Page 24 - 《中国药房》2021年2期

药品集中带量采购政策与我国医保支付制度的协同作用探讨 Δ

谭清立 1，2＊ ，高江源 ，林岱衡（1.广东药科大学医药商学院，广东 中山 528400；2.广东药科大学药品监管研究
1
1
中心，广东 中山 528400）

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2021）02-0146-06
DOI 10.6039/j.issn.1001-0408.2021.02.04

摘 要 目的：探讨我国药品集中带量采购政策与医保支付制度的协同作用及尚存不足，为进一步提升其协同水平提出可行性建
议。方法：采用文献分析法和政策评估法，分别对目前我国药品集中带量采购政策与医保支付制度的直接协同与间接协同作用进
行阐述，分析其存在问题，并提出可行性建议。结果与结论：药品集中带量采购政策对我国医保支付制度在技术层面的付费方式、
效果层面的绩效评估、管理层面的过程管控等方面有着直接影响。其间接协同作用包括：药品集中带量采购政策可促使药品供应
保障体系作出调整以适应医保支付改革；可调整医药市场，影响医保支付制度改革。不足之处为：中选药品品种少，采购范围与医
保降费均有进一步提升空间；医保对于非中选药品“一刀切”的支付标准可能会削弱药企对仿制药研发的积极性等。因此，下一步
还需大幅扩大药品采购品种和范围，对于本身品种就较少的药品，可以适当放开医保支付限制；协调医保报销政策和采购方案，提
升医保支付的合理性和完善性；引导医疗机构从“价格医疗”到“价值医疗”理念的转变，兼顾市场多方利益，形成全方位的药品价
格与医保支付制度的协同调整机制。
关键词 药品集中带量采购政策；医保支付制度；药品供应保障体系；协同作用

Investigation on Synergistic Effect between Centralized Drug Quantity Purchase Policy and Medical
Insurance Reimbursement System
1，2
1
TAN Qingli ，GAO Jiangyuan ，LIN Daiheng（1. School of Pharmaceutical Business，Guangdong Pharmaceu-
1
tical University，Guangdong Zhongshan 528400，China；2. Drug Regulatory Center，Guangdong Pharmaceutical
University，Guangdong Zhongshan 528400，China）
ABSTRACT OBJECTIVE：To investigate the synergistic effect and deficiencies between centralized drug quantity purchase
policy and medical insurance reimbursement system，and to provide feasible suggestion to further improve its synergistic effect.
METHODS：The literature analysis method and policy evaluation method were adopted to expounds the direct and indirect
synergistic effect between the current centralized drug quantity purchase policy and medical insurance reimbursement system in
China，and analyze the existing problems so as to put forward the feasible suggestions. RESULTS & CONCLUSIONS：The
centralized drug quantity purchase policy had a direct impact on the payment mode of medical insurance reimbursement system in
technical level，performance evaluation in effect level and process control in management level. The indirect synergy included：
centralized drug quantity purchase policy could promote the adjustment of drug supply security system to adapt to the reform of
medical insurance payment；it could adjust the pharmaceutical market，and affect the reform of medical insurance reimbursement
system. The disadvantages were as follows：the varieties of selected drugs was still narrow，and there was room for further
improvement in purchasing scope and medical insurance fee reduction；“one-size-fits-all”payment standard for unselected drug
might weaken pharmaceutical companies’enthusiasm for generic drug research and development. Therefore，the next step is to
significantly expand the variety and scope of procurement，and appropriately liberalize the medical insurance payment restrictions
for drugs with fewer varieties；coordinate medical insurance reimbursement policies and procurement programs，and improve the
rationality and perfection of medical insurance payment；guide the medical institutions to change the concept from“price-based
medical treatment”to“value-based medical treatment”，take into account the interests of all parties in the market，so as to form a
comprehensive coordination adjustment mechanism of drug price and medical insurance reimbursement system.
KEYWORDS Centralized drug quantity purchase policy；Medical insurance reimbursement system； Drug supply security
system；Synergistic effect

Δ 基金项目：广东省科技创新战略专项资金（软科学面上与重点 药品集中带量采购（以下简称“带量采购”）是近年
[1]
专）项目（No.2019A101002068）；广东省科技创新战略专项资金（“攀登 来我国解决“看病贵”问题的最有效举措之一 。随着带
计划”专项资金）立项项目（No.pdjh2020b0313）；广东省普通高校青年
量采购良好效益的逐步扩大，国家组织药品集中采购和
创新人才类项目（No.2018WQNCX064）
使用联合采购办公室（以下简称“联合采购办公室”）于
＊讲师，博士。研究方向：社会保障与医药卫生政策。电话：
0760-88207911。E-mail：qinglitan87@163.com 2020 年 7 月 29 日发布了《全国药品集中采购文件（GY-

·146 · China Pharmacy 2021 Vol. 32 No. 2 中国药房 2021年第32卷第2期