基本药物集中招标采购政策的实施效果

目的：分析基层医疗卫生机构基本药物集中招标采购政策实施效果。方法：以安徽省、河南省和重庆市为样本地区，采用定量与定性相结合的研究方法，从基本药物价格、质量和配送等方面进行改革前后和地区之间的比较分析。结果：改革后三省市基本药物中位价格比值和人均每日费用降低，以安徽省和河南省的价格降幅较为明显；大部分医务人员认为改革后药品质量得到提升，但安徽省药品质量满意度相对较低；基本药物配送率均较高，但存在地区差异。结论：“双信封”制在降低药品价格上有优势，重庆市组建采购联合体的做法有利于有资质的药品生产企业中标，但总体上兼顾质量和价格是完善评标机制的挑战；基本药物配送受货源提供及配送方式影响。建议：完善药品限价机制，合理确定招标方式，保证药品生产企业的供应能力，加强对基本药物配送方式的监管。

Effect on implementing essential medicine centralized bidding and purchasing policy

Objective ：In this paper, we study the effects of implementing centralized bidding on and purchasing of essential medicine. Methods： We sample primary medical and health institutions in Anhui, Henan, and Chongqing. Quantitative and qualitative methods were used for data collection, and we evaluated price, quality, and distribution of essential medicine. Results： The MPR and per-capita cost per day reduced after the reforms especially in Anhui and Henan provinces. Medical staff thought that the quality of some essential medicine had improved after reform, but An- hui province was in relatively poor condition. The delivery rate in all three provinces was high; however, in some places, there was bias when selecting high-priced drugs and low-priced drugs. Conclusions： ＂Double envelope＂ bid- ding significantly reduces drug prices. The purchasing consortium method in Chongqing was propitious to well-qualified pharmaceutical manufacturers. However, balancing quality and price was a challenge. Distribution was affected by supply and distribution mode. Suggestions： We suggest improving the drug price mechanism, determining the bidding mode, en- suring the supply capacity of drug manufacturers, and strengthening the supervision of essential medicine distribution.