医改政策中量价挂钩、以量换价问题的思辨

Analysis of Volume-Price-Linkage and Volume-for-Price in Medical Reform Policy

目的:对我国医改政策中经常出现的量价挂钩、以量换价问题进行经济学分析和思辨。方法:基于经济学原理,分析医药采购交易中供求双方对量和价的追求,探讨量价挂钩、以量换价的实现条件,并基于集中招标采购和国家谈判准入两个政策实践对该问题进行了分析和印证。结果:供求平衡是确定量价的关键,量价挂钩、以量换价并非必然实现,往往还需要采取措施降低供应成本才有望达成。结论:“量价挂钩、以量换价”相关政策需要有全面合理的制度安排。

Objective:It analyzes the mechanism of volume-price linkage and volume-for-price widely used in China medical reform.Methods:Based on the principle of economics,it analyzes the pursuit of volume and price by both supply and demand sides in pharmaceutical procurement transactions,explores the conditions for the realization of volume-price linkage and volume-for-price exchange,and analyzes and corroborates the issue based on centralized bidding and procurement and national negotiated access.Results:Keeping the balance of supply&demand is a key to fulfill volume-price linkage policy.Volume-price linkages and volume-for-price exchanges are not inevitable,and often require measures to reduce supply costs before they can be expected to mate-rialize.Conclusion:Comprehensive institutional arrangement was essential for volume-price linkage and volume-for-price.