發(fā)布時(shí)間：2018-12-29 21:02

【摘要】：自建國(guó)到現(xiàn)在,針對(duì)藥品價(jià)格政府實(shí)施了一系列的管制政策,試圖通過(guò)多重管制使藥價(jià)達(dá)到合理水平,然而實(shí)踐證明,過(guò)度的管制扭曲了正常的市場(chǎng)機(jī)制,民眾的醫(yī)療負(fù)擔(dān)依然沒(méi)有得到減輕,相反,看病難看病貴這一問(wèn)題更加突出了。2015年5月,出臺(tái)了《關(guān)于印發(fā)推進(jìn)藥品價(jià)格改革意見(jiàn)的通知》,決定取消政府對(duì)多數(shù)藥品的定價(jià)行為,使藥品的價(jià)格通過(guò)市場(chǎng)競(jìng)爭(zhēng)確立。同時(shí)指出由醫(yī)保部門(mén)聯(lián)合相關(guān)部門(mén)擬定力醫(yī)保藥品支付標(biāo)準(zhǔn),探索建立引導(dǎo)藥品價(jià)格形成的機(jī)制。這就為本文藥品價(jià)格形成機(jī)制與要支付標(biāo)準(zhǔn)的制定提供了研究的契機(jī),而本文的研究也將對(duì)完善我國(guó)當(dāng)前的藥品定價(jià)體系與醫(yī)保支付制度具有重要意義。針對(duì)當(dāng)前的改革,本文擬藥品價(jià)格形成與醫(yī)保支付標(biāo)準(zhǔn)確立的一般機(jī)理出發(fā),通過(guò)地區(qū)的案例研究和比較研究,提出適合我國(guó)國(guó)情的藥品價(jià)格形成與醫(yī)保支付機(jī)制。本文主要研究以下四個(gè)部分的內(nèi)容:(1)第一部分,對(duì)藥品的屬性及市場(chǎng)失靈進(jìn)行分析,由此提出在市場(chǎng)經(jīng)濟(jì)下藥品價(jià)格的形成與醫(yī)保支付制度標(biāo)準(zhǔn)確立必須來(lái)自于自由競(jìng)爭(zhēng),任何行政管制都是無(wú)效的。(2)第二部分,對(duì)我國(guó)建國(guó)以來(lái)的藥品定價(jià)方式進(jìn)行梳理,并分析了當(dāng)前藥品定價(jià)機(jī)制下出現(xiàn)的問(wèn)題、問(wèn)題的根源。通過(guò)分析發(fā)現(xiàn)發(fā)現(xiàn)長(zhǎng)期以來(lái)藥品價(jià)格都處于政府的行政干預(yù)之下,在定價(jià)機(jī)制下,民眾的醫(yī)療負(fù)擔(dān)和藥價(jià)虛高的問(wèn)題依然沒(méi)有得到緩解。(3)第三部分,介紹國(guó)內(nèi)外關(guān)于藥品價(jià)格形成與醫(yī)保支付制度的探索與改革,通過(guò)對(duì)這些地區(qū)的比較分析,為我國(guó)目前的改革提供經(jīng)驗(yàn)借鑒。(4)第四部分,基于以上四個(gè)部分的研究,提出在我國(guó)當(dāng)前的改革中必須遵循的原則與改革的路徑,即在改革中一定要遵循自由競(jìng)爭(zhēng)原則和漸進(jìn)性原則,促進(jìn)參與主體間的競(jìng)爭(zhēng),改革不是一蹴而就的,從長(zhǎng)遠(yuǎn)來(lái)說(shuō)要消除公立醫(yī)院的壟斷地位,近期可以先完善醫(yī)保付費(fèi)制度。
[Abstract]:Since the founding of the people's Republic of China, the government has implemented a series of regulatory policies against drug prices, trying to achieve a reasonable level of drug prices through multiple controls. However, practice has proved that excessive regulation distorts the normal market mechanism. The burden of medical care for the public has not been alleviated. On the contrary, the problem of difficult and expensive medical treatment has become even more prominent. In May 2015, the Circular on the publication of opinions on promoting Drug Price Reform was issued. Decided to cancel the government pricing of most drugs, so that the price of drugs through market competition. At the same time, it is pointed out that the medical insurance department should work out the standard of medical insurance drug payment together with the relevant departments, and explore the mechanism to guide the formation of drug price. This provides an opportunity for the study of the mechanism of drug price formation and the formulation of payment standards in this paper, and the research in this paper will be of great significance to the improvement of the current drug pricing system and the payment system of medical insurance in China. In view of the current reform, this paper proposes the general mechanism of drug price formation and medical insurance payment standard, and puts forward the mechanism of drug price formation and medical insurance payment suitable for China's national conditions through regional case studies and comparative studies. This paper mainly studies the contents of the following four parts: (1) the first part, the analysis of the properties of drugs and market failure, Therefore, it is proposed that the formation of drug price and the establishment of the standard of medical insurance payment system under the market economy must come from free competition, and any administrative control is ineffective. (2) part two, combing the way of drug pricing since the founding of the people's Republic of China. And analyzed the current drug pricing mechanism under the problem, the root of the problem. Through the analysis, it is found that for a long time the drug price has been under the administrative intervention of the government. Under the pricing mechanism, the problems of the people's medical burden and the false high drug price have not been alleviated. (3) the third part, This paper introduces the exploration and reform of drug price formation and medical insurance payment system at home and abroad. Through the comparative analysis of these regions, it provides experience for China's current reform. (4) part IV, based on the above four parts of the research, This paper puts forward the principles and paths that must be followed in the current reform of our country, that is, the principle of free competition and the principle of gradual progress must be followed in the reform to promote the competition among the participants, and the reform is not accomplished overnight. In the long run, to eliminate the monopoly of public hospitals, we can improve the health insurance payment system in the near future.
【學(xué)位授予單位】：首都經(jīng)濟(jì)貿(mào)易大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.1;F842.684

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