Study On Implementation Of Drug Purchase Policy In Shanghai Public Hospitals ——A Case Study Of Shanghai A Hospital

The high cost of medical treatment has always been a hot topic in the problems of people’s livelihood in China,and the main reason for the high cost of medical treatment is the high price of drugs,and the national government has been committed to solving the problem that the people look down on the disease and cannot afford to eat medicine.On March 27,2015,the Shanghai Municipal Human Resources and Social Security Bureau and other four departments jointly formulated and issued the Notice on Doing a Good Job in the Procurement of Medical Insurance Drugs in Shanghai（Hu ren she yi fa [2015] 13）.Shanghai Municipal Drug Procurement Policy officially began to implement,the policy for some clinical use of large,high prices,and more production enterprises of basic drugs and non-patented drugs carried out pilot procurement,on the basis of ensuring the purchase of drugs,greatly reduced the price of drugs,to achieve the purpose of exchanging prices for quantity,not only to ensure the survival of drug manufacturers,but also to truly benefit the people.Moreover,the policy of drug procurement with quantity has been continuously reformed and the variety has been expanding,which has played a vital role in solving the problem of expensive medical treatment for the people.However,after all,the policy is still in the pilot exploration stage,and there are still some problems exposed in the implementation process,which need to be improved and improved.Through the research of domestic and foreign literature,it is found that scholars at home and abroad are constantly exploring the mode of drug procurement,and have done a lot of research on volume-price linkage and procurement forms.Domestic scholars have more research on centralized procurement of drugs,while there is a relative lack of research on procurement with quantity.From the perspective of public hospitals,this paper takes the drug procurement policy as the starting point,and compares the process of change in the quantity procurement,clarifies the implementation status of the drug procurement in Shanghai at this stage,and finds out the results brought by the policy.Based on the background of the implementation of shanghai drug procurement policy in public hospitals,taking Shanghai A Hospital as an example,this paper conducts research on various stakeholder groups of the volume procurement policy through questionnaire survey method and interview method,and draws the problems caused by the implementation of the policy,including serious overdue procurement cycle,untimely collection of payment by medical institutions,unstable supply of some drugs,low enthusiasm of clinicians,and contradictions in patient medication.And analyze the causes of the above problems,mainly for the imperfect policy implementation system of medical institutions,the clinical use of some drugs is not as expected,the interest pattern of medical institutions has been broken,the medical insurance funds are advanced to the hospital to reduce the pressure,the supply chain of drug distribution enterprises is unstable,the enthusiasm of enterprises to supply is not strong,the varieties of clinically replaceable drugs are limited,the winning pharmaceutical companies abandon the sales model with gold,the medical institutions lack incentive systems,and the payment standards for drug medical insurance are unreasonable,patients’ distrust of domestic generic drugs,etc.Some suggestions were put forward for improving the implementation of Shanghai’s drug procurement policy.Including optimizing the platform,improving the evaluation feedback system,improving the system to ensure the stability of policy implementation,and coordinating departments to effectively strengthen the implementation of supervision.Specifically,it is necessary to optimize the data measurement system of the procurement platform with quantity,build a feedback mechanism for the evaluation of drugs with quantity procurement,improve the price protection system for the winning drugs in the purchase of the amount,improve the incentive and constraint system of the drug procurement policy,and improve the withdrawal system of the winning drugs with the amount of procurement Strictly control the process of capital circulation of drug procurement,improve the payment standards for drugs,strengthen the production supervision of drugs,and increase the publicity of the consistency evaluation of domestic generic drugs.It is hoped that these suggestions will help the implementation of the drug procurement policy in Shanghai public hospitals.