药品集中带量采购政策对药品利用与支出的影响分析

Analysis on the Impacts of Impacts of the National Volume-based Procurement Policy on Drug Utilization and Drug Expenditure

目的:分析药品集中带量采购政策对于药品利用与支出的影响。方法:利用2018—2019年的药品采购数据,采用双重差分模型比较了集采品种和同类替代非集采品种的价格、采购量、采购金额、质优药品的使用比例在药品集中带量采购政策实施后的变化。结果:药品集中带量采购试点政策实施后,与未实施试点政策的省份相比,实施试点政策或部分实施试点政策的省份集中采购试点品种的标化价格下降72.2%,标化采购量增加16.9%,采购费用下降55.3%,质优药品的使用比例增加15个百分点(均为P<0.01)。尚未发现集采品种的采购向同类替代非集采品种转移的证据。结论:药品带量集采政策有利于药品支出的控制和用药质量水平的提升,有必要扩大药品带量集采的覆盖面,尽快将中成药和生物类似药纳入集采之中。

Objective:To analyze the impact of national volume-based procurement policy on drug utilization and expenditure.Methods:The drug procurement data from 2018 to 2019 was collected.The Difference-in-Difference(DID) model was used to compare the changes that occurred in centrally-purchased drugs and alternatives in terms of price,purchasing volume,purchasing expenditure,and the ratio of good-quality drugs.Results:After the implementation of the national volume-based procurement policy,the price of centrally-purchased drugs decreased by 72.2%,the volume increased by 16.9%,the procurement cost decreased by 55.3%,and the ratio of good-quality drugs increased by 15 percentage points(all P<0.01).Conclusion:The volume-based procurement policy is conducive to the medicine expenditure containment and the improvement of medicine quality.It is necessary to select more drugs into the volume-based procurement process,including Chinese patent medicines and bio similars.