国际经验对我国完善基本药物招标采购机制的启示

Inspiration of the International Practices on Improving Bidding and Procurement Mechanism of Essential Medicine in China

目的:针对我国基本药物招标采购存在的问题,通过归纳主要发达国家、地区药品价格和招标采购经验形成改革思路。方法:文献归纳与理论分析。结果:首先,医保基金作为支付者参与药品价格管理是国际主流做法。其次,药品管理方式应该与药品种类相适应。第三,在实施批量采购时,中央合同式的集中采购对象为应用量大,占药品费用支出比例高的少数药品品种。此外,WHO建议建立事前与事后评价机制以确保中标药品质量。结论:建议建立药品使用后评价机制,加强医保基金在基本药物招标采购中的作用,并落实药品分类管理,根据药品特点实施不同采购策略。

Objective： To solve the problems of essential bidding and procurement in China, form the reforming measurements by generalizing medicine prices in developed countries and areas and the experiences of bidding and procurement Methods： Literature induction and theoretical analysis. Results： First, using medical insurance fund as the payer in medicine price management is the main international practice. Second, medicine management methods should be suitable for the types of medicine. Third, during bulk procurement, the procedure target of central contract are decided as several medicine types which are applied widely and accounted as high proportion in medicine expenditure. Besides, to secure qualify of medicines which win the bid, WHO proposes to build pre-qualification procedures and post-qualification procedures system. Conclusion： Setting up post-evaluation procedures for procured medicines, enhancing the impact of health insurance, implementing the medicine classification management, and applying compatible bidding and procurement strategies to different medicines are suggested.