如何挤兑集中招标采购制度下的药价虚高部分,是困扰我国医改的一个难点问题.本文从机制设计的角度,详细演绎了药品从招标到采购,再到医生开处方和患者用药整个流通过程中的定价机理,剖析药价虚高产生的根源及其虚高药价下对应的利益裙带关系;然后,探讨业界热议的几个医改政策对降低药价虚高部分的政策效果;最后,从机制设计本源上,提供一个实践中可操作的,能完全剥离药价虚高部分的政策工具.
It is a very difficult problem in Chinese medical reform as to how to remove the artificially high part of the drug price in the centralized bid-and-procurement scheme. From the perspective of mechanism design, this paper demonstrates the drug's pricing mechanism in its whole circulation process in detail -- from the bid to the procurement, to the prescription and to the use of drug. Then, we analyze the origin of high drug price and associated profit ring. Further, several popular medical reform measurements are discussed in terms of their contribution to removing the artificially high part of the drug price. Finally, by using of mechanism design theory, a practical policy tool is provided in order to completely remove the artificially high part.