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尽管我国建立了省级基本药物集中招标采购制度,但由此形成的药品价格并不合理,群众医药负担仍然过重。在这种情况下,一些试点省份提出实行药品“二次议价”的对策。然而,“二次议价”引起了广泛争议,此种方法并不是解决医药费用支出过快增长问题的有效措施。要控制医药费用支出过快增长,关键在于完善基本药物集中招标制度以及医院与医生的激励机制,具体措施包括:改革集中招标采购办法;建立管办分离、独立的法人市场主体;制约医疗卫生行政主管部门的权力;改变医疗保险付费方式等。
Although China has established a provincial centralized bidding and purchasing system for essential medicines, the prices of the medicines thus formed are not reasonable and the medical burden on the masses is still too heavy. Under such circumstances, some pilot provinces proposed to implement the drug “second bargain ” countermeasures. However, the “second bargaining” has caused widespread controversy. Such an approach is not an effective measure to solve the problem of excessive growth in medical expenses. The key to controlling the excessive growth of medical expenses is to improve the centralized bid invitation system for basic drugs and the incentive mechanism for hospitals and doctors. Specific measures include: reforming the centralized bidding and purchasing methods; establishing separate and independent legal person market management bodies; restricting medical and health administration The authority of the competent authority; changing the payment method of medical insurance and so on.