我国基本药物集中采购量价挂钩实施影响因素分析

目的:为完善我国基本药物集中采购工作和量价挂钩政策提供建议。方法:搜集基本药物集中招标采购文件和文献,结合文献研究和半结构化访谈法设计调研问卷。通过问卷调研和电话访谈,分析我国基本药物集中采购中量价挂钩政策实施相关影响因素。结果:量价挂钩定义需明确药品的剂型和规格,其主要影响因素有:采购区域范围、采购的药品类别、疾病与药品替代性、采购方式、采购周期、回款时间和结算方式、采购过程中的违规行为。建议:实施量价挂钩,需明确预测采购数量的主体和方式、营造量价挂钩价格合理形成的政策环境,取消药品中标价联动机制,严格执行回款期限、统一结算方式,加强省级药品采购平台的信息化建设,并做好部分药品量价挂钩试点工作,为量价挂钩的推广奠定基础。

Influencing factors of quantity-based pricing in the essential medicines' centralized bidding procurement in China

Objective: The paper aims to provide recommendations for improving the essential medicines' centralized bidding procurement and quantity-based pricing policy. Methods: Based on the documents and literature on essential medicines' centralized bidding procurement, we analyzed the factors which have a great impact on implementation of the quantity-based pricing in essential medicines' centralized procurement using the text research, semi-structured interview questionnaire and on-phone interviews. Results: The quantity-based pricing needs to define a generic name and specific dosage form of drugs in the essential medicines' centralized procurement. Its implementation was mainly influenced by the following factors: the procurement area accessibility, the pharmaceuticals category, disease and drug alternative procurement methods and cycle, the payment and settlement time, and irregularities in the procurement process. Suggestions: During this implementation, we also need to clearly predict the quantity and procurement method, set up a proper policy environment for a quantity-based pricing, cancel the price linkage mechanism, strictly put into practice the payment deadline, employ a unique billing method and strengthen the information construction for the provincial centralized procurement platform. Some medicines' quantity-based pricing should be carried out in the chosen pilots for laying a good foundation for its promotion.