摘要
药品集中采购政策在实施过程中涉及诸多利益相关主体，主要有政府及药品招标采购机构、医疗机构和医生、医药企业、患者和医保机构等。主要的博弈过程有3个阶段：一是政府和药品采购机构与医院、医生之间的博弈；二是医院与中标企业之间的价格谈判博弈；三是医生、患者和医保部门之间的博弈。药品集中采购政策实施中存在问题主要有药品市场上低价竞争导致一些经典廉价药品停产消失，“二次议价”现象中回扣和提成的产生、带量采购政策推行进展缓慢、全民医保下医疗费用快速攀升等。提出了优化药品集中采购政策的对策建议，包括健全和完善公立医院绩效考评制度、推行带量采购模式、构建医院和医药企业之间平等谈判的博弈格局、引入医保支付价格管理等。
Many stakeholders are involved in the implementation of centralized drug procurement, namely government agencies, drug bidding or procurement agencies, pharmaceutical companies, medical institutions, doctors, patients and health care institutions among others. The game falls into three stages. The first is that between government agencies or drug procurement agencies and medical institutions or doctors; the second is that of price negotiations between the hospital and the winner pharmaceutical enterprise; the third is that between doctors, patients and medical insurance agencies. Major setbacks found in the implementation of such a policy are as follows： disappearance of classic inexpensive drugs from the market; rebates and commissions in the ＂ second bargaining＂ phenomenon; slow progress in the implementation of the purchase with quantity indication policy; rapid rise of medical costs for national health insurance. Recommendations by the authors include optimization of the centralized drug procurement; improvement of the public hospital performance appraisal system and talent evaluation system; promotion of the purchase with quantity indication policy; building of the game pattern of equal-footing negotiation between hospitals and pharmaceutical companies; and introduction of the payment management of medical insurance.
出处
《中华医院管理杂志》
北大核心
2016年第7期518-521,共4页
Chinese Journal of Hospital Administration
关键词
药品集中采购
利益相关者
博弈
价格谈判
Centralized drug procurement
Stakeholder
Game theory
Price negotiation
