中国药品集中采购的演变以及与医保支付的逻辑关系

本文主要通过政策梳理和文献回顾的方法,详细阐述了药品集中采购政策的发展演变及其与医保支付的逻辑关系。文章首先梳理了药品集中采购的三个发展阶段,并分析了当前药品集中招标采购的特点和趋势;进而重点探讨了药品集中采购与医保支付体系的关系以及两者配套改革对于解决药品问题的现实可行性。研究认为,药品集中招标采购已经演变为省级平台限价下的议价、最低价联动采购方式;药品集中招标采购可为医保支付标准的形成提供依据,但国家药品谈判以及省级医保特药谈判存在功能重叠;药品招标采购、医保支付等制度安排可助推医药分开,配套相关改革可为解决"药价虚高"提供一种思路。

The evolution of the Chinese centralized drug procurement and its logical relationship with medical insurance payment

In this study,the evolution of the centralized drug procurement policy and the logical relationship between drug procurement policy and medical insurance payment policy were explored by means of policy and literature review.This paper first examined the three stages of the centralized drug procurement policy,and especially analyzed the characteristics and trends of the current centralized bidding of drugs.Focus was put on the relationship of between the centralized drug procurement and medical insurance drug payment were then explored,and the practical feasibility to solve the drug problem with the help of supporting reforms of the above two systems.As a result,the study found that centralized drug bidding procurement has evolved into negotiation and the lowest price linkage procurement method under the price control of the provincial platform and it could also provide the basis for the formation of medical insurance payment standard of generic drugs.But the functions of National Drug negotiations and the Provincial Health Insurance negotiations overlapped.Fortunately,the drug bidding procurement,medical Insurance payment and other related institutional arrangements could promote the separation of pharmacy from medicine which is likely to provide a solution to the issue of unrealistic drug prices with the support of other coordinated sets of reforms.