药品上市决策中的多方利益博弈

Game Analysis on Muti-stakeholders in the Listing Decision of Drugs

目的:为政府处理好药品的社会属性和商业属性之间的关系提出建议。方法:通过建立博弈模型,研究药品上市决策中多方利益主体及相互关系。结果与结论:明确了医药产业的创新程度P、药品经营者的盈利率E、影响药品经营者收益的其他因素K、药品的额外镀金成本C1、镀金药品的额外销售成本C2等因素是影响药品生产企业进行药品上市决策的关键因素,并建议政府从加大政策倾斜、鼓励药品创新、对医疗机构销售药品实行差别加价率、优化医疗机构效益组成、鼓励临床合理用药、制定药品"上市价值"与"临床必需性"评价规范等方面保障人民合理、公平用药。

OBJECTIVE： To provide proposal for government on dealing with the relationship between commercial and social property of drugs.METHODS： Multi-stakeholders subjects and their interrelation in the listing decision of drugs were investigated using game model.RESULTS CONCLUSIONS： Innovation level of pharmaceutical industry （P）,profitability of drugs operator （E）,other factors affecting the proceeds of drug operators （K）,additional gold cost of drugs （C1）,additional cost of gold drugs sale （C2） were confirmed to be the key factors which affected the listing decision of drugs by pharmaceutical manufacturers.Governments are suggested to ensure the rational and fair use of drugs in public by policy supports,encouraging drug innovation and make-up on difference of drugs in medical institutions,optimizing benefit components of medical institutions,creating evaluation criteria for ＂listing value＂ and ＂necessity in clinic＂ of drugs.