Study On Pooled Procurement Modes Of Drugs And Its Effect In China

Since 1993,Henan Province started the pooled procurement of drugs in China.In 2000,it officially opened the pooled procurement of drugs in China.So far,the centralized purchase of drugs in China has developed for more than 20 years.The purpose of this article is to analyze the main pooled procurement modes from their cost control effects and satisfaction evaluations,then to select the best and most cost-controlled mode,and to support the promotion of pooled procurement modes in the future,and to propose solutions to existing problems.First of all,through the study of policy literature,the pooled procurement modes of drugs in China is divided into two categories,namely,the provincial and municipal level independent purchase mode and the national organization purchase mode.This paper analyzes the development history,policy measures,advantages and disadvantages of each mode,and makes reference to the effective measures taken by the main foreign procurement modes.Secondly,through the principal component analysis method,select drug price,drug cost,medical cost and other indicators to rank the cost control effect of 31 provinces in 2018,and objectively select therepresentative provinces of each procurement mode to analyze the cost control effect in detail.And using case analysis method,take a public general hospital in Guangzhou as an example,to explore the impact of "4+7" procurement mode on drug utilization rate,inpatient medical costs and medical insurance fund.Then using the questionnaire survey method to conduct satisfaction surveys of various types of pooled procurement of drugs in China,the survey content includes the comprehensiveness of the drug centralized procurement policy,the strength of price reduction,the rationality of winning prices,medical insurance Relevance and other six dimensions.The results of this study show that:(1)The implementation of China's pooled drugs procurement modes has achieved certain results.The prices of traditional Chinese medicine and western medicine are generally close to the growth rate of prices,and the bid price of drugs has a downward trend.The growth rates of total per capita drug costs,the proportion of medicines,and per capita medicine costs in public hospitals have all decreased,and the burden of per capita medicine costs has decreased.(2)At present,the problems of second bargaining and exclusive bid winning are relatively prominent,and there are still some deficiencies in the procurement modes.In terms of drug price,the price of Western medicine has increased rapidly,and the top five drugs with the highest bid price are injection drugs,and the change range of bid price of high-priced drugs is less than that of low-priced drugs.In terms of patients' burden,the per capita medical expensesaccount for more than 40% of the personal consumption expenditure.There is still a risk of catastrophic medical expenditure,and patients' burden is still heavy.In terms of medical expenses,although drug expenses are reduced,the total medical expenses are still increasing,and the awareness and policy of overall cost control are more important.(3)In 2018,among the provincial and municipal independent procurement modes,Shanghai's overall cost control effect of drug group procurement is the best.Shanghai's centralized procurement mode and "4+7" procurement mode both have clear procurement volume,among which "4+7" procurement drug price is lower and the cost control strength is stronger.(4)According to the survey,the medical institutions prefer the provincial online and municipal bargaining mode,and the "4+7" procurement mode has the highest satisfaction score and comprehensive evaluation in five dimensions,but the evaluation of the rationality of the bidding price is low,and the expenditure of medical fund increases.(5)From the perspective of comprehensive cost control effect and satisfaction evaluation effect,the "4+7" procurement mode has the best overall implementation effect.Therefore,in view of the main problems existing in China's centralized drug procurement,this article suggests that the control of other medical items should be strengthened for overall cost control,the promotion of volume purchases should be used to increase the cost control effect,and the exclusive bidding system should be partially cancelled.At the same time,some drugs have gradually cancelled the exclusive bid winning system to ensure the availability of drugs,strengthen supervision and punishment,and prevent the second bargaining in private.In addition,big data can be used to establish drug price monitoring mechanism to improve the rationality of drug bid price.