A retrospective and prospective assessment of the zero-markup drug reform in China from the perspective of policy diffusion
A retrospective and prospective assessment of the zero-markup drug reform in China from the perspective of policy diffusion
复制标题
政策扩散视角下我国药品零加成改革的回顾与前瞻性评估
DOI：
10.1002/hpm.2562
复制
发表时间：
2018-10-01
影响因子：
2.7
通讯作者：
Tian, Xu
中科院分区：
文献类型：
--
作者：
Deng, Jianwei;Tian, Huilin;Tian, Xu
药品零加成政策是2009年开始的中国新一轮医疗改革的重要组成部分，旨在促进医药分开，减轻患者医疗负担，完善医疗供应保障体系。8年来，药品零加成改革政策已进行了4轮试点（具有中国特色的政策扩散模式），并在中国大陆地区推广。在这个关键时刻，有必要系统地审查这一政策。因此，本研究以文献、政府文件、访谈记录为基础，运用政策扩散理论，分析药品零加成改革的特点、进展、成效、挑战与建议。研究发现，药品零加成改革通过“政策试验”的方式完成了初步推广，在一定程度上降低了药品价格和患者负担。但在政策扩散的下一阶段，改革仍需调整和创新措施，以应对未来的挑战。总体而言，药品零加成改革作为中国独特的医疗改革实践，其经验可为其他国家控制药价、实行医药分开、建立现代医院运行制度提供借鉴。
The zero-markup drug policy is an important component of the new round of Chinese health care reform that began in 2009 to promote the separation between medical and pharmaceutical services, reduce patients' medical burden, and improve the medical supply security system. Over the past 8 years, the zero-markup drug reform policy has been carried out in 4 pilot rounds (a policy diffusion model with Chinese characteristics) and has been promoted throughout the mainland China. At this critical point, it is necessary to review this policy systematically. Therefore, based on the literature, government documents, and interview records, this study analyzed the characteristics, progress, achievements, challenges, and recommendations of zero-markup drug reform by using the policy diffusion theory. The study found that zero-markup drug reform has completed its initial diffusion by use of the "policy experiment" method and has reduced drug prices and patients' burden to a certain extent. However, in the next phase of policy diffusion, the reform still requires adjustment and innovative measures to respond to future challenges. Generally speaking, as China's unique health care reform practice, the experience of zero-markup drug reform could be used as a reference for other countries to control drug prices, separate medical and pharmaceutical services, and establish a modern system of hospital operation.