通讯作者: 孙强, qiangs@sdu.edu.cn

DOI：10.12201/bmr.202011.00015

Analysis of the impact of the Two Ballot System policy on drug supply in Shandong province

• 摘要：目的：探究“两票制”政策对山东省药品供应状况的影响,为保障政策进一步实施提供科学依据和政策建议。方法：对比政策实施前后山东省药品集中采购平台数据,采用企业集中度分析药品供应市场的集中状况,采用间断时间序列方法分析政策对药品到货率和订单完成率的影响。结果：药品供应企业数量逐步降低,由政策实施前的627家降为565家；市场集中度逐步提升,由316.42提高到366.29；大型企业市场份额逐步提升,份额占比前75%的企业数量由54家降为47家。政策实施后,山东省总体到货率呈下降趋势(=-0.012,p=0.002),经济发达地区(=-0.011, p<0.001)、相对较弱地区(=-0.011,p<0.001)和欠发达地区(=-0.014,p=0.003)的药品到货率也相应呈下降趋势。结论：“两票制”政策的实施,使得山东省药品供应市场集中度逐步提升,供应市场秩序逐步规范。但政策实施后,有部分地区医疗机构反映出药品供应下降的趋势,不利于患者用药可及性的提升,需要进一步关注。

  关键词： 两票制; 药品供应企业; 间断时间序列分析; 实施效果

   

  Abstract: Objective: To explore the impact of the two ballot system on the drug supply situation in Shandong Province, and provide scientific basis and policy recommendations to ensure the further implementation of the policy. Method: Compare the data from Shandong Provinces centralized drug procurement platform before and after the policy is implemented. The concentration of enterprises was used to analyze the concentration of the drug supply market. Use the interrupted time series method to analyze the impact of the policy on the drug order delivery rate and completion rate. Results: The number of pharmaceutical supply companies has gradually decreased, from 627 before the implementation of the policy to 565; the market concentration has gradually increased, from 316.42 to 366.29; the market share of large companies has gradually increased, with the number of companies accounting for the top 75% from 54 reduced to 47. After the implementation of the policy, the arrival rate of overall areas was on a downward trend (=-0.012,p=0.002), the arrival rate of developed areas (=-0.011,p<0.001) , relatively weak areas(=-0.011, p<0.001) and underdeveloped areas(=-0.014,p=0.003) showed a downward trend. Conclusion: The implementation of the two ballot system policy has gradually increased the concentration of the drug supply market in Shandong Province and gradually standardized the supply market order. However, after the implementation of the policy, some medical institutions in some regions showed downward trend of drug supply, which is not conducive to the improvement of the availability of drugs for patients and requires further attention.

  Key words: Two ballot system，Drug supply company，Interrupted time series，Implementation effect; ; ; 

  提交时间：2021-02-01

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2020-11-03	bmr.202011.00015V1	下载

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