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药价虚高是我国的一个老大难问题,政府推出了一系列降低药品价格、整顿和规范药品市场的政策措施,但收效不大。本文认为导致药品价格居高不下的原因有:药品生产企业低水平重复建设,市场集中度低,药品信息资源不能共享,医药物流成本高;新药审批上的权力寻租造成“新药”泛滥,老药变相成“新药”规避管制,药价管理失控;政府与市场双重失灵,给医药商业贿赂预留了空间;药品营销监督管理的法规缺位,医务人员寻租,临床用药过度,药品价格出现“逆调节”现象。“以药养医”是我国独特的医疗卫生体制长期累积下来的结果,目前医药分业条件还不成熟,无法保障安全用药;医药分业是经济利益的转移,不可能切断经济利益链,对降低药品费用作用有限,医药分业应慎重缓行。本文认为药品审批泛滥是药价虚高的根源所在。为此,要建立医药合并的统一行政管理体制、全国性的药品信息资源数据库和全国性的药品交易电子网络平台;加强药品监管,严把药品准入关,规范药品促销行为;完善药品价格管理,控制药品利润;加强合理用药监督,切断医药代表与医务人员的利益链。
The high drug price is an old problem in China. The government has introduced a series of policies and measures to reduce the price of drugs, rectify and standardize the drug market, but it has had little effect. This article believes that the reasons for high drug prices are: low-level repeated construction of pharmaceutical production enterprises, low market concentration, drug information resources can not be shared, high cost of medical logistics; new drug approval for the power of rent-seeking caused by the “new drug” proliferation The old drugs disguised as “new drugs” circumvented control, drug price management was out of control; the government and the market failed in two ways, leaving room for medical and commercial bribery; lack of regulations for drug marketing supervision and management, medical staff rent-seeking, excessive clinical drug use , Drug prices appear “reverse adjustment ” phenomenon. “The use of drugs to support medical care” is the result of long-term accumulation of China’s unique medical and health care system. At present, the conditions for the separation of medical services are not yet mature, and it is impossible to guarantee the safe use of drugs; medical division is the transfer of economic interests and it is impossible to cut off the economic interest chain. The effect of reducing the cost of drugs is limited, and the medical division should be cautiously delayed. This article believes that the proliferation of drug approvals is the root cause of high drug prices. To this end, it is necessary to establish a unified administrative management system for pharmaceutical mergers, a nationwide drug information resource database, and a nationwide electronic trading platform for drug transactions; strengthen drug supervision, strictly control drug access, and standardize drug promotion behavior; and improve drug price management. Control drug profits; strengthen supervision of rational drug use and cut off the interests chain of medical representatives and medical personnel.