药品集中采购政策对药品价格和使用影响的系统综述

目的：评价国家组织药品集中采购和使用政策对药品价格及用量的影响。方法：采用系统综述的方法检索中国知网、万方、维普、EMbase、PubMed和Web of Science六个数据库，提取和分析有关集采政策的实证研究结果。结果：本研究共纳入58篇文献，大多数文献发现集采政策实施后中选药品的限定日费用(DDC)明显下降，同类非中选药品的DDC也出现下降。同时，仿制药品的用药频度(DDDs)整体上大幅度增长，实现了对原研药部分国产替代。但是，集采政策的实施效果也存在一定的地区差异，部分药品出现了“量价脱钩”现象，需要进一步加强和完善。结论：基于对已有实证研究效果的总结评价，集采政策已经初步达到了其政策预期的效果，建议继续推进低价优质药品均等化，并加大政策宣传和药品质量与价格监管力度。

A systematic review on the impact of the volume-based procurement policy on prices and dosages of drugs

Objective: To evaluate how the volume-based procurement policy influences prices and dosages of drugs. Methods: The data indicating empirical evaluation results of centralizing drug procurement from databases of CNKI, WanFang Data, VIP, EMbase, PubMed, and Web of Science were obtained and analyzed by using a systematic review approach. Results: Among 58 studies included,the majority showed a significant decrease the defined daily cost (DDC) of the selected drugs after the implementation of the volume-based procurement policy, together with a decrease in DDC of non-selected same kinds of drugs. Meanwhile, the defined daily doses (DDDs)of generic drugs increased in a big scale in general, which indicated the domestic replacements of some originally-developed drugs. However, there existed regional differences in terms of effects of the policy,and there were misconnections between quantities and prices of certain drugs that need to be regulated. Conclusion: According to previous empirical findings, the policy of central government purchasing drugs collectively realizes initial expectations. Further suggestions include promoting equalization of low-priced high-quality drugs, strengthening publicity of policies, and enforcing the supervision of drug quality and price.