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基于财务视角的药品采购“两票制”改革思考
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| 篇名： | 基于财务视角的药品采购“两票制”改革思考 |
| TITLE： | |
| 摘要： | 目的：为我国全面推进和完善药品采购“两票制”提供参考。方法：分析“两票制”对各利益相关者的影响、药品采购现存问题及财务方面原因，提出应对药品采购现存问题的财务策略。结果与结论：“两票制”对药品生产企业、药品流通企业、公立医疗机构和政府药品监管部门均有一定影响。目前我国药品采购现存问题主要有“以药养医”机制推动了药品价格虚高、药品企业以回扣的方式拉动药品销售、“挂靠”“走票”等潜规则破坏了药品流通秩序，分析其财务原因，主要有“以药养医”模式片面追求自身利益最大化、忽视患者药费负担问题，部分企业投资不到位、研发投入明显不足，内部财务控制措施薄弱、社会责任意识缺失，依靠“挂靠走票”获利、低估了财务风险等。建议药品生产企业调整营销模式、降低成本费用，药品流通企业科学预测定位、拓展获利空间，公立医疗机构改革财政供给、降低用药费用，政府药品监管部门减少监管成本、提升综合效能。通过不断深入推进医药卫生体制改革，不断完善药品采购“两票制”的配套措施，逐步解决药品流通环节存在的以上问题。 |
| ABSTRACT： | OBJECTIVE： To provide reference for China to comprehensively promote and perfect the “two-vote system” for drug purchase. METHODS： The effects of “two-vote system” on interested parties， the existing problems of drug purchase and its financial reasons were analyzed； the finance strategies were put forward to deal with the existing problems of drug purchase. RESULTS & CONCLUSIONS： “Two-vote system” has certain impact on drug production enterprises， drug circulation enterprises， public medical institutions and government drug supervision departments. At present， the existing problems of drug purchase mainly include that the mechanism of “drug to support hospital” has promoted the virtual-high price of drugs； drug enterprises pull drug sales by the way of rebate； hidden rules disrupt the circulation of drugs as “be subordinate to”“amateur performance”. Financial reasons mainly include that the mode of “drug to support hospital” pursuit the maximization of its own interests unilaterally and ignore the drug cost burden of patients； some enterprises have poor investment， lack of R&D investment， have weak internal financial control measures， lack of social responsibility consciousness， rely on “be subordinate to” “amateur performance” profit， underestimate financial risk， etc. The drug production enterprises should adjust marketing model and reduce cost； drug circulation enterprises should predict positioning scientifically and expand profit space； public medical institutions should reform financial supply and reduce drug cost； government drug supervision departments should reduce the supervision cost and improve the comprehensive efficiency. Only by deepening the reform of the medical and health care system， improving the supporting measures for the “two-vote system” in drug purchase can the problems existing in the circulation of drugs be solved gradually. |
| 期刊： | 2018年第29卷第3期 |
| 作者： | 乌婷，陈俊岗，吴君科 |
| AUTHORS： | WU Ting，CHEN Jungang，WU Junke |
| 关键字： | 两票制；药品采购；财务管理；药品生产企业；药品流通企业；公立医疗机构；政府药品监管部门 |
| KEYWORDS： | Two-vote system； Drug purchase； Financial management； Drug production enterprise； Drug circulation enterprise； Public medical institution； Government drug supervision departments |
| 阅读数： | 503 次 |
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