The impact of medical insurance payment standard reform on clinical drug use in designated medical institutions:Based on Fujian provincial level,Fuzhou medical insurance insured per-sonnel empirical evidence / 中国卫生政策研究

Objective:To evaluate the influence of medical insurance payment standard reform on clinical drug use in designated medical institution.Methods:The medical expenses and drug consumption data of provincial level and Fuzhou medical insurance management center 3.31 million is included from April to September of 2016 and the same period of last year were statistically analyzed.The annual drug cost,drug use and the payment standard of med-ical insurance analysis were performed according to the annual statistics.Results: Before and after the reform, the proportion of the payment of standard drugs increased from 22.50%to 64.95%.The top 10 outpatient drugs in pub-lic hospitals and non-public hospitals were changed only in serial number,and after the reform,the cost of outpatient service fee was 73.21%and 39.30%respectively.Meanwhile,the variety and amount of drugs changed greatly of top 10 drugs public hospitals.The increase in drug cost of drugs with joint purchasing price difference was higher,and non-public hospitals were relatively stable.Conclusions: As per the findings of this study, Medicare insurance payment standard reform has significantly affected the choice of drug brands and drug use structure.To focus on the medical insurance payment standard of concentrated purchase of drugs combined with the amount of joint procurement of medicines is beneficial to reduce drug prices.The medical insurance payment standard reform combined with com-prehensive reform of medical and health system measures are much more conducive to play a guiding role.

Critical thinking and analysis of procurement of drugs with target quantity in Shanghai / 中国卫生政策研究

By analyzing relevant documents of procurement of drugs with target quantity in Shanghai, com-bined with onsite investigations and interviews, this paper summarizes the practice of procurement of drugs with target quantity in Shanghai from six aspects, namely the basic situation of centralized procurement, pilot scope and variety of procurement of drugs with target quantity, business qualification and certification, determination of successful bid-der, drug distribution, and drug payment settlement. This paper argues that Shanghai has successfully implemented the policy of procurement of drugs with target quantity, by scientifically establishing a comprehensive evaluation index of quality, setting up private drug procurement accounts, prepaying drug procurement loans and strengthening plat-form services and regulatory capabilities, in order to effectively guarantee the operation of procurement of drugs with target quantity. From this case study of Shanghai, it can draw the following implications that in order to successfully achieve procurement of drugs with target quantity mechanism, setting up functional departments of unified authority is the most important guarantee, and using technical means and platform building is the basic conditions. Therefore, the setting up of economic and technical bidding should focus on the individual properties of generic drugs, and the pro-moting of tripartite system reform will help to further expand the scope of procurement of drugs with target quantity.