集采政策对制药企业在公立医疗机构药品销售的影响——以首批国家集采药品为例

Impact of National Centralized Drug Procurement on Pharmaceutical Companies'Drug Sales in Public Medical Institutions

目的:以首批国家集采药品为例,分析集采政策对制药企业在公立医疗机构药品销售的影响,以期为集采政策的完善提供理论依据。方法:运用中断时间序列分析集采政策实施前后集采品种和可替代品种药品在公立医疗机构的销售情况。结果:集采政策实施后,中选企业的集采品种药品采购量增长163.28%,占所有企业采购量的比重从37.45%上升至86.45%;未中选企业的采购量降低75.30%,占所有企业采购量的比重从62.55%下降至13.55%。中选企业中非百强企业的集采品种药品采购量增长313.27%,而百强企业药品采购量仅增长5.76%。通过中断时间序列分析发现,在集采政策干预后,中选企业在中选产品非供应地区的药品采购量瞬时效应显著下降(β2=-58.727,P<0.001),长期趋势呈显著下降状态(β3=-4.550,P=0.010)。结论:集采品种中选与未中选企业市场份额变化较大,可替代品种采购量变化有限;中选百强企业采购量增长幅度较小;未中选企业采购量呈长期下降趋势;中选企业在中选产品非供应地区药品销售量显著下降。政府部门应持续关注中选企业合理的利润诉求,引导企业转变营销策略,保障中选产品稳定供应。

Objective:The paper analyzes the impact of the centralized procurement policy on pharmaceutical companies'drug sales and provide a theoretical basis for the improvement of the policy.Methods:The interrupted time series method was used to analyze the sales of centralized drug varieties and alternative drugs varieties by pharmaceutical companies before and after the implementation of the centralized procurement policy.Results:After the implementation of the centralized procurement policy,the procurement volume of the selected enterprises increased by 163.28%and the proportion of procurement volume in all enterprises increased from 37.45%to 86.45%,while the procurement volume of unsuccessful enterprises decreased by 75.30%and the proportion of procurement volume in all enterprises decreased from 62.55%to 13.55%.Among the selected companies,the procurement volume of centralized drug varieties of non-top 100 enterprises increased by 313.27%,while the procurement volume of centralized drug varieties of top 100 enterprises increased by only 5.76%.The interrupted time series analysis revealed that in the non-supply regions,the procurement volume of selected companies had significant immediate changes(β2=-58.727,P<0.001)and the long-term trend was downward after the policy intervention(β3=-4.550,P=0.010).Conclusion:The policy has led to significant change in market share for the selected and unsuccessful companies in centralized drug varieties,but with limited impact on alternative varieties.The procurement volume of the selected top 100 companies has seen small growth.The procurement volume of unsuccessful enterprises shows a long-term downward trend.The sales of drugs by selected enterprises in non-supply areas have significantly decreased.Government departments should pay continuous attention to the reasonable profit demands of selected enterprises,guide them to change marketing strategies,and ensure the stable supply of selected products.