RESUMEN
In this study, the evolution of the centralized drug procurement policy and the logical relationship between drug procurement policy and medical insurance payment policy were explored by means of policy and literature review.This paper first examined the three stages of the centralized drug procurement policy, and especially analyzed the characteristics and trends of the current centralized bidding of drugs.Focus was put on the relationship of between the centralized drug procurement and medical insurance drug payment were then explored, and the practical feasibility to solve the drug problem with the help of supporting reforms of the above two systems.As a result, the study found that centralized drug bidding procurement has evolved into negotiation and the lowest price linkage procurement method under the price control of the provincial platform and it could also provide the basis for the formation of medical insurance payment standard of generic drugs.But the functions of National Drug negotiations and the Provincial Health Insurance negotiations overlapped.Fortunately, the drug bidding procurement, medical Insurance payment and other related institutional arrangements could promote the separation of pharmacy from medicine which is likely to provide a solution to the issue of unrealistic drug prices with the support of other coordinated sets of reforms.
RESUMEN
The paper argues that if the policy of separating pharmacy from medicine is to be implemented in China in the current situation, medical institutions will appear to be the direct interest losers while the broad masses of drug consumers (or payers) will be the eventual interest losers. In other words, consumers (or payers) will have to cover the costs entailed in separating pharmacy from medicine whereas the channels for drug circulation(wholesalers and retailers) and the drug producers will benefit from the policy. The government will be faced not only with the pressure of either raising the level of charges for medical services or increasing compensations for medical institutions, but also the dilemma of whether to stunt the development of medical institutions or to allow the abnormal growth of medical expenses. Besides, it will be confronted with moral accusations of supporting the channels for drug circulation at the expense of the interests of medical institutions and consumers and increased government input. These problems have already emerged in an embryonic form in the cunent implementation of the policy of "progressive separation of pharmacy and medicine" by the drug administration agencies. The ideal state for adopting the policy of separating pharmacy from medicine would be the overall reduction of drug prices by 26% to 30%, the turnover of the drug gross profit valued at 46.9 to 54.7 billion yuan into the scope for readjusting the level of charges for medical services, and a yearly readjustment in future of the level of charges for medical services according to the price index.