我国药品采购经历了医院分散采购、地市招标采购、省级招标采购、联盟带量采购四个阶段。经过30多年的不断探索和完善,采购制度发展到以“国家组织、联盟采购、平台操作”为总体思路,以“带量采购、量价挂钩、招采合一、保证使用、确保质量、保障供应、保障回款”为基本原则的带量采购模式,并将在2025年前成为我国最主流的药品采购模式。国家医保局成立后,先后组织开展了6批药品和2批耗材集采,在全国形成了国家、省级、跨省联盟采购协同推进的工作格局。今后,药品集中采购要加强“系统集成、高效协同”,应在推动公立医院高质量发展中发挥突破口的作用,有机协调医药企业和参保患者各方利益,分阶段解决不同的主要矛盾和主要问题,从体制机制上根治带金销售、净化行业生态、激励规范竞争、促进医药行业转型升级健康发展。未来,带量采购将呈现常态化、广覆盖、多层级、大联盟、优规则、更集约、全配套、稳接续、强平台、守信用等趋势。

China's centralized drug procurement experienced four stages of hospital decentralized procurement, prefectural procurement by invitation to bid, provincial procurement by invitation to bid and alliance volume-based procurement. After more than 30 years of exploration and improvement, the procurement system has developed into a volume-based mode with the general idea of "national organization, alliance procurement and platform operation" and the basic principles of "volume-based procurement, exchanging volume for price, integration of bidding and procurement, use guarantee, quality guarantee, supply guarantee and payment guarantee", which will become the most mainstream drug procurement mode in China by 2025. After the establishment of National Healthcare Security Administration, it has organized 6 batches of drug procurement and 2 batches of consumables. A working pattern of coordinated promotion of national, provincial and trans-provincial alliance procurement has been formed. In the future, centralized drug procurement should strengthen "system integration and efficient coordination", play a critical role in promoting the high-quality development of public hospitals, coordinate the interests of pharmaceutical enterprises and insured patients, solve main problems by stages, eradicate improper sales from system and mechanism, purify the industry ecology, stimulate normative competition, and promote the transformation and healthy development of the pharmaceutical industry. In the future, volume-based procurement will show the trend of normalization, wide coverage, multi-level, large alliance, excellent rules, more intensive development, full supporting, stable connection, strong platform and trustworthy use.