response of society to these questions seems to be worse. In drug circulation in China,drug production and management is basically determined by the market,but medicine circulation terminal involves more monopoly and non-market intervening,public medical institutions sell 85% drugs of the market. Under this pattern of circulation,the government established many policies,especially the drug centralized bid procurement policy and medical institutions drug price increase policy,trying to promote the reform of the drug circulation system,aimed at solving the problems caused by artificially high drug prices involving excessive medication,drug-maintaining-medicine and high health care costs. In this paper,from the perspective of the analysis of economic incentive mechanism,based on the actual condition of China’s current drug market,systematically analyze the related policy and its effect of the drug circulation,with the respect for providing the scientific basis for government decision-making departments to launch further reform and improve the relevant work.
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