对药品采购实施两票制的分析与思考

长期以来，“医药合业、以药补医”的体制虽然在特定历史阶段促进了我国医药卫生事业的快速发展，但也为“看病难、看病贵”的顽疾埋下了体制性成因。深化医药卫生体制改革选择以改革公立医院药品采购方式、整肃和重建医药生产流通秩序作为切入点和突破口，对药品实行分类采购，属于挂网集中采购的药品在医改省市实施“两票制”，压缩过多和相对无序的商业流通环节。作为降低药品流通成本、破除药价虚高的有益探索尝试，从源头上治理长期困扰医药卫生行业的药价虚高、商业贿赂屡禁不止等问题，以促进医药流通兼并整合。

Analysis and thinking of two-vote system implemented in drug procurement

For a long time, the rapid development of health care enterprise in our country was promoted by the system of“integration of pharmaceutical industry with medicine to complement medicine with drug sale”in a certain historical period, but the ills of“dififcultly and expensively to see a doctor”were also planted due to the institutional causes. Deep reform of the health care will take the way of drug procurement implemented in the reformed public hospitals and the purge and reconstruction of pharmaceutical production and circulation order as an entryway and breach so as to carry out the category procurement of drugs and to implement“a system of two votes”for the drugs of online centralized purchase in the provinces and municipalities with health care reform to reduce relatively excessive and disordered links of commercial circulation. The artificially higher drug prices, the repeated commercial bribery and other issues plagued the medical and health industry for long time will be fundamentally eliminated as a useful exploration to solve those issues so as to promote the mergers and integration of medicine circulation.