目的: 探索医用耗材价格监测的科学路径,通过编制价格指数监测价格变化,弥补相关理论研究不足,为完善医药价格治理体系提供实践参考。方法: 基于南宁市2022年1月至2023年9月的医保报销数据,构建月度医用耗材链式费氏价格指数,从整体情况、耗材级别以及销售渠道维度分析耗材价格的变化趋势和原因。结果: 监测期内医用耗材价格呈现持续下降趋势,平均降幅达15.2%。全自费耗材受高值医用耗材集采影响大,驱动了整体价格下降。市场主体性质差异导致价格分化,药店渠道价格在波动中上涨,医疗机构渠道价格稳定下降,非营利性医疗机构降幅显著大于营利性医疗机构。此外,高级别医疗机构降幅大于低级别医疗机构。建议：持续深化医用耗材监测工作,发挥价格监测对医疗服务改革的支撑作用,实施分级分类价格监测策略,纳入营利性医疗机构、零售药店等多元市场主体,构建全产业监测协同机制。
Abstract
Objective: This study explores a scientific approach to monitoring medical consumable prices by establishing a price index, and aims to make up for the lack of relevant theoretical research and provide practical insights for improving pharmaceutical pricing governance system. Methods: A monthly chain-linked Fisher price index is developed using medical insurance reimbursement data from Nanning City from January 2022 to September 2023. Medical consumable price trends and driving factors are analyzed across overall conditions, consumable categories, and distribution channels. Results: During the monitoring period, medical consumable prices show a continuous decline, with an average decrease of 15.2%. Consumables that are paid fully out-of-pocket experience a significant price reduction due to centralized procurement of high-value items, driving the overall price drop. Price differentiation emerges due to variations in market entity characteristics. While the price of consumables distributed through pharmacies increase amid fluctuations, the price of consumables in hospitals decline steadily. Non-profit medical institutions experience a greater price reduction compared to for-profit institutions. Additionally, higher-level medical institutions experience a larger price drop than lower-level ones. Conclusion: It is suggested to continue to deepen the monitoring of medical consumables, and leverage the supportive role of price monitoring for medical system reform. We recommend the government to implement tiered and categorized price monitoring strategies, include diverse market entities such as for-profit medical institutions and retail pharmacies, and establish a collaborative monitoring mechanism across the entire industry.
关键词
价格监测 /
医用耗材 /
价格指数 /
医药价格
Key words
price monitoring /
medical consumables /
price index /
pharmaceutical prices
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 国家医疗保障局.关于印发《医疗保障行政执法事项指导目录》的通知[EB/OL].(2020-08-27)[2025-03-05].https://www.gov.cn/zhengce/zhengceku/2020-11/05/content_5557633.htm.
[2] 国务院办公厅.关于印发“十四五”全民医疗保障规划的通知[EB/OL].(2021-09-23)[2025-03-05].https://www.gov.cn/zhengce/content/2021-09/29/content_5639967.htm.
[3] 马芳芳,吴晶.药品价格指数的方法学综述[J].中国卫生政策研究,2015,8(07):61-67.
[4] 王凤明.新医改以来山东省医疗服务价格指数分析及其调整对策研究[J].中国卫生经济,2023,42(04):50-52.
[5] 许坦,戴智敏,翟飞,等.公立医院医疗服务项目成本及价格指数建模[J].中国卫生经济,2017,36(09):39-41.
[6] 叶顺萍,康洽福,高锦娟,等.基于药品价格指数的福建省“4+7”政策实施效果研究[J].中国医疗保险,2020(08):35-39
[7] 李丹丹,林新,张力元.我院医用耗材降价效果探讨[J].中国医疗设备,2018,33(09):172-174.
[8] 王瑶,李敬伟.新医改下医疗服务价格政策对公立医院收支影响研究——兼析药品和耗材集中带量采购政策影响[J].价格理论与实践,2024(11):93-99+224.
[9] 曹晓琳,李亚子,聂子潞,等.我国医药价格和招标采购信息监测实施路径研究[J].中国医疗保险,2022(12):5-10.
[10] 日本中央社会保险医疗协会.特定补偿医用耗材价格调査结果[R].日本:中央社会保险医疗协会,2015.
[11] 广东省物价局课题组.医用耗材价格管理研究(下)[J].市场经济与价格,2010(05):20-27.
[12] 威海市医疗保障局.关于印发《威海市医药价格监测试点工作方案》的通知[EB/OL].(2022-10-17)[2025-03-05].https://www.weihai.gov.cn/art/2022/10/17/art_103324_13250.html.
[13] 王婕妤,邰侠.我市发布二季度医用耗材价格监测指数[N].南京日报,2022-08-26(A04).
[14] 国家医疗保障局.关于印发医疗保障标准化工作指导意见的通知[EB/OL].(2019-06-20)[2025-03-05].https://www.gov.cn/zhengce/zhengceku/2019-10/12/content_5438776.htm.
[15] 广西壮族自治区医疗保障局.关于印发广西壮族自治区基本医疗保险、工伤保险和生育保险医疗服务项目的通知[EB/OL].(2022-04-13)[2025-03-05].http://ybj.gxzf.gov.cn/xwdt/tzgg/t11752922.shtml.
[16] NUTTER G W.On measuring economic growth[J].Journal of political economy, 1957, 65(1): 51-63.
[17] 张小娟,于保荣.美国医疗价格指数编制方法探讨[J].中国卫生经济,2009,28(09):102-104.
[18] 国家卫生健康委.关于印发2022年度全国三级公立医院绩效考核国家监测分析情况的通报[EB/OL].(2024-02-07)[2025-03-05].http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=516d9853b9204e31867972c1a0e0be36.
[19] 国家卫生健康委.关于印发三级医院评审标准(2020年版)的通知[EB/OL].(2020-12-21)[2025-03-05].https://www.gov.cn/zhengce/zhengceku/2020-12/28/content_5574274.htm.
[20] 国家卫生健康委办公厅.关于印发国家二级公立医院绩效考核操作手册(2023版)的通知[EB/OL].(2023-04-11)[2025-03-05].http://www.nhc.gov.cn/yzygj/s3594q/202304/9249d294e36b41c38ee89ac153965582.shtml.
[21] NEWHOUSE J P.Toward a theory of nonprofit institutions: an economic model of a hospital[J].The American economic review, 1970, 60(1): 64-74.
基金
广西壮族自治区南宁市医疗保障局委托项目“南宁市医药价格动态监测机制研究”
