药品集中招标采购机制招标采购主体设置规律述评——基于欧盟国家不同医疗保障制度实践经验的总结

目的:为完善我国药品招标采购体系,为解决药价虚高和药价畸低带来的质量问题提供参考。方法:将部分欧盟国家药品招标采购机制,依照社会医疗保险和国家卫生服务两种医疗保障模式分类,分别进行经验总结。以医药费用支付方式为纽带,建立相应主体之间的财务联系,以此分析各国在相应医药费用支付方式组合下的药品招标采购系统,讨论相应机制下医药费用超支承担者或分担者与药品招标采购主体之间的关系。结果与结论:医疗保障模式及其相关设计与药品集中招标采购机制设计关系紧密,决定着招标采购系统的具体设计。各国药品集中招标采购的主体都为医药费用超支责任的承担者。这遵循了博弈论分析招标采购机制相关文献中所提的"利益直接相关者作为招标主体参与招标博弈才能使其本身利益得到最大化满足"的基本原则。

Commentary on Regular Pattern of Purchaser Setting in Centralized Drug Bidding and Purchase Mechanism:Experiences of European Union Countries Based on Different Health Care System

OBJECTIVE:To provide reference for improving drug bidding and purchase system in China and to solve the drug quality problem caused by abnormal high price and low price.METHODS:The drug bidding and purchase systems used in some European union countries were reviewed respectively under 2 different health care system,which were the social health insurance and national health services.Linked with payment means of medical cost,the financial relationship among different undertakers were established to analyze drug bidding and purchase system under different payment means of medical cost and discuss the relationship between the undertakers of the exclusive medical expenditure and the main bodies of drug bidding and purchase.RESULTS & CONCLUSIONS:The mode and design of health insurance is closely associated with the settings of centralized drug bidding and purchase system,which determine the design details of bidding and purchase system.The main bodies of centralized drug bidding and purchase are the undertakers of the exclusive medical expenditure in European Union countries,which follows the game theory:the relevant stakeholders as the main body to take part in the process of drug bidding can maximize their interest.