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论文编号：	8555
作者编号：	2120142414
上传时间：	2016/6/17 20:47:02
中文题目：	药品采购平台收费决策及对企业创新投入影响研究
英文题目：	Study on Drug Purchasing Platform’s Charging Decision and the Influence on Companies’ Innovation Investment
指导老师：	侯文华
中文关键字：	药品供应链；集中采购；药品采购平台；收费决策；创新投入
英文关键字：	drug supply chain; centralized purchasing; drug purchasing platform; charging strategy; innovative investment.
中文摘要：	随着医疗技术的快速发展和人口老龄化速度的加快，“看病难，看病贵”成为社会反映最强烈的问题之一，医院药价虚高更是其中亟待解决的问题。新医改已提出政策的实施效果并不明，其中集中采购政策更是出现了负面作用，由于省级集中招标采购的特点是“只招标、不采购”，最终采购权在医院手中，再加上顺加作价政策使医疗服务机构在已中标的类似药品中优先采购批发价格高或“暗扣”大的药品，导致消费终端药品价格不降反升，出现了权力寻租等腐败问题。 为了解决上述问题，本文提出药品的两次价格形成机制，通过省级药品招标系统确定药品零售价，使市场在政府监督下实现充分竞争，合理控制药品的利润空间，防止药价虚高；然后通过药品采购平台确定药品批发价，制药企业和医疗服务机构讨价还价，分配药品利润，真正实现集中采购的政策目的，完善集中采购政策的实践。 为帮助在实践中构建药品采购平台，本文建立药品采购平台、制药企业以及医疗服务机构之间的三阶段动态博弈模型，研究药品采购平台的收费决策。结果表明平台可通过合理制定费率，使中标入围的制药企业通过药品采购平台与医疗服务机构进行交易，同时对纳入医保目录的药品给予一定的费率优惠。并在此基础上，通过建立制药企业以及医疗服务机构之间的三阶段博弈模型，进一步探讨了药品采购平台对制药企业创新投入的影响，发现其对中标入围企业的创新投入具有激励作用，但对不同类型创新活动激励程度不同，具体是由制药企业自身特点决定的，平台并不能主动区分。故改善我国制药产业创新现状，尤其是加大药品质量创新，需要通过药品采购平台与一些显性扶持政策相结合激励制药企业加大产品创新投入。 本文在实践方面提出了完善集中采购政策实施的药品两次价格形成，同时为建立药品采购平台提供了理论基础，为解决医药行业现存问题，降低药品价格，激励制药企业创新进行了积极探索，有利于医疗体制改革的进一步深化。
英文摘要：	With the prosperity of medical technology and population ageing, the difficulty and high cost of getting fairly medical treatment have become a sharp political issue and the unreasonably high price of medicine has been a problem that should be treated urgently. The new medical reform initiates essential drug policy, new medical insurance catalog policy, drug price policy, drug centralized purchasing policy, while the effect of the implement of the above polices is not as obvious as expect. The drug centralized purchasing policy even generates several detrimental impacts. As the characteristic of centralized purchasing in province is just tender without purchasing, the eventual purchasing right belongs to hospital and drug price plus fixed rate policy makes the hospital give priority to higher price drugs among the drugs winning the bidding, leading to the higher medicine price instead of cheaper ones. Meanwhile, some cheaper drugs but with therapeutic effect are excluded, breeding the power of rent-seeking and other corruption issues. To tackle the above issues, this thesis proposes twice pricing mechanism of medicine. Ensuring the sale price of medicine through provincial drug bidding system, achieving complete competition under official supervision and controlling the profits at a reasonable level, preventing unfair price. The centralized purchasing policy and the improvement of centralized purchasing practice can be achieved by the ensuring wholesale price though drugs purchasing platform, bargaining between pharmaceutical company and medical organizations and the distribution of medicine profits. To assist the establishment of drug purchasing platform in practice, this thesis construct a three stage dynamic game model among drugs purchasing platform, pharmaceutical company and medical organizations, researching the charging strategy of drug purchasing platform. The outcomes show that the platforms can make pharmaceutical companies that get the bidding trade with medical organizations through reasonable charging strategy. When considering medical insurance payment, the platform should give discount rates to those drugs included into the medical insurance catalog. Based on the drug purchasing platform, this thesis researches the impact of the platform to the innovative investment of pharmaceutical companies though constructing a three stage dynamic game model between pharmaceutical companies and medical organizations. This thesis finds that the platforms have motivations to the innovative investment of the companies getting the bid, but have different impacts to different innovative activities. Specifically, such differences are decided by the characteristics of pharmaceutical companies and the platforms cannot differentiate actively. In this case, to improve the innovative situations of pharmaceutical industry, especially to enhance the innovation of medicine quality, it is necessary to integrate the drugs purchasing platform with some support policies, motivating the pharmaceutical firms to increasing the innovative investment. In practice, this thesis proposes twice pricing mechanism of medicine to improve the implementation of centralized procurement policy, as well as provides a theoretical basis for the establishment of drug procurement platform. This thesis have actively explored how to solve the existing problems of the pharmaceutical industry, lower drug prices and encourage pharmaceutical companies to be innovative, in favor of health care reform further deepened.
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