医院追求高价药巍然成风,降价药品百姓难以见面:以2000-2008年上海市医疗机构青霉素使用为例

Patients hardly benefit from drug price reduction and hospital following higher price drugs:An analysis on penicillin prescriptions from 2000 to 2008 in Shanghai

通过对2000-2008年上海样本医院购药前100位中青霉素类药品销售额、加权价、剂型、规格以及不同价位药品销售情况分析,明确医院恶性补偿机制下,药品降价措施对医院青霉素购药用药的影响。研究发现,上海医院青霉素类用药占抗感染类比重、加权价格逐年下降;青霉素类药品剂型规格逐年增多,新剂型规格首年价格最高,此后年份逐渐下降,降到一定程度则退出市场;同剂型同规格的同种药品中,医院偏爱使用高价位药。可见,在恶性循环机制下医院"喜见高价药",药品降价措施效果难以惠及患者。因此,要想从根本上解决药价虚高等问题,必先解决医院恶性循环机制。

In order to specify the impacts of drug price reduction policies on hospitals buying and using penicillin, this paper analyzed the amount, weighted price, dosage forms, and specification of penicillin in the top 100 medicines procured during 2000-2008 in Shanghai. It showed that the proportion of penicillin accounting for anti-in- fective drugs and weighted prices decreased, but dosage forms and specifications of penicillin increased year by year. The new dosage form or specification of penicillin＇ s price was highest in the first year, but then the price decreased gradually. Finally, this dosage form or specification of penicillin was out of the market when its price was too low. The same low-priced medicines with the same dosage form and the specifications, hospitals preferred to use high- priced medicine. It has discovered that, when hospitals were in a vicious cycle mechanism, patients hardly benefited from drug price reduction policies. Therefore, in order to solve the problems of dugs fundamentally, we should solve hospital＇ s vicious cycle mechanism firstly.