药品价格形成机制与医保支付标准的研究

发布时间：2018-12-29 21:02

【摘要】：自建国到现在,针对药品价格政府实施了一系列的管制政策,试图通过多重管制使药价达到合理水平,然而实践证明,过度的管制扭曲了正常的市场机制,民众的医疗负担依然没有得到减轻,相反,看病难看病贵这一问题更加突出了。2015年5月,出台了《关于印发推进药品价格改革意见的通知》,决定取消政府对多数药品的定价行为,使药品的价格通过市场竞争确立。同时指出由医保部门联合相关部门拟定力医保药品支付标准,探索建立引导药品价格形成的机制。这就为本文药品价格形成机制与要支付标准的制定提供了研究的契机,而本文的研究也将对完善我国当前的药品定价体系与医保支付制度具有重要意义。针对当前的改革,本文拟药品价格形成与医保支付标准确立的一般机理出发,通过地区的案例研究和比较研究,提出适合我国国情的药品价格形成与医保支付机制。本文主要研究以下四个部分的内容:(1)第一部分,对药品的属性及市场失灵进行分析,由此提出在市场经济下药品价格的形成与医保支付制度标准确立必须来自于自由竞争,任何行政管制都是无效的。(2)第二部分,对我国建国以来的药品定价方式进行梳理,并分析了当前药品定价机制下出现的问题、问题的根源。通过分析发现发现长期以来药品价格都处于政府的行政干预之下,在定价机制下,民众的医疗负担和药价虚高的问题依然没有得到缓解。(3)第三部分,介绍国内外关于药品价格形成与医保支付制度的探索与改革,通过对这些地区的比较分析,为我国目前的改革提供经验借鉴。(4)第四部分,基于以上四个部分的研究,提出在我国当前的改革中必须遵循的原则与改革的路径,即在改革中一定要遵循自由竞争原则和渐进性原则,促进参与主体间的竞争,改革不是一蹴而就的,从长远来说要消除公立医院的垄断地位,近期可以先完善医保付费制度。
[Abstract]:Since the founding of the people's Republic of China, the government has implemented a series of regulatory policies against drug prices, trying to achieve a reasonable level of drug prices through multiple controls. However, practice has proved that excessive regulation distorts the normal market mechanism. The burden of medical care for the public has not been alleviated. On the contrary, the problem of difficult and expensive medical treatment has become even more prominent. In May 2015, the Circular on the publication of opinions on promoting Drug Price Reform was issued. Decided to cancel the government pricing of most drugs, so that the price of drugs through market competition. At the same time, it is pointed out that the medical insurance department should work out the standard of medical insurance drug payment together with the relevant departments, and explore the mechanism to guide the formation of drug price. This provides an opportunity for the study of the mechanism of drug price formation and the formulation of payment standards in this paper, and the research in this paper will be of great significance to the improvement of the current drug pricing system and the payment system of medical insurance in China. In view of the current reform, this paper proposes the general mechanism of drug price formation and medical insurance payment standard, and puts forward the mechanism of drug price formation and medical insurance payment suitable for China's national conditions through regional case studies and comparative studies. This paper mainly studies the contents of the following four parts: (1) the first part, the analysis of the properties of drugs and market failure, Therefore, it is proposed that the formation of drug price and the establishment of the standard of medical insurance payment system under the market economy must come from free competition, and any administrative control is ineffective. (2) part two, combing the way of drug pricing since the founding of the people's Republic of China. And analyzed the current drug pricing mechanism under the problem, the root of the problem. Through the analysis, it is found that for a long time the drug price has been under the administrative intervention of the government. Under the pricing mechanism, the problems of the people's medical burden and the false high drug price have not been alleviated. (3) the third part, This paper introduces the exploration and reform of drug price formation and medical insurance payment system at home and abroad. Through the comparative analysis of these regions, it provides experience for China's current reform. (4) part IV, based on the above four parts of the research, This paper puts forward the principles and paths that must be followed in the current reform of our country, that is, the principle of free competition and the principle of gradual progress must be followed in the reform to promote the competition among the participants, and the reform is not accomplished overnight. In the long run, to eliminate the monopoly of public hospitals, we can improve the health insurance payment system in the near future.
【学位授予单位】：首都经济贸易大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1;F842.684

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