药品和耗材跨区域带量采购的实践与思考

目的比较我国药品和耗材跨区域带量采购的实践,厘清该模式的基本逻辑。方法比较分析国家组织集中采购(以下简称“国家集采”)和非国家集采框架下我国药品和耗材跨区域带量采购的实践,总结实践的基本特点,分析采购内容、采购环境及采购规则的内在关系。结果我国药品和耗材跨区域采购的实践包括:以国家组织药品集中采购和使用试点(以下简称“‘4+7’试点”),“4+7”试点扩围,第二、第三批国家组织药品集中采购和使用,深圳药品集中采购组织(group purchasing organization,GPO)模式为代表的药品带量采购;以京津冀联盟及由其发展而来的“3+6”联合采购模式,黔滇豫渝4省(直辖市)联盟以及陕西省牵头的15省(自治区、兵团)省(自治区、兵团)际联盟为代表的耗材带量采购;以三明联盟为代表的药品和耗材带量采购。实践特点是平台统一、信息共享,允许多家企业中标和价格差异,价格联动。结论跨区域带量采购将成为药品和耗材带量采购的主要模式,而合作共享的信息平台和科学合理的质量评价体系是重要保障。

AN ALGORITHM FOR THE DETERMINATION OF THE ECONOMIC ORDER QUANTITY IN A TWO-LEVEL SUPPLY CHAIN WITH TRANSPORTATION COSTS:COMPARISON OF DECENTRALIZED WITH CENTRALIZED DECISION

This paper considers a two-level supply chain consisting of one warehouse and one retailer. In this model we determine the optimal ordering policy according to inventory and transportation costs. We assume that the demand rate by the retailer is known. Shortages are allowed neither at the retailer nor at the warehouse. We study this model in two cases; decentralized and centralized. In the decentralized case the retailer and the warehouse independently minimize their own costs; while in the centralized case the warehouse and the retailer are considered as a whole firm. We propose an algorithm to find economic order quantifies for both the retailer and the warehouse which minimize the total system cost in the centralized case. The total system cost contains the holding and ordering costs at the retailer and the warehouse as well as the transportation cost from the warehouse to the retailer. The application of this model into the pharmaceutical downstream supply chain of a public hospital allows obtaining significant savings. By numerical examples, the costs are computed in MATLAB to compare the costs in the centralized case with decentralized one and to propose a saving-sharing mechanism through quantity discount.