| 引用本文：周若婧, 杨照, 江滨.国家组织药品带量采购政策的控费效果及其影响因素研究[J].中国卫生政策研究,2022,15(9):56-63 |
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| 国家组织药品带量采购政策的控费效果及其影响因素研究 |
| 投稿时间：2022-04-29 修订日期：2022-09-02 PDF全文浏览 HTML全文浏览 |
| 周若婧1, 杨照2, 江滨3 |
1. 北京大学政府管理学院 北京 100871;
2. 北京大学第一医院 北京 100034;
3. 北京大学药学院 北京 100191 |
| 摘要:国家组织药品带量采购是我国药品政府采购的最新改革方向，本研究基于药品采购数据对该试点政策的控费效果及其影响因素进行研究。基于局部断点回归模型的控费效果评估显示，该试点政策使总体药品费用降低了23.44%，即控费效果良好；但其控费效果在不同试点城市存在显著差异，药品费用变化百分比分布在-37.38%~17.54%之间。控费效果的影响因素研究显示，单一条件变量无法充分解释试点城市间的控费效果差异，高比例医保基金结余和低比例财政卫生健康支出是良好控费效果的核心保障，而政策相关组织经验缺乏是导致控费效果不佳的核心因素。由此建议适时扩展国家组织药品带量采购模式的实施范围，强化政策激励机制与资源禀赋的匹配性以及加强地区间政策相关组织经验的互动交流。 |
| 关键词:药品政府采购 控费效果 影响因素 断点回归 |
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| A study on effect of cost control and influencing factors of state volume-based drug procurement policy in China |
| ZHOU Ruo-jing1, YANG Zhao2, JIANG Bin3 |
1. School of Government, Peking University, Beijing 100871, China;
2. Peking University First Hospital, Beijing 100034, China;
3. School of Pharmaceutical Sciences, Peking University, Beijing 100191, China |
| Abstract:State Volume-based Drug Procurement (SVBP) represents the latest reforming trend in government procurement of drugs in China. Based on the empirical data of drug procurement, this study evaluates the effect of cost control of SVBP, and explores its influence factors. The evaluation of the cost-control effect of SVBP in RDD model shows a fairly satisfying result with the overall drug cost drops by 23.44%. Meanwhile, the cost-control effect of this policy varies in different pilot cities, with the cost changes ranging between -37.38% to 17.54%. The study on influencing factors of cost control effect shows that individual conditional variable is insufficient in explaining the above difference. While high medical insurance surplus and low medical expenditure are keys for a good effect in cost control, lacking of policy-related experience is the main reason for a poor effect. Finally, this study puts forward three proposals in terms of policy, i.e., timely expanding the implementation scope of SVBP, matching the incentive system and policy-related resources, and promoting interaction and policy-related experience exchange between regions. |
| Key words:Government procurement of drugs Effect of cost control Influencing factors RDD |
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