Policy analysis on procurement cohesion between essential medicine and low-price medicine at the primary healthcare institutions / 中国卫生政策研究

ABSTRACT

Objective: This article aims to provide empirical evidence for procurement cohesion policies be-tween essential medicine and low-price medicine. Methods: The paper reviews the relevant transaction cost theory and presents the study framwork that was confirmed by the content analysis from relevant provincial policy documents on low-price medicine. Results:Compared with essential medicine lists, low-price medicine lists lacked standardized procedures and institutional control for market entry and exit. More than 65% of provinces directly purchased low-price medicine online, but only 25% of provinces insisted on an economic and technological standards review. 60%of provinces did not build relationships with essential medicine suppliers and public hospitals. There was no pharma-ceutical delivery policy in 60% of provinces and no pharmaceutical payment policy in 80% of provinces. 32% of provinces intended to establish connections between low-price medicine and medical insurance lists, however there were no reimbursement policies of low-price medicine in China. Conclusions:Two polices lacked cohesion in terms of list promulgation, market entry and exist mechanisms, bidding, procurement, utilization, deliveries, payment and reimbursements, which led to difficulties in resolving the shortage of low-price medicine because of pharmaceutical market fragmentation, complex competition, and increasing transaction costs.