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目的:为实现我国医药价值链整体价值最大化的改革目标提供路径选择。方法:通过评价国内外政府监管医药价值链的手段与效果,为探索我国医药价值链再造和深化医改提供路径选择,以实现我国医药价值链整体价值最大化的改革目标。结果:国外政府监管医药价值链,通常选择从市场容易失灵的环节入手,重点监管医疗机构的行为,药品流通环节则主要交由市场调节,这样的监管路径较为合理。我国在实施新医改之前,医药价值链存在市场和政府监管双重失灵;实施新医改以来,医药价值链价值中心逐渐回归需求终端,患者效用有所提高;“虚高”的药价被进一步挤出;医疗服务质量缺口依然存在;基层医疗机构的补偿机制仍有待完善。结论:我国医药价值链再造与深化新医改的路径选择,应通过构建医药供求双向约束机制,重点监督医疗机构行为和药品定价,保持医药经营实体活力并持续提高基层医疗机构服务水平,从而实现我国医药价值链整体价值最大化的改革目标。
Objective: To provide a path to achieve the reform goal of maximizing the overall value of Chinese medicine value chain. Methods: By means of evaluating the means and effects of government regulation of medical value chain both at home and abroad, this paper provides a path selection for exploring the reconstruction of Chinese medicine value chain and deepening medical reform in order to achieve the reform goal of maximizing the overall value of Chinese medicine value chain. Results: Foreign government regulates the value chain of medicine, usually from the point of market failure, focusing on regulating the behavior of medical institutions. Drug circulation is mainly regulated by the market. Such a regulatory path is more reasonable. Before the implementation of the new medical reform in our country, the pharmaceutical value chain has dual failures in the market and government regulation. Since the implementation of the new medical reform, the value center of the pharmaceutical value chain has gradually returned to the demand terminal, and the utility of the patient has been raised. The price of “virtual high” Extrusion; gap in the quality of medical services still exists; the compensation mechanism of primary medical institutions still needs to be improved. Conclusion: The rebuilding of medical value chain in our country and the path of deepening new medical reform should be achieved by building a bidirectional restraint mechanism of medical supply and demand, focusing on monitoring the behavior of medical institutions and drug pricing, maintaining the vitality of medical operations and continuously improving the service level of primary medical institutions, The reform goal of maximizing the overall value of the pharmaceutical value chain.