医保价格谈判与医药企业研发积极性

Price Negotiation in Medical Insurance and the R&D Incentives of Pharmaceutical Companies

作为我国医保体系的一项重要制度安排,医保价格谈判对医药企业研发积极性的影响值得关注。本文以2010—2021年我国A股上市医药企业为研究样本,分析并检验药品经过医保价格谈判进入医保目录对企业研发积极性的影响。研究发现,药品被纳入医保目录可以显著提高医药企业的研发投入强度。机制检验表明,药品进入医保目录主要通过扩大市场需求、提升外部资金可得性和吸引高质量人才进而促进企业创新。进一步检验发现,没有竞品的药物、“天价”药物和疾病负担重的药物进入医保目录对企业研发强度的影响更显著;药品进入医保目录数量越多的企业,进入医保目录对企业研发强度的影响越大;医保谈判药品的降价幅度与企业研发强度之间存在“倒U型”关系;民营企业以及处于成长期和成熟期企业的药品进入医保目录对企业研发强度的促进作用更强。此外,企业药品再次通过谈判进入医保目录以及实施政策的出台都对医药企业研发强度具有增量促进作用。企业药品进入医保目录可以提高企业声誉,其所引发的创新有助于提升行业地位及企业价值。上述研究结论既丰富了创新领域的研究文献,也为进一步完善医保政策提供了理论支持。

Drug regulatory policies and centralized procurement of drugs will affect the innovation of pharmaceutical companies.As an important institutional arrangement in China's medical insurance system,the impact of medical insurance price negotiation on the innovation of pharmaceutical companies is also worthy of attention. Specifically,the medical insurance negotiation between the national medical insurance department and pharmaceutical enterprises is a kind of access negotiation which is based on the inclusion of the national medical insurance drug catalog as the bargaining chip,and the expected amount of the national market as the target amount,while a series of supporting policies and measures have greatly improved the accessibility and sales of medical insurance negotiated drugs.Taking the pharmaceutical companies in A-share listed companies from 2010 to 2021 as research samples,this paper analyzes and tests the impact of drugs entering the medical insurance catalogue through medical insurance price negotiation on the innovation of pharmaceutical enterprises and its mechanism.The empirical test finds that the inclusion of drugs in the medical insurance catalogue through medical insurance negotiation can significantly improve the R&D intensity. The mechanism test shows that the entry of drugs into the medical insurance catalogue can expand potential market demand and send positive signals of product quality and innovation ability to the market which can attract more sufficient funds and more high-quality talents for the enterprises,and then promote enterprise innovation.Further research also finds that due to the lack of competition,drugs without competing products entering the medical insurance catalog are more likely to expand market demand and significantly increase the R&D intensity.Compared with common drugs,high-price and high-burden drugs entered the medical insurance catalog have a more significant impact on enterprise innovation. At the same time,the more drugs enter the medical insurance catalogue,the greater the positive impact on enterprise innovation;There is an “inverted U-shaped” relationship between price cut and enterprise innovation.In other words,if the price cut of drugs entering the medical insurance catalogue is too large,then the R&D intensity is still likely to decline.Compared with the first time that enterprise drugs enter the medical insurance catalog,the promotion effect of re-entering the medical insurance catalog on enterprise innovation is still gradual. Only drugs of growing and mature enterprise entering the medical insurance catalog can improve the level of innovation investment.The introduction of the “Notice on Doing a good job in the Landing of National Medical Insurance negotiation drugs in 2019” can further strengthen the correlation between the entry of enterprise drugs into the medical insurance catalog and the intensity of enterprise R&D investment.The expanded trial also finds that the inclusion of drugs in the medical insurance catalog can improve the reputation of enterprises and enable enterprises to obtain more positive media coverage.Besides,the entry of enterprise drugs into the medical insurance catalogue will force enterprises to improve product quality,reduce production costs and expand market share through technological innovation,which will help enterprises to improve their industry status and ultimately enhance corporate value. The above conclusions have enriched the research literature in the field of the impact of government regulation on innovation.At the same time,this not only provides theoretical support for the medical insurance department to further improve the medical insurance policy,but also provides suggestions for pharmaceutical enterprises to enhance their industry status and market value.