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目的:为降低我国儿童基本药物价格提供循证支持。方法:采用世界卫生组织(WHO)和国际健康行动组织(HAI)共同制定的WHO/HAI标准化法,对陕西省西安市和安康市的公立医院、药品批发企业、配送企业等机构进行实地调研。结果:西安市“三统一”药品和非“三统一”药品的平均总加成率分别为11.60%和20.38%,安康市为41.25%和22.11%;西安市原研药和仿制药的平均总加成率分别为17.36%和17.47%,安康市为17.77%和33.85%;西安市和安康市的注射剂平均加成率分别为26.11%和32.50%,药品从批发商到医院中间环节的费用加成率分别为20.26%和2.14%。结论:“三统一”药品总加成率较非“三统一”药品低;原研药的平均总加成率与仿制药的平均总加成率相近,但加价金额仍过高;注射剂型的平均总加成率最高;从批发商到医院中间环节的费用加成占比较大。建议提高药品集中采购机制的有效性,完善我国药品定价机制,规范我省从批发商到医院中间环节的价格加成。
Objective: To provide evidence-based support for lowering the price of children’s essential medicines in China. Methods: Based on the WHO / HAI standardized method jointly developed by the World Health Organization (WHO) and the International Health Action Organization (HAI), field research was conducted on public hospitals, drug wholesalers and distribution enterprises in Xi’an and Ankang, Shaanxi Province. Results: The average total rate of additions of “three unified drugs” and non-“three unified drugs” in Xi’an was 11.60% and 20.38% respectively, while in Ankang City was 41.25% and 22.11% respectively. The original research drug and generic drug in Xi’an Averaged 17.36% and 17.47%, respectively, while Ankang City was 17.77% and 33.85% respectively. The average addition rates of injection in Xi’an and Ankang were 26.11% and 32.50% respectively. Drugs went from wholesaler to hospital intermediate The cost bonus rates were 20.26% and 2.14% respectively. Conclusion: The total additive rate of “three unities” is lower than that of non-“three unification” medicines. The average total addition rate of the original research drug is similar to the average total additive rate of generic drugs, but the fare increase is still too high. The average injection rate of the highest total addition rate; from the wholesaler to the hospital intermediate part of the cost plus a larger proportion. Proposes to improve the effectiveness of centralized drug purchasing mechanism, improve China’s drug pricing mechanism, standardize the province from the wholesaler to the hospital intermediate part of the price plus.