陕西省儿童基本药物价格成分研究

Study on the Price Components of Paediatric Essential Medicines in Shaanxi Province

目的:为降低我国儿童基本药物价格提供循证支持。方法:采用世界卫生组织(WHO)和国际健康行动组织(HAI)共同制定的WHO/HAI标准化法,对陕西省西安市和安康市的公立医院、药品批发企业、配送企业等机构进行实地调研。结果:西安市"三统一"药品和非"三统一"药品的平均总加成率分别为11.60%和20.38%,安康市为41.25%和22.11%;西安市原研药和仿制药的平均总加成率分别为17.36%和17.47%,安康市为17.77%和33.85%;西安市和安康市的注射剂平均加成率分别为26.11%和32.50%,药品从批发商到医院中间环节的费用加成率分别为20.26%和2.14%。结论:"三统一"药品总加成率较非"三统一"药品低;原研药的平均总加成率与仿制药的平均总加成率相近,但加价金额仍过高;注射剂型的平均总加成率最高;从批发商到医院中间环节的费用加成占比较大。建议提高药品集中采购机制的有效性,完善我国药品定价机制,规范我省从批发商到医院中间环节的价格加成。

OBJECTIVE： To provide evidence-based support for lowering the price of paediatric essential medicines. METH- ODS： By using WHO/HAI standard methods developed by WHO and HAI, field investigation was conducted in public hospitals, medicine wholesalers and distributor in Xi＇ an city and Ankang city of Shaanxi province. RESULTS ： In Xi＇ an, the average total price mark-up ratio of “uniform purchased” medicines and “non-uniform purchased” medicines were 11.60% and 20.38%, which we：re 41.25 % and 22.11% in Ankang. In Xi＇an, the price mark-up ratio of original brand and generic medicines were 17.36% and 17.47% ,which were 17.77% and 33.85% in Ankang. In Xi＇an and Ankang, the price mark-up ratio of injection was 26.11% and 32.50% ;those of intermediate link from wholesalers to hospitals was 20.26% and 2.14%, respectively. CONCLUSIONS： The total price mark-up ratio of “uniform purchased” medicines is lower than that of “non-uniform purchased” medicines in Xi＇ an; average total price mark-up ratio of original brand is close to that of generic medicines, but price mark-up is still in high level; the average total price mark-up ratio of injection is the highest among all drug forms; the expenses for the intermediate link from wholesalers to hospitals take up large percentage. It is suggested to improve the effectiveness of drug centralized purchase mechanism, perfect pric- ing system and standardize price mark-up for the intermediate link from wholesalers to hospitals.