制度互补性与药品流通体制的中外差异  

Institutional Complementarities and Differences in Pharmaceutical Circulation Systems Between Foreign Countries and China

作　　者：杜创[1] 朱恒鹏[1] 方燕[2] 

机构地区：[1]中国社会科学院经济研究所 [2]中国社会科学院规制与竞争研究中心

出　　处：《财贸经济》2015年第4期109-120,共12页Finance & Trade Economics

基　　金：国家社会科学基金"医保付费机制创新与公立医院改革研究"(14BGL145)的资助

摘　　要：本文比较了发达国家与中国的药品流通体制,发现二者之间有多方面差异,涉及医药是否分业、零售市场结构、批发市场结构、分销体系、门诊与住院药品价格管制模式、是否允许二次议价等。运用经济学"互补性理论",我们进一步论证了,上述系统性、多方面差异源于药品流通体制内部构成要素的互补性,且不同的药品流通体制与各自外部环境相适应(尤其是医疗价格体制和行政管理体制)。本文的政策含义是,药品流通体制改革政策或措施应具有系统性、完善配套,改革若仅触及药品流通体制内部单一要素,将难以成功,药品流通体制改革也需要与医疗服务价格体系改革等相互配套。In this paper, we compare China with developed market economies in pharmaceutical circulation systems using complementarity theory in economics. We find that systematic differences are shown in the following elements.the relation between diagnosis and treatment, structures of retail/wholesale markets, distribution systems, modes of pharmaceutical price controls for outpatient and inpatient services, permitting price bargaining or not, etc. We argue that the reason for these systematic differences is pharmaceutical circulation systems behaving as a whole, whose internal components are complementary, and different pharmaceutical circulation systems ad^pt to corresponding external environment, especially medical services pricing system and administrative system. The policy implication of this paper is that reforming policies or measures on pharmaceutical circulation system should be systematic or complementary. Policy simply changing particular element in a pharmaceutical circulation system will be difficult to succeed, and the reform of pharmaceutical circulation system should be consistent with the reform of medical services price regulation system.

关 键 词：药品流通 价格管制 制度 互补性 

分 类 号：F426.72[经济管理—产业经济] F724