医保付费机制改革颠覆药企市场竞争规则

Subversion of the competition rule of pharmaceutical market with the reform of medical insurance payment mechanism

通过实地考察调研,本文分析了医疗保险付费机制改革对医院用药结构的影响,以及将会给药品生产、配送、使用等利益相关方的影响。医疗保险付费机制由"后付制"改革为"预付制"后,销售药品在医院中将由利润来源改变为费用成本,医院的用药结构将发生根本改变,价格虚高的药品将逐渐被性价比高的廉价药品所替代,药企的市场竞争规则将由"高定价、暗回扣"的非法竞争转化为"高性价、明折扣"的公平竞争,对患者的过度用药、不合理用药等现象将得到相应的遏制。

The inlfuence of the medical insurance payment reform on drug prescription of hospitals and the stakeholders such as pharmaceutical enterprises, distributors and users was analyzed through ifeldwork research. After the medical insurance payment changes from＂post payment system＂to＂prospective payment system＂, drug sales in hospital will be changed from the source of proifts to costs, which leads to the fundamental change of the drug usage structure in hospitals and the replacement of the artiifcially high pricing medicines with the cheap ones with high quality. Meanwhile, the competition rule will be switched from the illegal competition so called＂overpricing with sales commission under table＂to the rational and fare competition called＂high cost-effective with commission on the table＂. Phenomena such as overuse and unreasonable use of medicines will be depressed or decreased.