对国家基本药物集中采购价格政策的逆向思考与建议

目的解析基本药物集中采购过程中存在主要问题及其原因,并针对价格问题提出有效的解决方案,以确保基本药物的质量与正常供应,有效降低患者负担,保障患者用药安全。方法对6家三级医院的基本药物集中采购实施情况进行调查,对存在主要突出问题进行归纳分析,找出其内在原因并提出相应解决方案。结果基本药物集中采购工作进展较顺利,但在实施过程中也存在因实行最低价中标原则导致部份产品价格过低而产生药品质量与药品供应难以保障等诸多问题。结论基本药物集中采购的价格政策不能简单地以最低价中标,而应当科学地、全面地分析制定策略。建议实行平均价格区间内低价中标,适当放宽差率控制,既能降低药品价格,也能避免恶性竞争,药品质量和生产供应也得到保障,同时医疗机构也愿意更多地使用,从而真正减轻患者负担,缓解看病贵的难题。

The opposite thought and advice for the price policy of centralized purchasing in national essential drugs

Objective To analysis the major problems and the causes in the process of centralized purchasing of national essential drugs,and to give some effective solutions according to the price problems for ensuring the quality and regular supply of national essential drugs,decrease patients burden effectively and safeguard the medication safety of patients.Methods The implementation of centralized purchasing of national essential drugs was investigated,the problems which were major and outstanding were analyzed to find out the internal causes and the effective solutions were given.Results The progression of centralized purchasing of national essential drugs was successfully in general.The implementation of the principle of winning of the bidding with the lowest bid price lead to excessive low price,which caused some problems such as lower quality or bad supplied of some national essential drugs.Conclusion The price policy of centralized purchasing of national essential drugs should not be instituted based on the lower price,more winning of biddings.It needed more scientific and overall perspective thoughts.It maybe solve the problems mentioned above by winning of the bidding with the lowest bid price in the interval average price,appropriately loosing the control of difference rate with the results of decreasing the drug price,avoiding cut-throat competition,ensuring the quality and supply of drugs,lightening the patients’ burden,releasing the problem of high cost of getting medical treatment.