Research on the Development and Reform of Centralized Drug Procurement System / 中国药房

ABSTRACT

OBJECTIVE：To put forward policy suggestions for the adjustment and reform of centralized drug procurement mode in China. METHODS ：The evolution process of centralized drug procurement mode in China was reviewed ，and problems were found through literature research and expert interview. Combined with the experience of drug procurement platform construction，GPO procurement and medical insurance payment control fee management in the United States and Singapore ，the reform suggestions were put forward for basic model assumption of bidding procurement based on cost control target and drug bidding procurement policy. RESULTS & CONCLUSIONS ：China’s drug bidding procurement system has gone through the stages of unified purchase and marketing ，decentralized procurement ，centralized procurement start-up and adjustment ，comprehensive implementation of online centralized drug procurement ，exploration of the integration of “two bidding ”（bidding for essential medicine and bidding for non-essential medicine ）and joint procurement ，and pilot stage of national drug bidding and procurement. At the present stage ，there are many problems in centralized drug procurement ，such as the diversified subordination relationship of the platform ，the possible monopoly of enterprise selection under the policy of “two invoice system ”，price reduction becoming the core performance index of bidding procurement ，and the suspected monopoly operation of GPO procurement exploration. The model analysis based on the goal of cost control shows that drug cost is a function of efficiency ，drug quantity and price. High price leads to high cost ，while low efficiency leads to high cost. In the future ，the goal of drug bidding and procurement should not only foucs on price control ，but also on efficiency. The function of bidding and procurement will return to the essential function of “price for quantity ”. It is suggested that a relatively independent and unified platform should be established for drug bidding and procurement in China ，and the grouped procurement mode should be gradually standardized ，the expenditure control function of medical insurance payment audit should be exerted instead of simple price reduction ，and absolute unified lowest price procurement should be avoided.