ABSTRACT
OBJECTIVE： To analyze the effect of the national designated production pilot policy for drug in shortage in China. METHODS： Taking 2 batches of drugs from 7 designated production manufacturers in Chongqing from Sept. 2012 to Sept. 2018 as an example， the overall supply situation of designated production （using the average satisfaction rate of medical institution’s order as index）， the changes of drug supply （average satisfaction rate of order） before and after the implementation of national designated production policy （during designated production period and non-designated production period） were all analyzed. According to the level of medical institutions and the order quantity of medical institutions （three sections： small amount， suitable， big amount）， the classification analysis was carried out. At the same time， telephone interview was conducted among the business personnel of related pharmaceutical production enterprises to understand and summarize the reasons for the supply problems of these drugs. RESULTS： Except for the average satisfaction rate of drug order was 0 in one designated production manufacturers， the satisfaction rate of drug order in the other 6 designated production manufacturers ranged from 58.05％ to 92.31％. During the designated production period， the satisfaction rate of drug order was increased significantly， compared with non-designated production period. However， after the expiration of the designated production of drugs， the order satisfaction rate mostly declined， and satisfaction rate of some drug orders were even lower than that before designated production. Average satisfaction rate of drug order in third level medical institution was higher than those of second level， first level or primary medical institutions. During designated production period， the average satisfaction rate of drug order in designated production manufacturers to medical institutions at all levels was higher than during non-designated production period or in non-designated production enterprises. There are 5 kinds of reasons for supply problem of designated production and drug with same specification： the limited price is lower than the cost； the production is stopped due to raw material； the production is stopped because of enterprise； the medical insurance payment price is far lower than the supply price； the hospital demand is small. CONCLUSIONS： The designated production pilot policy has played a significant role in improving the shortage of drug supply， but it still needs to be improved by establishing a dynamic adjustment mechanism for the scope， price and duration of designated drug production.
ABSTRACT
Objective: To analyze the institutional design and key issues of essential medicine designated production. Methods: It analyzed the institutional design and key issues based on theoretical and policy study. Results: The relevant institutional design included coordination and incentive mechanism. But coordination mechanism was short of control to supply activity; the quantity uncertainly weakened the role of incentive mechanism; bulk material, production capacity and supply network made the transaction activity complicated. Conclusion: Government should strengthen the coordination of supply activity , release the uncertainty of essential medicine’s quantity by internet information system, monitor the bulk material’s price and production capacity by the pharmaceutical industry association and reduce the complexity of transaction activity by the intermediate supply.
ABSTRACT
There is an insufficient supply in essential medicines, so the nation intends to reconsider the designated medicine production. But this will raise certain risks such as negative distribution, monopolies and weakening price signal. Thus the supporting methods should be proposed as below: improving the incentive of enterprises, the efficiency of designated products, and the government administration level to promote the development of the pharmaceutical market and improve the level of public health.