医保国谈药落地问题的交易成本视角分析

Analysis from the perspective of transaction cost on drug delivery in national reimbursement drug list

医保国谈药的落地受阻问题是近年来的政策关注热点。文章通过文献分析和政策回顾,基于经济学相关理论,从交易成本视角对国谈药落地过程中的筹资、支付、配送、使用等环节进行了分析和探讨,认为:药品谈判准入是国家医保和医药厂商之间达成的采购行为,但在采购交易落地过程中还存在大量中间环节交易成本,而医保和厂商均缺乏足够的物质资源去克服这些交易成本,由此导致了国谈药的落地困难。因此在医保谈判准入政策制定中需要对后续交易成本和各方克服成本的资源能力进行综合考虑并完善相关的制度设计。

In resent years, the problem of blocking delivery of drug in national reimbursement drug list(NRDL)has been a hot issue of policy attention. Through the literature analysis and policy review, based on economic theories, we perform the analysis and discussion in process of financing, payment, delivery and use, etc. from the perspective of transaction cost on drug delivery in NRDL. This paper think that drug negotiation access is a procurement behavior reached between the national medical insurance and pharmaceutical manufactures, but there are still a lot of intermediate transaction costs in the procurement transaction implementation process, and the medical insurance and manufactures lack enough material resouces to overcome these transaction costs, which leads to difficult implementation of drug delivery in NRDL. Therefore, in the formulation of medical insurance negotiation access policy, it is necessary to comprehensively consider the subsequent transaction costs and the resource ability of all parties to overcome the costs, and improve the relevant system design.