WTO药品报销“第一案”——“土耳其药品案”及其对中国的启示

“The First Case”of WTO Drug Reimbursement--“Turkey-Pharmaceutical Products Case”and Its Enlightenment to China

2022年7月25日公布仲裁裁决的土耳其药品案,是DSU第25条上诉仲裁“第一案”,也是涉及药品报销制度的WTO“第一案”。该案专家组和上诉仲裁庭裁定土耳其政府报销私人药店所售药品不构成政府采购,本地化措施也不符合GATT1994第20条(b)项公共健康例外。上诉仲裁庭纠正了专家组的一项错误法律解释,尊重专家组的事实认定,但本案仍有许多法律解释和适用问题有待澄清和完善。土耳其药品案给中国带来如下启示:关注WTO规则对医疗体制改革的规制和影响;供应链韧性建设必须遵守WTO规则;可以合理利用WTO政府采购豁免确保国内供应链安全,但应避免设置超出豁免范围的歧视性附加条件。

The Turkey-Pharmaceutical Products case,which promulgated the arbitral award on July 25,2022,is the first case making use of appeal arbitration under Article 25 of DSU and the first case concerning pharmaceutical reimbursement system.The Panel and the Arbitrators of this case both ruled that the reimbursement by the Turkish government for medicines sold in pharmacy did not constitute government procurement and that the localization measures was not conformity with the public health exception under Article 20(b)of GATT1994.The Arbitrators corrected a wrong legal interpretation developed by the Panel and substantially respected the fact finding of the Panel.There are still many legal interpretations and application issues that need to be clarified and improved.This case brings the following enlightenments to China:paying attention to the regulation and impact of WTO rules on the reform of medical system,the building up of supply chain resilience should be compatible with WTO rules,reasonably making use of government procurement derogation of WTO to ensure the security of domestic supply chain,and avoiding setting discriminatory additional conditions beyond the scope of the government procurement derogation of WTO.