三重目标约束下的进口药品费用:药价改革中的结构调整与改进优化  

Expenditure of Imported Pharmaceuticals under the Constraint of Triple Objectives:Structural Adjustment and Improvement Method during the Reform of Pharmaceutical Pricing

作　　者：袁雪丹 毛振华 王健[1] Yuan Xuedan;Mao Zhenhua;Wang Jian(Dong Fureng Institute of Economic and Social Development,Wuhan University;Shanghai Health Development Research Center(Shanghai Medical Information Center);School of Economics,Renmin University of China)

机构地区：[1]武汉大学董辅礽经济社会发展研究院 [2]上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所) [3]中国人民大学经济学院

出　　处：《管理世界》2024年第2期149-171,共23页Journal of Management World

基　　金：国家自然科学基金项目(基金号:71373146);国家卫生健康委、中国卫生经济学会卫生健康经济管理重点研究项目(基金号:CHEA2122040301)的资助。

摘　　要：药品进口贸易的增长满足了我国药品市场对高价值药品的需求,但是进口药品的价格和费用长期居高不下,给医保基金和人民群众带来了沉重的经济负担。为了在药品费用可控的范围内,促进高质量药品进口,保障药品供应和公平可及,本文提出了我国药品进口的科技性、公共性和资本性目标,并根据三重目标的理论内涵对其进行测度,构建了嵌入三重目标的药品进口贸易引力模型和优化的特征价格模型,实证分析了与三重目标相关的主要因素对进口药品费用和价格的影响。研究发现:我国进口药品费用的增长方向和资本性目标的发展方向基本一致,公共性目标的发展方向不利于药品进口贸易增长,而科技性目标基本不起作用。三重目标之间的耦合协调度在2017年以后随着公共性目标的改变而快速下降,从2016年的0.9074下降至2018年的0.2995。公共性目标导向政策降低进口药品价格的效果受到市场竞争程度影响。本研究成果为完善药品进口政策,减轻人民群众用药负担提供了参考和借鉴。The rise of pharmaceutical import trade has satisfied the need of high-value medicines in the Chinese pharmaceutical market.However,the price and expenditure of imported pharmaceuticals remains at a high level in the long term,which brings social health insurance and citizens heavy economic burden.In order to promote the import of high-quality drugs,guarantee the supply of pharmaceuticals and ensure fair access to medicines within the controlled scope of pharmaceutical expenditure,this paper proposes three objectives of pharmaceutical import:scientific objectives,public objectives and capital objectives.Based on the theoretical analysis of triple targets,three objectives are measured.A trade gravity model embedded with triple targets and an optimized hedonic price model are established.We empirically analyze the impact of main factors related to the above targets on the cost and the price of imported drugs.The study finds that the growth direction of the expenditure of imported drugs in China is basically consistent with the development direction of capital goal,while the development direction of the public goal is not beneficial for import trade of pharmaceuticals.The scientific goal is ineffective.The coupling coordination degree among triple objectives has declined rapidly since 2017 due to the change of the public goal,which dropped from 0.9074 in 2016 to 0.2995 in 2018.The impact of public-oriented policies on cutting pharmaceutical price is influenced by the degree of market competition.This study provides reference for improving drug import policies and reducing people's economic burden of medication.

关 键 词：进口药品 三重目标 药品费用 

分 类 号：R95[医药卫生—药学]