医院“以药养医”不改变,药品降价措施效果难以惠及患者:以医院头孢类药品使用为例

Patients can hardly benefit from the government's drug price reduction policies:analysis of hospitals' cephalosporin using during top 100 medical prescription drugs from 2000 to 2008 in Shanghai Take cephalosporin drugs as an example

目的:分析上海地区样本医院购药前100位中的头孢类药品用药现况,反映降价措施下医院头孢类药品用药的变化趋势;方法:对2000-2008年长江流域用药系统上海地区样本医院购药前100位中头孢类药品销售额、销售额占抗感染类药品比例、销售数量、加权价、剂型规格以及同药品同剂型同规格不同价位药品销售情况等进行统计分析;结果和讨论:单纯的药品降价政策下,医院通过追求并使用高价品种、高价剂型和规格等用药行为,使得单纯的药品降价政策难以惠及百姓。在此情况下,唯有实施支付方式改革如总额预付制的引入,激发医院的主动节约成本意识,有效切断医疗机构与药品之间的经济关联,方能从根本上解决药价虚高等问题,恢复药品市场的正常秩序,实现医院和药品领域的双赢。

Objectives： To analyze hospitals＇ cephalosporin using in the top 100 medical prescription drugs from 2000 to 2008 in Shanghai and specify the impact of drug price reduction policies on hospital＇ s cephalosporin buying and using. Methods： Analyze the sales amount, weighted price, dosage forms, and specification of cephalo- sporin of the top 100 medicines that hospitals purchased during 2000-2008 in Shanghai. Results and discussion： Drug price reduction policies can not reduce the cost burden of drugs, Only through the implementation of payment re- forms, the introduction of total pay in advance, stimulate the hospital to save costs actively and cut off the association between health care institutions and drug revenues effectively, can solve the problem of over-high drug prices and restore the normal order of the pharmaceutical market.