完善中国药品器械招标采购的思路与对策

发布时间：2018-01-13 05:17

本文关键词：完善中国药品器械招标采购的思路与对策　出处：《经济研究参考》2014年32期 　论文类型：期刊论文

【摘要】：中国政府采用公开招标方式对药品实施政府集中采购,经历了较为复杂而漫长的政策博弈过程。总体来看,行政机构越来越直接地介入药品采购过程,市场主体的自由选择权越来越少。由于集中招标制度设计的原因,行政性规定的低价竞争,造成了实际上的"唯低价"中标,甚至出现价格低于成本的情况,导致部分药品难以维持正常再生产。本文提出改革药品集中采购制度的两种方案。一是"大改"治本,即按照国际惯例推进"医药分开"的制度设计,制度核心是把处方权与销售权分开,从根本上切断医药回扣。在此基础上,落实招投标主体责任,政府无须再通过专门机构,采取行政手段直接管理药品集中采购环节,但需要加快培育社会零售体系,完善医保支付管理体系。二是"小改"治标,即采取更加市场化的方式规范集中采购。实行质量分级的招标制度,选取临床使用效果、安全性评价等更具合理性的指标作为质量指标,将技术标权重提高到50%左右,重新设计商务标的"低价加分"环节与规则。同时建立中央和地方常用药或廉价药目录,只招厂家而不再招最低价格;建设公开、透明的药品与医疗器械信息管理系统,实现标准化精细化的全流程管理;强化合同约束力,避免长期大量拖欠药款的现象。
[Abstract]:Chinese government through public bidding for the implementation of government procurement of drugs, through the policy game process is long and complex. Overall, the administrative institutions more and more direct involvement in the drug procurement process, the main market of the right to freedom of choice and less. Because of the centralized bidding system design, administrative provisions of the low price competition by actually the only low-cost bid, even lower than the cost price, resulting in some drugs is difficult to maintain the normal reproduction. This paper puts forward two kinds of scheme of centralized procurement system reform of medicines. One is "big change" solution, which in accordance with international practice to promote the system design of "medical separation" of the system is to separate the core the prescription right and the right to sell, radically cut kickbacks. On this basis, the implementation of the bidding of the main responsibility, the government no longer by the specialized agencies, to take administrative measures to direct the tube Management of centralized drug procurement links, but need to accelerate the development of social retail system, improve the medical insurance payment management system. The two is "small change" is temporary, take the form of specification more market-oriented centralized procurement. Implement quality grading bidding system, selected the clinical effect, safety evaluation more reasonable index as the quality index. The technical index increased to about 50%, redesign the business standard "low points" link and rules. At the same time, the establishment of the central and local common medicine or cheap medicine directory, only recruit manufacturers instead of the lowest price bidding; the establishment of an open, transparent drugs and medical devices, information management system, realize the standardization management of the whole process of refinement; strengthen the contract binding, to avoid a large number of long-term arrears Yaokuan phenomenon.

【分类号】：F812.45;F426.4
【正文快照】： 本文主要研究中国公立医疗机构采用公开招标方式,集中采购药品或医疗器械的制度体系及相关问题。1历经近10年政策体系的演变,药品集中采购已经成为中国政府的一项行政管理职责,涉及卫生部等多个部委,行政机构直接干预的色彩愈发浓厚。药品集中采购制度自出台以来,各省(市)不断

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