限价政策下药品供应链采购策略研究  

Research on the procurement strategy of the pharmaceutical supply chain under price cap regulation

作　　者：吴璐 郭强[1] 聂佳佳[1] WU Lu;GUO Qiang;NIE Jiajia(School of Economics and Management,Southwest Jiaotong University,Chengdu 610031,China)

机构地区：[1]西南交通大学经济管理学院,四川成都610031

出　　处：《管理工程学报》2023年第4期123-134,共12页Journal of Industrial Engineering and Engineering Management

基　　金：国家自然科学基金资助项目(72071165、71962037);中国国家铁路集团有限公司科技研究开发计划项目(N2019Z009)。

摘　　要：为了控制药品价格过快增长,减轻居民医疗负担和破除“以药养医”弊端,政策制定者自新医改以来已出台多项药品限价政策对药品价格进行调整。本文立足于中国药品市场,研究了不同限价政策对药品供应链采购策略的影响。首先,以无价格规制模型为基准,发现当市场规模较大时,医疗机构采取分散采购策略;当市场规模较小时,其采取的采购策略与规模经济相关。然后,本文分别考察医疗机构限价和医药企业限价政策对采购策略的影响。当规模经济带来的折扣越大时,随着市场规模的增加,两种限价政策下的采购策略由集团采购策略转为分散采购策略。当规模经济带来的折扣越小时,政府选择医药企业限价政策时采购策略与此相同,政府选择医疗机构限价时,医疗机构选择集团采购策略。最后,考虑政府对限价政策的选择,当规模经济带来的折扣越小时,随着医药企业最高限价的增加,政府的策略由医药企业限价政策转为医疗机构限价政策。当规模经济带来的折扣越大时,若医疗机构选择分散采购策略时两种限价政策效用相同;若医疗机构选择集团采购时,政府选择医疗机构限价政策。The pharmaceutical industry plays an important role in the economy,society,and public health of almost every country.Pharmaceutical pricing remains a crucial and controversial issue faced by both developed and developing countries.For developed countries,the high drug fees may not pose a challenge to patients because of medical insurance coverage,but the high drug expenditure increases the public health economic burden;thus,the government regulates the drug prices.In developing countries,reasonable drug pricing is related to the affordability of drugs for patients.Hence,countries are increasingly implementing drug price regulations,which critically affect the drug manufacturers and medical institutions.We explore the effects of the price cap regulations over medical institutions and pharmaceutical manufacturers on procurement strategies.There are two types of pharmaceutical procurement strategies:decentralized procurement and group procurement strategies.Recently,group procurement has become the primary model of pharmaceutical procurement.The healthcare group purchasing organization(GPO)plays a role in the healthcare supply chain by maintaining low prices and helping healthcare system members achieve cost savings.China has explored the GPO in drug procurement since 2016,and there are three GPO models in Shanghai,Shenzhen,and Guangzhou.Although the three models operate differently and have been examined,they achieve cost savings and control drug prices.Based on China′s drug market,we investigate the procurement strategies adopted by the drug supply chain,including a pharmaceutical company,a GPO,and two different medical institutions,under the price cap regulation.First,considering the model without price cap regulation,it was observed that group procurement is adopted if the market size is small when the economies of scale are moderate.When the market size is moderate,the procurement strategy changes from group procurement to decentralized procurement with increasing contract administration fees(CAFs).When the e

关 键 词：价格规制 采购策略 集团采购 药品供应链 

分 类 号：F270.5[经济管理—企业管理]