發(fā)布時間：2018-12-29 21:02

【摘要】：自建國到現在,針對藥品價格政府實施了一系列的管制政策,試圖通過多重管制使藥價達到合理水平,然而實踐證明,過度的管制扭曲了正常的市場機制,民眾的醫(yī)療負擔依然沒有得到減輕,相反,看病難看病貴這一問題更加突出了。2015年5月,出臺了《關于印發(fā)推進藥品價格改革意見的通知》,決定取消政府對多數藥品的定價行為,使藥品的價格通過市場競爭確立。同時指出由醫(yī)保部門聯合相關部門擬定力醫(yī)保藥品支付標準,探索建立引導藥品價格形成的機制。這就為本文藥品價格形成機制與要支付標準的制定提供了研究的契機,而本文的研究也將對完善我國當前的藥品定價體系與醫(yī)保支付制度具有重要意義。針對當前的改革,本文擬藥品價格形成與醫(yī)保支付標準確立的一般機理出發(fā),通過地區(qū)的案例研究和比較研究,提出適合我國國情的藥品價格形成與醫(yī)保支付機制。本文主要研究以下四個部分的內容:(1)第一部分,對藥品的屬性及市場失靈進行分析,由此提出在市場經濟下藥品價格的形成與醫(yī)保支付制度標準確立必須來自于自由競爭,任何行政管制都是無效的。(2)第二部分,對我國建國以來的藥品定價方式進行梳理,并分析了當前藥品定價機制下出現的問題、問題的根源。通過分析發(fā)現發(fā)現長期以來藥品價格都處于政府的行政干預之下,在定價機制下,民眾的醫(yī)療負擔和藥價虛高的問題依然沒有得到緩解。(3)第三部分,介紹國內外關于藥品價格形成與醫(yī)保支付制度的探索與改革,通過對這些地區(qū)的比較分析,為我國目前的改革提供經驗借鑒。(4)第四部分,基于以上四個部分的研究,提出在我國當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爭原則和漸進性原則,促進參與主體間的競爭,改革不是一蹴而就的,從長遠來說要消除公立醫(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.
【學位授予單位】：首都經濟貿易大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.1;F842.684

【參考文獻】

相關期刊論文 前10條

1 天則經濟研究所課題組;盛洪;錢璞;;醫(yī)療行政部門資源配置的效率與公平性研究[J];學術界;2016年03期

2 張錄法;;藥品醫(yī)保支付價制度設計及實踐探索模式比較——以三明、重慶和紹興市為例[J];價格理論與實踐;2015年09期

3 董朝暉;;對于醫(yī)保支付標準形成機制的展望[J];中國醫(yī)療保險;2015年07期

4 熊先軍;;藥品價格由市場機制確定的幾個常識[J];中國社會保障;2015年07期

5 丁錦希;白庚亮;黃澤華;柳鵬程;李偉;;藥品醫(yī)保支付價格制度框架下的支付模式實證研究[J];中國醫(yī)藥工業(yè)雜志;2015年06期

6 張杰;熊先軍;李靜湖;;臺灣健保藥品價格與支付管理體系[J];中國醫(yī)療保險;2015年04期

7 熊先軍;;藥品醫(yī)保支付價與醫(yī)保支付制度改革是個啥關系[J];人才資源開發(fā);2015年05期

8 顧昕;;醫(yī)保將成為藥品市場的主要買家[J];中國衛(wèi)生;2015年03期

9 顧昕;袁國棟;;從價格管制改革到支付制度改革——美國的經驗及其對中國醫(yī)改的啟示[J];國家行政學院學報;2014年04期

10 古新功;;中國藥品價格管制現狀及對策思考[J];湖北社會科學;2014年08期

相關會議論文 前1條

1 陳成;張方;;日本藥品定價方法研究[A];2013年中國藥學會藥事管理專業(yè)委員會年會暨“醫(yī)藥安全與科學發(fā)展”學術論壇論文集（下冊）[C];2013年

相關重要報紙文章 前2條

1 張維迎;;決定生活品質的十個經濟學思維[N];消費日報;2016年

2 武濱;;用市場規(guī)律調節(jié)藥品供應機制[N];經濟日報;2015年

相關博士學位論文 前4條

1 沈洪濤;中國藥品價格管制問題研究[D];哈爾濱工業(yè)大學;2014年

2 張慶霖;縱向市場、政府規(guī)制與創(chuàng)新扭曲：中國制藥產業(yè)的研究[D];暨南大學;2011年

3 王強;基本藥物流通價值鏈的經濟學研究[D];復旦大學;2010年

4 王廷惠;微觀規(guī)制理論研究[D];華南師范大學;2003年

相關碩士學位論文 前3條

1 王薇;中國藥品價格規(guī)制改革效果的實證研究[D];東北財經大學;2012年

2 江穎萍;中國藥品價格規(guī)制策略研究[D];南昌大學;2012年

3 周望陽;我國藥品價格虛高的經濟學分析[D];暨南大學;2008年

，

本文編號：2395398