价格规制降低药品招标价格了吗?——基于基本药物制度和取消药品加成政策准自然实验的研究  

How Do Price Regulations Impact Drug Prices in China?A Study of the National Essential Medicine Policy and Zero Markup Policy

作　　者：岳阳 龙小宁 朱恒鹏[3] Yue Yang;Long Xiaoning;Zhu Hengpeng(School of Economics,Xiamen University;Intellectual Property Research Institute,Xiamen University;Institute of Economics,Chinese Academy of Social Sciences)

机构地区：[1]厦门大学经济学院 [2]厦门大学知识产权研究院 [3]中国社会科学院经济研究所

出　　处：《经济科学》2023年第2期163-182,共20页Economic Science

基　　金：国家自然科学基金面上项目“社会医疗保险中的委托代理问题研究:中国医保支付制度改革的政策分析”(项目编号:72173106);国家自然科学基金面上项目“科技创新的知识产权保护研究:测量指标构建与最优政策选择”(项目编号:72073114);世界银行科研项目“国家治理视角下财政卫生投入政策研究”(项目编号:SBS-2020-03)的阶段性成果。

摘　　要：为了回答我国政府能否通过药品价格规制来解决“以药养医”这一问题,本文首先构建理论模型分析药企面对价格规制的策略性反应。理论结果表明,药企会针对价格规制来调整药品投标价格和返利额度,以保证医生处方选择的激励;这种调整会提高招标价格,从而部分抵消价格规制对药价的抑制作用。在实证部分,本文将药品中标数据与国家基本药物目录、国家和各省的医保目录中的药物名单进行匹配构建数据样本,并使用此数据分析基本药物制度和取消药品加成政策对药品招标价格的影响。结果表明,基本药物制度导致招标价格提高约8%,而取消药品加成制度则导致招标价格提高约9%。可以看出,药企的策略性定价行为部分抵消了价格规制对药品价格的影响。The Chinese government has proposed the establishment of a zero markup drug policy to reduce medical expenditure and improve the appropriate use of medication.Will this policy be effective?In order to answer question,we first use a theoretical model to investigate the strategic response of pharmaceutical enterprises to price regulation.The theoretical results show that pharmaceutical enterprises will adjust the bidding price and rebate limit of drugs according to the price regulation to ensure the incentive for doctors'prescription choice;and this adjustment will raise the bidding price,thus partially offsetting the inhibitory effect of price regulation on drug prices.In the empirical part,we utilize the drug bidding,national essential drug list,and security-covered drug purchasing data of both central and local levels to estimate the impact of zero markup drug policy and national essential medicine policy on drugs'tender price.The results indicate that the implementation of zero markup drug policy has increased the tender price by about 9%,and the implementation of national essential medicine policy has increased the tender price by 8%.We can see that the pharmaceutical pricing policies have failed to achieve the intended goal of reducing drug prices,because of the pricing strategy of drug manufactures.

关 键 词：基本药物制度 取消药品加成 以药养医 定价行为 药品招标 

分 类 号：F420[经济管理—产业经济] F423F2