基于扎根理论的“天价药”形成机理与政府监管策略研究  

Research on Formation Mechanism of“Extremely Expensive Drugs”and Regulatory Policy Based on Grounded Theory

作　　者：李华强 庄易霖 范春梅[2] Li Huaqiang;Zhuang Yilin;Fan Chunmei(the School of Public Affairs&Law,Southwest Jiaotong University,Chengdu 610031;the School of Economics and Management,Southwest Jiaotong University,Chengdu 610031)

机构地区：[1]西南交通大学公共管理与政法学院,成都610031 [2]西南交通大学经济管理学院,成都610031

出　　处：《中国行政管理》2020年第5期140-145,共6页Chinese Public Administration

基　　金：国家社会科学基金项目“基于演化博弈和仿真的重大行政决策社会稳定风险防控研究”(编号:19XZZ007);四川省科技计划软科学研究项目“社会风险化解机制研究”(编号:2019JDR0216)。

摘　　要：党的十八大以来,医药卫生管理领域的改革不断深化,取得了显著成效,但在药品市场仍存在"天价药"的问题。本文通过扎根理论研究方法,发现在供给端,专利保护、研发投入、单独定价政策和缺乏可替代仿制药导致了原研药的定价高昂;在药品流通中,公立医院的"双重垄断"和集中采购政策不完善诱发了药品加价;在使用端,医疗服务价格管制、补偿机制、绩效考核和医保控费,导致进销高价药和医保药可及性差的现象并存;在支付端,社会医疗保险支付模式、医保目录调整和商业重疾险还有待改进。研究结论为解决"天价药"问题,深化医药卫生领域的"放管服"改革提供了有价值的参考。Since the 18th National Congress of the Communist Party of China,the management reform in the field of medicine and health has made significant achievements.However,the problem of"extremely expensive drugs"that still exists in the drug market has attracted great attention from the society.In this paper,based on a theoretical analysis,it was found that on the supply side,patent protection,R&D investment,separate pricing policies,and lack of alternative generic drugs led to high pricing of original research drugs.During circulation process,the public hospital’s"double monopoly",incomplete centralized procurement policies and dark sides of interest chain triggered high price increases.On medical service side,the price control of medical service,compensation mechanism,performance evaluation and medical insurance control mechanism lead to the behavior of buying and selling high-priced drug and poor access to insured high-priced anti-cancer drugs.On the payment side,the social insurance payment mode,catalog adjustment and commercial critical illness insurance still needs to be improved.Finally,this paper puts forward policy recommendations in the field of medicine and health.

关 键 词：天价药 抗癌药 药价监管 扎根理论 放管服 

分 类 号：D035[政治法律—政治学]