Research On The Influencing Factors And Control Mechanisms Of Pharmaceutical Expenditure In China

Pharmaceutical expenditure rapidly rising is a difficult problem that many countries have confronted with,China is not exceptional.Difficult Medical Services and Expensive Medical Cost has became one of the Three Livelihood Problems,and pharmaceutical cost accounted for a large propotion.Because pharmaceutical expenditures had contributed for above eighty percent of health care expenditures ever before,visibly higher than other countries,and recently,it also contribute for above forty percent in general hospitals in China. The growth rate of total pharmaceutials expenditure is about twenty to thirty percent. Pharmaceutical expenditure growth would reasonably speed up in certain extent,as economic developing and residents' income rising,the health service demand rising.Population increasing and aging,change of disease spectrum and medical model,science and technology innovation inevitably would make the medical expenditure increase rapidly.But,it is severity that the inperfect compensation mechanism problem,pharmaceutical circulation complexity and irrational drug use produced the expenditure increase.And the efficient control of pharmaceutical expendture could reduce the health expenditure,optimize the health resouce, improve the equity and acquirablity of health sevices and lighten people's burden.So the key to settle the problem of difficult medical services and expensive medical is to settle the rapid increasing of drug expenditure.How to constitute a efficient mechanism to control the drug expenditure irritionality increasing has been a stricking point of health care reform.It is more difficult to control drug expenditure in most countries,because of the particularities of drug and economic particularities of drug market.More researchers expanded the research about drug expenditure,but few carried out qualitative analysis, quantitive analysis and comprehensive research.This research will try to base on economic theory,to analysis the drug produce,perchase,distribution and consumption in our country, according to the principle to rudder the establishion and implemention of governmental policies and to organize capital collection and management of drug consumption.It will provide a relative perfect sample of drug expenditure research that integratively use economic and society theories and more advance research methods. Fistly,the research analysed the relational parts in drug market and their gaming,and finded that the doctor was in a most important status,he can help and replace the demand part to chose the drug,and become the agency of hospital to sale the drugs.We can say he has a double status that was demand part and suply part of drug market.So we could control the generics and quantitis of drug in doctors' prescription to reach the aim to control the drug expenditure.The research also found that if there was no one to supervise the doctors' induce demand behaviors,and the patients choiced the doctor because they could not identify the doctors' hehaviors,the doctors' behaviors would not be controlled.The faulty health care system made the drug expenditure increase more severity.And also people mostly care the drug price policies.From the research that drug expenditure affective facors modol according to the drug consuming of three cities,we find that the quantity and introduce new drug is as important facors as the price factor,so we can't consider the price policies only,but to igore controling drug consuming quantity.The research based on the drug expenditure control theories,combined many contries' experiences,and analysed the theories and practises,and then construed the policies in China. This research figured the economic theories including government drug price restrict, information asymmetry theory,supply part inducement theory and principal-agent theory. The third party interpositon is the optimal control principal part,it changes the relationship of doctor and patient,becomes the strong part to supervise the prescription and to negotiate drug price.Concerning the international experience of pharmaceutical expenditure control,this research emphasized to analyse drug price policy,reference price program,co-payment of pharmaceutical expenditure and pharmacoeconomics application.Chinese polycies include depreciate drug price,zero added drug price,and incite public bidding and stock.Finally it is puted forward that an integrative frame of drug expenditure control mechanism,and proposed many suggestions.We should proceed with inspirit and inhibit doctors' behaviors in microcosmic arrangement and control the suply and demand part of drug market in mocrocosmic arrangement to control the quantity and price irrationality,it will help us to analyse and setle the realistic problems,and to rationally use the limited resourse.