解决药品市场混乱的宏观策略研究

文章依据政策制定科学化程序，在逻辑推论“药品市场混乱”的直接相关因素和间接促发因素基础上，总结出药品市场混乱问题的根源和作用机制模型，即医疗机构补偿机制恶性循环模型，针对根源研制并论证了相应的政策思路模型，即医疗资源最优利用模型。提出实施该政策思路并能取得成效的前提条件是在政府统一的领导下，各有关部门通力协作，总结出从医疗机构入手，解决药品市场混乱政策思路实施的逻辑顺序依次为：控制药品费用总量；逐步控制药品毛利，摆脱医疗机构对药品的依赖性；加强药品市场的管理，完善市场“游戏规则”并研制了各相应步骤中的关键技术。逻辑推论的政策方案实施效果的评价表明，上述政策思路具有科学性、合理性和可操作性，政策方案切实可行。

Study of the macro-strategies regulating the chaotic drug market

In light of the scientific procedure of policy making and based on the logical deduction of direct and indirect factors related to the chaotic drug market, the authors found the root of the chaos, viz. The mechanism of reimbursement ofr medical institutions that formed a vicious circle. Inview of the root, a policy model was developed and verified, viz. The optimal utilization of medical resources. The prerequisite condition to the implementation and success of the policy is the exertion of concerted efforts by various departments concerned underthe centralized leadership of the government. And it has been proven by experience that to tackle the chaos of the drug market it is necessary to start with medical institutions and the logical order of the steps to be taken to carry out the policy is as follows: control of the total drug expenses, gradual control of the gross profit from drugs, extrication of medical institutions from their dependence on drugs, improvement of the management of the frug market,perfection of the "rules of game" of the market, and development of key techniques for each procedure. Evaluation of the results of the implementation of the policy indicates that the policy is scientific, rational and easy to operate and the steps are feasible.