医药产业政策落地 药品招标采购或取消
今年3月,国务院办公厅出台《关于促进医药产业健康发展的指导意见》。此后,关于这一指导意见的落地工作逐步推进。今年7月25日,上述方案正式对外发布,针对该指导意见的具体落地执行细则出台。
根据方案内容显示,方案明确了国家各职能部门的具体分工,并将各项任务进行分解,且提出了明确的时间进度要求。方案还对中国医药(600056,股吧)产业链条的各个环节包括研发、生产,到抽检、流通、零售等环节,都确立了明确的目标和要求,此外,在三医联动、医保、药价政策的改革、中医药现代化等方面予以明确规定。
“这一方案中最大的亮点是确立药品交易价格的市场机制。”上述负责人认为,根据《方案》规定,今后我国将实施医疗、医保、医药联动改革,充分发挥市场机制作用,药品实际交易价格主要由市场竞争形成。“这就是说,药有可能实现真正的市场价格。”
当前中国药品价格的定价机制仍是行政定价机制,即各省通过药品集中招标采购的方式进行药品采购,“这一方式的弊端在于,诸多并非在市场一线的政府部门根据各企业的报价进行定价,不一定真正符合市场规律”,上述负责人说,这种情况下,还容易滋生一些权力寻租空间,使得中国药品价格的下降空间有限。而且把进入医疗机构的药品销售价格进行了行政化的统一规定,让药品丧失了市场调节的机制。
有部分地方政府通过与流通企业集中采购的方式,尝试降低药品价格,“比如安徽和福建省的部分地市,通过地市级的集中采购,将地方药品采购价格下降了30%左右。”上述负责人说,这说明在药品省级集中招标采购过程中,还有一定的下降空间。
但这并非没有解决之道,“如果后续国家的监管侧重于药品报销价格的监督,但在其他环节则由药厂和医院之间按照正常的市场机制定价,药厂在自己的成本和利润考量下,与医院协商确定出供货价格,可能不同医院的供货价格会有差异,但这样才能体现出市场机制,也能真正调动药厂和医院的药品采购积极性。”上述负责人说,如果担心在这种机制下,企业或医院的利润过高,仍无法控制费用,但有了上述市场价作为参考标准,国家也可继续降低报销价格来进行调节,而这种调节能真正符合市场的特征。
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