基本药物政策问题的新制度经济学分析.pdfVIP

Ch inese Journal ofH ealth Policy, June 2010, Vol13 No1 6 # # * 王 强 陈 文 复旦大学公共卫生学院 上海 200032 =摘 要运用新制度经济学合约租值消散交易费用等相关理论, 将医生视为医生) 医院) 药 利益集 团的主导者, 从医生租值的角度分析了基本药物短缺等问题的经济学根源及供求机制指出由于政府对医生 服务价格的管制造成其租值损失, 在各方寻租过程中, 处于优势地位的医生选择通过药品销售对其服务租值 进行弥补, 进而导致医生对高租值药品的诱导使用和市场交易费用高企, 最终造成上述政策问题相应提出 了医保总额预付处方外配销售使用决策规范等市场机制竞争性平抑药品租值等应对策略 =关键词基本药物;租值; 交易费用; 新制度经济学 中图分类号: R9 1 文献标识码: A doi: 10. 3969/j. issn. 167422982. 2010. 06. 00 An a ly sis on essen tia l m ed icin es p olicy w ith n ew in stitu tion a l econ om ics WAN G Q iang, CHEN Wen School of P ublicH ea lth, F udan Un iver sity, Shangha i 200032, Ch ina =Ab stract Based on the theories of contract, rent dissipation and transaction costs in new institutional econom2 ics, the paper analyzed the supply and demand mechanism of the problems for essentialmedicines policy and revealed the routtine causes in econom ics, regarding the physician as the dom inator of the interest group ofphysician, hospital and pharmaceu tical, concluded that due to the restraint to the price ofphysician service, the rent of physician dissipa2 ted, relative stakeholders seek rent through drug selling, and physicians induced consumption ofh igh price pharmaceu2 ticals to compensate the service rent, then increased transaction costs and caused above problems. F inally, the paper raised the targeted strategies to solve the problems by lowering the rent, using the marketmechan ism such as insurance pre2payment, sellingmore pharmaceuticals through drugstores, regu lation of prescription, and so on. =K ey w ord s E ssentialmedicines; Rent; Transaction costs; New institutional econom ics / 0 [ 1] , , , , , ,