“两票制”政策对我国药品价格和药品流通企业交易成本的影响  

Impact of Two-invoice System Policy on Drug Prices and Transaction Costs of Drug Circulation Enterprises in China

作　　者：彭宁 周茜[1] PENG Ning(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing,Jiangsu,211198,China)

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198

出　　处：《医学与社会》2023年第9期115-121,共7页Medicine and Society

基　　金：国家社会科学基金资助项目,编号为20CJY001。

摘　　要：目的:探究“两票制”政策对我国药品价格和药品流通企业交易成本的影响。方法:基于DID模型,使用2016-2019年我国城乡药品零售价格指数实证检验“两票制”对药品价格的政策效果;从药品流通企业视角出发,利用大型医药流通上市企业2013-2021年财务数据,探究“两票制”对药品流通企业交易成本的影响;再将“两票制”、药品价格与药品流通企业纳入同一框架,进一步探究三者的关系。结果:“两票制”实施后一段时间内使药品价格显著上涨(P<0.001),影响系数为0.087。“两票制”也增加了药品流通企业交易成本(P<0.05),影响系数为0.167,其中对销售费用的影响更大(P<0.001),影响系数为0.637,结果具有稳健性。药品流通企业交易成本与药品价格呈正相关关系(P<0.001),影响系数为1.428。结论:“两票制”的实施在短期内增加了药品价格和药品流通企业交易费用,该短期冲击影响可能受到低估,影响机制是通过提高药品流通企业交易费用进而提高药品价格,其中对交易费用中的销售费用影响更大。建议在政策过渡期及时评估政策执行情况,采取多种措施保障药品价格和药品供应,药品流通企业则需做好财务风险防控。长期来看“两票制”要与其他医药政策协调配合,实现政策效果最大化。Objective:To investigate the impact of the two-invoice system(TIS)policy on drug prices and transaction costs of drug circulation enterprises in China.Methods:Based on the DID model,the effect of TIS on drug prices was tested by empirically using the urban and rural drug retail price indices from 2016 to 2019 in China.From the perspective of drug distribution enterprises,the financial data of large listed pharmaceutical distribution enterprises from 2013 to 2021 were used to investigate the effect of the TIS on drug prices.Finally,the relationship between TIS,drug prices and drug distribution enterprises was further explored in the same framework.Results:The TIS significantly increased the price of drugs(P<0.001)for a period of time after its implementation,with an impact coefficient of 0.087.The TIS also increased the transaction costs of drug distribution enterprises(P<0.05),with an impact coefficient of 0.167.The impact on sales costs was even greater(P<0.001),with an impact coefficient of 0.637,and the results were robust.There was a significant positive correlation between transaction costs of drug distributors and drug prices(P<0.001)with an impact coefficient of 1.428.Conclusion:TIS had increased drug prices and transaction costs for drug distributors in the short term,which may have been underestimated.The mechanism was to raise drug prices by increasing transaction costs for drug distributors,with a greater impact on the sales costs of the transaction costs.It is recommended to evaluate the implementation of the policy in a timely manner during the policy transition period,and to take various measures to protect the price and supply of medicines,while drug distribution enterprises need to do a good job of financial risk prevention and control.In the long run,TIS should be coordinated with other pharmaceutical policies to maximize the effect of the policy.

关 键 词：药品管理 药品价格 两票制 交易成本 药品流通企业 

分 类 号：R197.1[医药卫生—卫生事业管理]