中国药品价格水平变化实证研究

An Empirical Study on the Change of Medicine Price Level in China

目的客观反映中国取消药品最高零售限价以来的价格水平变化,为药品价格政策的完善提供参考。方法本实验采用2015年1月至2019年3月中国药学会全国医药经济信息网数据,编制链式费式药品综合价格指数和不同政策管制水平、不同治疗类别的分类价格指数。结果近4年来我国医疗机构销售西药呈现降价趋势,降幅为13.99%,中成药价格呈现先涨后降的趋势,降幅为3.54%。从不同政策管制水平上分析,医保西药、非医保西药、医保中成药和非医保中成药分别下降13.32%、14.27%、1.36%和14.29%,医保中成药药品价格降幅较少,非医保中成药存在短期内价格过快涨跌的情况,波动明显;在医保药品中,甲类西药价格上涨4.5%,乙类西药、甲类中成药和乙类中成药分别降价15.90%、0.66%和1.47%;基药西药、非基药西药、基药中成药和非基药中成药分别降价13.72%、13.90%、3.70%和3.60%。从不同治疗类别上分析,糖尿病药品、高血压药品和全身用抗感染药品价格分别下降6.78%、10.42%和12.72%,抗肿瘤药品降幅最大,达到26.69%。结论我国取消药品最高零售限价后,西药价格稳步下降,中成药价格先涨后降。不同政策管制水平的药品价格变化差异较大。不同治疗类别的药品降价趋势相同,但降幅差异较大。

OBJECTIVE To reflect the changes of medicine price level in China after canceling the maximum retail price limit,and to provide reference for the improvement of medicine price policy.METHODS This research utilizes data of Chinese medicine economic information database of Chinese Pharmaceutical Association from January 2015 to March 2019 and compiles comprehensive and classified chained fisher price indexes among diverse policy control levels and different treatment categories.RESULTS Over the past four years,the sale of west medicine(WM)by Chinese medical institutions showed a trend of decreasing price,with a decline of 13.99%.And the price of traditional Chinese medicine(TCM)showed a trend of first rising and then falling,with a decline of 3.54%.From the analysis on different policy control levels,the price of medical insurance WM,non-medical insurance WM,medical insurance TCM and non-medical insurance TCM decreased by 13.32%,14.27%,1.36%and 14.29%,respectively.The price of medical insurance TCM fell less.And the price of non-medical insurance TCM rose and fell too quickly in a short period of time,and its fluctuation was obvious.Among medical insurance medicines,the price of category A WM raised by 4.5%,while the prices of category B WM,category A TCM and category B TCM dropped by 15.90%,0.66%and 1.47%,respectively.The price of essential WM,non-essential WM,essential TCM and non-essential TCM reduced by 13.72%,13.90%,3.70%and 3.60%,respectively.From the analysis on different treatment categories,the prices of diabetes medicines,hypertension medicines and systemic anti-infection medicines decreased by 6.78%,10.42%and 12.72%,respectively.Anticancer medicines had largest price decline with 26.69%.CONCLUSION After canceling the maximum retail price limit,the price of WM declines steadily,while the price of TCM first rises and then falls.The changes of medicine prices vary greatly at different policy control levels.The trends of medicine price reduction among different treatment categories are the same,but the differences are large.