基于数量的采购政策下的药品支出变化:影响和影响因素
Ying Yang1, Yuanhui Duan1, Lei Zhou1
1School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
PloS one
|August 14, 2025
概括
中国的基于数量的采购 (VBP) 政策显著降低了VBP药物支出,但增加了替代药物成本. 政策的有效性是由市场变化和价格降低推动的,尽管增加的药物使用抵消了节省.
科学领域:
- 卫生经济学 卫生经济学
- 制药政策 制药政策
- 公共卫生 公共卫生
背景情况:
- 中国的基于数量的采购 (VBP) 政策旨在通过集中采购来降低药品成本.
- 了解对VBP和非VBP (替代) 药物支出的影响对于政策评估至关重要.
研究的目的:
- 量化中国的VBP政策对药物开支的影响.
- 根据VBP政策,确定影响药物支出变化的关键因素.
主要方法:
- 利用来自公共医疗机构的国家药物采购数据.
- 采用时间变化的差异差异 (DID) 模型来评估政策影响.
- 应用药物支出指数分解来分析成本驱动因素.
主要成果:
- 静脉血压药物支出下降了42.19% (p < 0.001),而替代药物支出增加了11.52% (p < 0.001).
- 总体而言,药物支出减少了5% (p < 0.001),第三级医院的下降幅度更大.
- 制造商结构和价格指数推动了VBP药物成本的降低,而增加的药物数量是抑制因素.
结论:
- 通过市场取代和降低价格,VBP政策有效地减少了毒品总支出.
- 替代药物的使用增加部分抵消了成本节约,突出了"溢出效应".
- 未来的政策改进应侧重于整体治理和优化药物利用质量.
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