本文選題：藥品價格虛高 + 藥品流通業(yè)　； 參考：《南開大學》2014年博士論文

【摘要】：藥品是關系人民生命健康的特殊商品,重構藥品生產流通秩序事關國計民生、人民幸福,既必要又緊迫。我國藥品流通業(yè)發(fā)展取得巨大成就,但藥品生產流通秩序混亂現(xiàn)象始終沒有得到很好解決,藥品價格虛高尚未根治,而且藥品集中招標采購推行以來又出現(xiàn)了一些新問題,規(guī)范和整頓藥品生產流通秩序已經成為我國醫(yī)藥衛(wèi)生體制改革中的重大課題之一。為此,在2013年開年之際中華人民共和國衛(wèi)生部推出了我國醫(yī)療衛(wèi)生系統(tǒng)綜合改革的路線圖,該路線圖包含了五大改革領域,一是醫(yī)療保障制度建設和改革,二是醫(yī)療服務體系的改革,三是公共衛(wèi)生體制改革的突破,四是藥品供應的新模式,五是政府監(jiān)管體制的改革和完善。本文所研究的問題將涉及后兩大改革領域。 本文在明確藥品流通內涵和特性,梳理藥品流通理論、政府規(guī)制理論以及藥品流通模式創(chuàng)新、藥品流通政府監(jiān)管制度等相關文獻綜述的基礎上,重點研究了以下幾個主要問題：首先,在把握全球藥品市場發(fā)展特點和藥品現(xiàn)代流通共同特征的前提下,從實行醫(yī)藥分開、推進標準化建設、提高藥品市場集中度、規(guī)范企業(yè)經營行為、發(fā)展社會中介組織、建立現(xiàn)代信息系統(tǒng)等多個視角,分析了我國藥品流通領域改革的問題,并對中國藥品流通政府監(jiān)管的五階段制度變遷進行了詳細的梳理；第二,對我國藥品流通業(yè)的參與主體以及藥品流通的全流程框架進行了系統(tǒng)提煉,將藥品生產到藥品銷售的整個流程分為藥品招標制度改進拍賣機制、縮減藥品流通渠道、建構藥品流通網(wǎng)絡、改革藥品流通終端四個模塊,進行了全面的理論闡述和模型分析；第三,在充分把握我國藥品流通業(yè)政府監(jiān)管現(xiàn)狀及問題成因的條件下,總結了發(fā)達國家藥品流通業(yè)政府監(jiān)管特征及經驗啟示,建立了藥品流通全流程價格監(jiān)管理論模型,進行了藥品流通價格監(jiān)管的機理分析,分析了藥品流通政府監(jiān)管的實際效果,并從完善藥品監(jiān)管的法律體系、建立統(tǒng)一獨立的藥品監(jiān)管體制、健全標準體系并建立長效監(jiān)督機制、完善藥品價格形成機制、加強藥品使用環(huán)節(jié)的監(jiān)管等方面,提出我國藥品流通全程價格監(jiān)管的對策體系。 相對于已有文獻,本文以解決藥品流通領域價格不合理問題為導向,其主要貢獻體現(xiàn)在以下幾個方面：首先,對我國藥品流通業(yè)的相關主體、相關環(huán)節(jié)的內在聯(lián)系進行邏輯判斷,從企業(yè)與政府兩個主體出發(fā),沿著企業(yè)模式創(chuàng)新和政府科學監(jiān)管兩條主線,系統(tǒng)的建立起能夠抓住藥品價格虛高等問題本質的分析框架；其次,利用拍賣機制模型證明了我國目前“雙信封”采購招標機制的制度性缺陷,針對其存在的弊端提出了第二價格密封拍賣機制的修正方案,以有效處理集中采購招標環(huán)節(jié)的激勵機制問題,并分為四個模塊對藥品流通全程的模式創(chuàng)新進行了系統(tǒng)化的研究；第三,在信息不對稱條件下,建立了藥品流通源頭控制的有條件價格監(jiān)管模型、考慮市場范圍影響的含有距離參數(shù)的中間環(huán)節(jié)價格監(jiān)管模型、提出了針對醫(yī)療機構和零售機構兩類藥品流通終端的政府分類監(jiān)管的基本思路。
[Abstract]:In 2013 , the Ministry of Health of the People ' s Republic of China launched a road map for the reform of the health system in our country .

On the basis of clarifying the connotation and characteristics of drug circulation , combing drug circulation theory , government regulation theory and drug circulation pattern innovation and drug circulation government regulation system , this paper mainly focuses on the following major problems : first , under the premise of grasping the characteristics of global drug market development and the common characteristics of modern medicine circulation , the article analyzes the problems of reform in the field of medicine circulation in China , and makes a detailed analysis on the five - stage institutional change of Chinese medicine circulation government regulation .
Second , the whole process framework of drug circulation in our country is systematically refined , and the whole process of drug sales is divided into drug bidding system to improve the auction mechanism , reduce the flow channel of drugs , construct the drug circulation network , reform the four modules of the drug circulation terminal , and carry out comprehensive theoretical exposition and model analysis ;
Third , under the condition of fully grasping the current situation and causes of the administration of drug circulation industry in our country , this paper summarizes the regulatory characteristics and experiences of drug circulation price supervision in developed countries , establishes the theory model of drug circulation price supervision , analyzes the practical effect of drug circulation price regulation , establishes a unified independent medicine supervision system , perfects the standard system and establishes long - term supervision mechanism , perfects the mechanism of drug price formation , strengthens the supervision of drug use link , and puts forward the countermeasure system of the whole course price supervision of drug circulation in China .

Compared with the existing literatures , this paper aims to solve the problem of unreasonable price in the field of medicine circulation . The main contributions of this paper are as follows : Firstly , the author makes a logical judgment on the relationship between the relevant subjects and relevant links of the pharmaceutical flow industry in China . From the two subjects of the enterprise and the government , the paper puts forward two main lines : the innovation of the enterprise model and the regulation of the government science , and the establishment of the system can grasp the analytical framework of the essence of the problem of the deficiency of medicine price and the like ;
Secondly , using the auction mechanism model to prove the institutional weakness of the bidding mechanism of " double envelopes " in our country , the paper puts forward the amendment scheme of the second price seal auction mechanism aiming at the shortcomings of the present " double envelope " procurement bidding mechanism , so as to effectively deal with the incentive mechanism problem of the centralized procurement bidding process , and divides into four modules to systematically study the mode innovation of the whole process of drug circulation ;
Thirdly , under the condition of asymmetric information , a conditional price regulation model controlled by the source of drug circulation is established , and the price regulation model of the intermediate link with distance parameter is considered , and the basic idea of the government classification supervision for the two types of drug circulation terminals in medical institutions and retail establishments is put forward .
【學位授予單位】：南開大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R95;F726

【參考文獻】

相關期刊論文 前10條

1 王燕;李文興;;基于多重委托-代理關系的規(guī)制俘虜模型研究[J];北京交通大學學報(社會科學版);2007年04期

2 莊小琴;平價藥房引發(fā)的經濟學思考[J];當代財經;2003年12期

3 吳喬藩;藥品集中招標采購的現(xiàn)狀及展望[J];廣東藥學院學報;2004年03期

4 郭子楓;李軍;;電子商務下我國藥品流通行業(yè)供應鏈管理探索[J];北方經貿;2011年04期

5 宋遠方;;中國醫(yī)藥行業(yè)物流運營模式研究[J];中國工業(yè)經濟;2005年12期

6 吳瑞華;國內外執(zhí)業(yè)藥師制度比較研究[J];國際醫(yī)藥衛(wèi)生導報;2005年07期

7 李先國;;藥品供應鏈的整合問題研究[J];管理世界;2010年05期

8 許進標,張新平;部分發(fā)達國家藥品價格管制政策比較及啟示[J];國外醫(yī)學(社會醫(yī)學分冊);2005年03期

9 熊平;如何構建我國藥品流通的良性機制[J];宏觀經濟管理;2005年08期

10 陳文玲;解決我國藥品價格問題的政策建議——對藥品價格問題的調查研究與思考(中)[J];價格理論與實踐;2005年02期

相關博士學位論文 前2條

1 唐圣春;市場經濟條件下我國藥品價格規(guī)制研究[D];華中科技大學;2009年

2 李緯;中國醫(yī)藥和醫(yī)療體制改革的回顧與反思[D];南開大學;2009年

，

本文編號：2070328