| 引用本文：李洪宇, 孙强.“两票制”政策对山东省药品供应状况影响分析[J].中国卫生政策研究,2021,14(1):29-36 |
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| “两票制”政策对山东省药品供应状况影响分析 |
| 投稿时间：2020-11-03 修订日期：2020-12-10 PDF全文浏览 HTML全文浏览 |
| 李洪宇1,2, 孙强1,2 |
1. 山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心 山东济南 250012;
2. 国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学) 山东济南 250012 |
| 摘要:目的：探究“两票制”政策对山东省药品供应状况的影响，为保障政策进一步实施提供科学依据和政策建议。方法：对比政策实施前后山东省药品集中采购平台数据，采用企业集中度分析药品供应市场的集中状况，采用间断时间序列方法分析政策对药品到货率和订单完成率的影响。结果：药品供应企业数量逐步减少，由政策实施前的627家降为565家；市场集中度逐步提升，由316.42提高到366.29；大型企业市场份额逐步提升，份额占比前75%的企业数量由54家降为47家。政策实施后，山东省总体到货率呈下降趋势，经济发达地区、相对较弱地区和欠发达地区的药品到货率也相应呈下降趋势。结论：“两票制”政策的实施，使得山东省药品供应市场集中度逐步提升，供应市场秩序逐步规范。但政策实施后，有部分地区医疗机构反映出药品供应下降的趋势，不利于患者用药可及性的提升。 |
| 关键词:两票制 药品供应企业 间断时间序列分析 实施效果 |
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| Analysis of the impact from the “Two-Ballot System” policy on drug supply in Shandong Province |
| LI Hong-yu1,2, SUN Qiang1,2 |
1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China;
2. NHC Key Lab of Health Economics and Policy Research(Shandong University), Jinan Shandong 250012, China |
| Abstract:Objective:To explore the impact from the "Two-Ballot System" policy on the drug supply situation in Shandong Province, and provide scientific basis and policy recommendations for ensuring further implementation of the policy. Methods:Comparison was made on the data from Shandong Province's platform for centralized drug procurement before and after the policy was implemented. The concentration of drug manufacturers was adopted to analyze the concentration of the drug supply market. The Interrupted Time Series analysis method was used to analyze the impact from the policy on the rate of drug order delivery and the rate of drug order completion. Results:The number of pharmaceutical suppliers has decreased step by step, from 627 before policy implementation to 565 thereafter; the market concentration has gradually increased, from 316.42 therebefore to 366.29 thereafter; and the market share of large-size manufacturers has gradually increased, with the number of manufacturers accounting for the top 75 percent share reducing from 54 to 47. After the implementation of the policy, the overall rate of drug order delivery in Shandong Province was on a downward trend (β3=-0.012, p=0.002), and the rate of drug order delivery in developed regions (β3=-0.011, p<0.001), relatively less developed regions (β3=-0.011, p<0.001) and underdeveloped regions (β3=-0.014, p=0.003) also showed a downward trend. Conclusions:The implementation of the "Two-Ballot System" policy has gradually increased the concentration of the drug supply market in Shandong Province and gradually standardized the supply market order. However, after policy implementation, some medical institutions in some regions showed a downward trend of drug supply, which is not conducive to the improvement of patients' access to drugs and requires further attention. |
| Key words:Two-Ballot System Drug supply company Interrupted Time Series analysis Implementation effect |
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