市场需方选用基本药物激励问题.docVIP

市场需方选用基本药物激励问题摘 要 目的：建议通过激励让作为市场需方的医方和患者积极选用基本药物，促进基本药物广泛、合理地使用。方法：基于信息不对称，从委托代理的角度探讨医方和患者在基本药物选用上的激励问题。结果：医方在处方选择时对患者有诱导需求，但选用基本药物的激励不足；由于可供应性障碍和医保覆盖，患者选用基本药物的激励亦不足。结论：医方作为患者和制药企业的共同代理人以及医方和患者共同作为医保部门的代理人，在基本药物的选用上均存在激励问题，有关部门应进一步完善基本药物制度，以激励医方和患者积极选用基本药物。 关键词基本药物 激励 代理 中图分类号：R19；R95 文献标识码：C 文章编号：1006-1533(2011)10-0505-03 Incentive problems of market demand-side on the use of essential drugs CHANG Feng，RUAN Ji （Research Center of Pharmaceutical Industry Development，China Pharmaceutical University，Nanjing，211198） ABSTRACTObjective: Based on a series of policies introduced in recent years，some suggestions were proposed so as to stimulate the medical side and patients as the market demand-side with active use of essential drugs，and promote the rational use of essential drugs widely. Method: Based on information asymmetry， the incentive problems in use of the essential drugs by the medical side and patients were discussed from the perspective of client-agent. Result: Because of the model of “drugs for the medical side”，the medical side has incentive to induce the patients demand on choosing prescription，but has insufficient incentive for the use of essential drugs; due to supply barrier and health insurance coverage，the patients have inadequate incentive for essential drugs. Conclusion: Owing to medical side as co-agents of patients and pharmaceutical enterprises while the medical side and patients together as agents of health care department，there are incentive problems for the use of essential drugs. The relevant departments should further improve the essential drugs system to encourage both medical side and patients to actively use essential drugs. KEY WORDSessential drugs；incentive；agent 2009年8月18日，我国卫生部、改革委、工信部、监察部、财政部、人力资源社会保障部、商务部、食品药品监管局、中医药局联合发布了《关于建立国家基本药物制度的实施意见》，其中指出“基本药物是适应基本医疗卫生需求，剂型适宜，价格合理，能够保障供应，公众可公平获得的药品”。 基本药物制度旨在“保障群众基本用药，减轻医药费用负担”。然而，现实中我国基本药物市场十分脆弱，问题至少表现在临床短缺、生产质量、处方选用和患者依从性等几个方面。而这一系列问题的根源在于相关制度不够完善，缺少一套保障市场各个环节有效运行的激励机制。