国家药品集中采购政策对四直辖市药品价格、费用及仿制药替代的影响分析

The Influences of National Centralized Drug Procurement Policy on Drug Price,Cost and Generic Drug Substitution:Taking the Four Municipalities Data

文章以首轮"4+7"试点四个直辖市为研究对象,选择其药品价格、药品费用、仿制药替代率指标,评价国家药品集中采购政策的阶段性效果。研究表明,首轮国家药品集中采购政策取得了显著的降价效果,降低了群众药费负担,也提高了过评仿制药的使用量。然而,首轮国家药品集中采购政策执行中也存在部分品种被临床同类品种替代、仿制药金额替代率反而下降等情况。建议国家药品集中采购政策的实施应当充分考虑我国医药产业国情,追求总采购成本最低、品种遴选中充分考虑临床用药特殊性、发挥经济激励措施作用、并采取加强公众教育、推动医疗、医保等配套改革。

Taking the data of four municipalities in the first round of"4+7"pilot program as an example,drug price,drug cost and generic drug substitution rate are selected to evaluate the phased effect of national drug centralized procurement policy.The result shows that the first round pilot program has achieved significant price reduction,reduced the burden of drug costs concerning the patients,and increased the use of generic drugs that have passed the quality and efficacy consistency evaluation.However,some varieties were replaced by similar clinical varieties and the value substitution rate of some generic drugs decreased.It suggests that the implementation of national drug centralized procurement policy should take into account the national conditions of China pharmaceutical industry,also it should pay attention to the pursuit of lowest total procurement cost.In the aspect of variety selection,the particularity of clinical medication should be fully considered.Furthermore,it should give full play to the role of economic incentives,strengthen public education,and promote the reform of medical care and medical insurance synchronously.