国外高值医用耗材采购管理模式及对我国的启示

目的:为优化我国高值医用耗材集中采购管理提供建议。方法:通过文献研究,从采购原则、采购组织、采购模式、监督管理等方面总结国外高值医用耗材采购管理成功经验。结果:国外高值医用耗材采购遵循"物有所值"的核心原则,并通过应用卫生技术评估(HTA)、完善编码系统、鼓励临床医生参与采购决策等手段来优化采购管理:医院直接采购、国家集中采购、地区集中采购及GPO采购是常见的四种采购模式。结论:建议从以下三方面优化我国高值医用耗材采购管理,(1)参考HTA部分评价指标优化高值医用耗材评标方式,实现价值购买;(2)建立规范统一的医疗器械编码系统;(3)充分发挥市场监督机制,借鉴GPO模式开展区域医疗机构联合带量采购。

Analysis of the high value medical consumables procurement in foreign countries and its inspiration to China

The main intention of this paper is to propose suggestions for optimizing China''s high-value medical consumables centralized procurement. In this paper, we have analyzed the developed countries'' best practices in high-value medical consumables procurement from the perspectives of procurement principle(s), key procurement bodies, procurement patterns, supervision, and management. The results of our analysis show that "Value for money" is the core principle in procurement and hospital route, national/regional centralized route(s), and group purchase organization (GPO) route are four primary procurement patterns in foreign countries. Procurement management is optimized through improving product coding system and encouraging health technology assessment (HTA) and clinical practitioners'' involvement in procurement decision-making. In that perspective, it''s been suggested that China''s high-value medical consumables centralized procurement could be improved from three aspects: referring partial HTA indicators so as to enhance tender evaluation and realize value-based purchasing; establishing a standard and unified coding system for medical devices; introducing GPO route and make market surveillance mechanism into full play.