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

【摘要】：藥品是關(guān)系人民生命健康的特殊商品,重構(gòu)藥品生產(chǎn)流通秩序事關(guān)國(guó)計(jì)民生、人民幸福,既必要又緊迫。我國(guó)藥品流通業(yè)發(fā)展取得巨大成就,但藥品生產(chǎn)流通秩序混亂現(xiàn)象始終沒(méi)有得到很好解決,藥品價(jià)格虛高尚未根治,而且藥品集中招標(biāo)采購(gòu)?fù)菩幸詠?lái)又出現(xiàn)了一些新問(wèn)題,規(guī)范和整頓藥品生產(chǎn)流通秩序已經(jīng)成為我國(guó)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(guó)衛(wèi)生部推出了我國(guó)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(lǐng)域,一是醫(yī)療保障制度建設(shè)和改革,二是醫(yī)療服務(wù)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(yīng)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(wèn)題將涉及后兩大改革領(lǐng)域。 本文在明確藥品流通內(nèi)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(guān)文獻(xiàn)綜述的基礎(chǔ)上,重點(diǎn)研究了以下幾個(gè)主要問(wèn)題：首先,在把握全球藥品市場(chǎng)發(fā)展特點(diǎn)和藥品現(xiàn)代流通共同特征的前提下,從實(shí)行醫(yī)藥分開、推進(jìn)標(biāo)準(zhǔn)化建設(shè)、提高藥品市場(chǎng)集中度、規(guī)范企業(yè)經(jīng)營(yíng)行為、發(fā)展社會(huì)中介組織、建立現(xiàn)代信息系統(tǒng)等多個(gè)視角,分析了我國(guó)藥品流通領(lǐng)域改革的問(wèn)題,并對(duì)中國(guó)藥品流通政府監(jiān)管的五階段制度變遷進(jìn)行了詳細(xì)的梳理；第二,對(duì)我國(guó)藥品流通業(yè)的參與主體以及藥品流通的全流程框架進(jìn)行了系統(tǒng)提煉,將藥品生產(chǎn)到藥品銷售的整個(gè)流程分為藥品招標(biāo)制度改進(jìn)拍賣機(jī)制、縮減藥品流通渠道、建構(gòu)藥品流通網(wǎng)絡(luò)、改革藥品流通終端四個(gè)模塊,進(jìn)行了全面的理論闡述和模型分析；第三,在充分把握我國(guó)藥品流通業(yè)政府監(jiān)管現(xiàn)狀及問(wèn)題成因的條件下,總結(jié)了發(fā)達(dá)國(guó)家藥品流通業(yè)政府監(jiān)管特征及經(jīng)驗(yàn)啟示,建立了藥品流通全流程價(jià)格監(jiān)管理論模型,進(jìn)行了藥品流通價(jià)格監(jiān)管的機(jī)理分析,分析了藥品流通政府監(jiān)管的實(shí)際效果,并從完善藥品監(jiān)管的法律體系、建立統(tǒng)一獨(dú)立的藥品監(jiān)管體制、健全標(biāo)準(zhǔn)體系并建立長(zhǎng)效監(jiān)督機(jī)制、完善藥品價(jià)格形成機(jī)制、加強(qiáng)藥品使用環(huán)節(jié)的監(jiān)管等方面,提出我國(guó)藥品流通全程價(jià)格監(jiān)管的對(duì)策體系。 相對(duì)于已有文獻(xiàn),本文以解決藥品流通領(lǐng)域價(jià)格不合理問(wèn)題為導(dǎo)向,其主要貢獻(xiàn)體現(xiàn)在以下幾個(gè)方面：首先,對(duì)我國(guó)藥品流通業(yè)的相關(guān)主體、相關(guān)環(huán)節(jié)的內(nèi)在聯(lián)系進(jìn)行邏輯判斷,從企業(yè)與政府兩個(gè)主體出發(fā),沿著企業(yè)模式創(chuàng)新和政府科學(xué)監(jiān)管兩條主線,系統(tǒng)的建立起能夠抓住藥品價(jià)格虛高等問(wèn)題本質(zhì)的分析框架；其次,利用拍賣機(jī)制模型證明了我國(guó)目前“雙信封”采購(gòu)招標(biāo)機(jī)制的制度性缺陷,針對(duì)其存在的弊端提出了第二價(jià)格密封拍賣機(jī)制的修正方案,以有效處理集中采購(gòu)招標(biāo)環(huán)節(jié)的激勵(lì)機(jī)制問(wèn)題,并分為四個(gè)模塊對(duì)藥品流通全程的模式創(chuàng)新進(jìn)行了系統(tǒng)化的研究；第三,在信息不對(duì)稱條件下,建立了藥品流通源頭控制的有條件價(jià)格監(jiān)管模型、考慮市場(chǎng)范圍影響的含有距離參數(shù)的中間環(huán)節(jié)價(jià)格監(jiān)管模型、提出了針對(duì)醫(yī)療機(jī)構(gòu)和零售機(jī)構(gòu)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(xué)位授予單位】：南開大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R95;F726

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本文編號(hào)：2070328