“两票制”实施对某三甲医院药品供应和价格的影响分析  

Effect of“Two-invoice System”on drug supply and price in a major comprehensive hospital

作　　者：刘永谦[1] 朱文思 陈泺 刘付伟清 阳巧凤[1] LIU Yong-qian;ZHU Wen-si;CHENG Luo;LIU Fu-wei-qing;YANG Qiao-feng(Department of Pharmacy,Guangdong Women and Children's Hospital,Guangzhou 511442;Department of Gynecology,Guangdong Women and Children's Hospital,Guangzhou 511442)

机构地区：[1]广东省妇幼保健院药学部,广州511442 [2]广东省妇幼保健院妇科,广州511442

出　　处：《中南药学》2021年第9期1988-1992,共5页Central South Pharmacy

摘　　要：目的探讨“两票制”政策在本院的实施效果,为“两票制”政策在医疗机构的实践推行和完善提供参考。方法收集“两票制”政策实施前后本院药库药品的采购供应和价格调整等相关数据。结果本院药库的缺药率、药品替换率和药品配送延迟率在“两票制”政策实施的当月,即2018年6月达到最高,分别为15.33%、5.03%和4.07%,随后逐渐降低。平均配送延迟时间由“两票制”政策实施前的3~4 d逐渐下降为1~2 d。药品供应逐渐趋向于稳定和充足状态。2018年6-11月,本院共有136种药品涨价,多数药品的涨价幅度在20%以内,占52.21%,而涨价幅度≥50%的药品占33.08%。涨价原因主要为非平台采购的药品,缺乏监管。本院共有131种药品降价,多数药品的降价幅度在10%以内,占58.78%,而降价幅度≥50%的药品占3.82%。降价原因主要为新中标价、供应价调整和政府限价等。结论从目前本院实施“两票制”政策后的效果来看,实施初期药品供应不稳定、部分药品供货周期延长。药品价格因新中标价和供应价调整导致反复变化,波动较大。整体药价得到有效控制或降低的同时,部分药品价格也发生了一定幅度的上涨。建议药品管理部门根据实际情况完善相关制度管理,使“两票制”在医疗机构的实施更加顺利。Objective To determine the effect of“Two-invoice System”in our hospital and to provide reference for further implementation and improvement of“Two-invoice System”in medical institutions.Methods The data of drug supply and price adjustment were collected.Results The drug shortage rate,replacement rate and delivery delay rate was 15.33%,5.03%and 4.07%respectively,reaching the highest in June 2018,the very month when the“Two-invoice System”was implemented formally,and then the rates decreased gradually.After its implementation,the average delivery delay time was shortened from 3-4 days to 1-2 days,the supply of drugs gradually tended to stabilize and be adequate.From June to November 2018,the price of 136 drugs rose in our hospital,52.21%of which rose by 20%,while 33.08%rose by more than 50%.The price rise mostly occurred in the non-platform procurement of drugs due to the lack of regulation.Meanwhile,131 drugs had price recuction,58.78%of which reduced by 10%,and 3.82%reduced by more than 50%.The main reasons for the price reduction included new bidding price,supply price adjustment and governmentcontrolled price.Conclusion At the early implementation stage,unstable medicine supply and prolonged delivery cycle are observed.Drug prices frequently flucuated due to new bidding price and supply price adjustment.The overall drug prices had been controlled or reduced effectively,while some drug prices had also increased to a certain extent.

关 键 词：两票制 药品供应 药品价格 

分 类 号：R95[医药卫生—药学]