中国药品集中采购政策解读与实证分析

Theoretical Interpretations and Empirical Analyses of China's Drug Volume-Based Procurement Reform

2018年底伊始的国家药品集中采购迄今为止已实施三轮,共涉及112个品种,预计每年约可节省医保药品支出539亿元。对三轮集中采购规则进行解读和实证分析,发现:选区规则对竞价结果具有显著性影响;熔断机制理论上会受到成本因素约束,实践中仍发挥了一定效果。国家药品集中采购促进了中国医药市场基于质量和成本的竞争,推动行业集中度上升。药品集中采购是中国医改深化的必由之路,有助于未来仿制药医保支付标准的确认,相关规则正在各省药品集采和耗材集采等领域应用推广。药品集中采购的核心问题是质量和成本的信息不对称,一致性评价和药物警戒等质量管理工作仍需加强。

Since 2018,three rounds of China’'s drug volume-based procurement(VBP)have been implemented,covering 112 kinds of drugs in total and saving about 53.9 billion health insurance expenditures every year.This paper focuses on the theoretical interpretations and empirical analyses of procurements.It is found that district choosing mechanism has a significant effect on bidding.The fusing mechanism is theoretically restricted by the cost factor,but it still exerts certain effects in practice.China's VBP reform promotes the development of quality-and-cost-based competition in the drug market,and increases the concentration ratio of the industry.VBP is an indispensable route to deepen the health care reform,which contributes to the establishment of the health insurance payment criteria.The reform is extended from the nation level to provinces and cities,as well as from drugs to medical supplies.The core problem of centralized drug procurement is the information asymmetry of quality and cost of drugs,thus quality control such as consistency evaluation and pharmacovigilance still needs to be strengthened.