摘要
目的:以血液制品为例,探讨特殊类别药品集采规则的差异化设计逻辑,为完善我国药品集中带量采购制度提供实证参考。方法:采用案头研究、实地考察、数据分析与专家调研相结合的方法。结果:血液制品具有原料稀缺、成本结构刚性及生产周期长等特征,集采面临刚性报量与临床动态需求不匹配、降价压力与高成本结构错位、临床支付限制影响可及性等挑战。面对这些挑战,各地在集采规则设计上进行了差异化探索,形成了不同的政策路径。其中,广东联盟实施的差异化集采规则在降价幅度上较为温和,保障了市场格局稳定与供应韧性。结论:血液制品集采应坚持临床价值导向,建立兼顾费用管理目标与供应韧性的精细化治理体系,包括构建弹性报量机制、优化价格形成机制、完善“保质稳供”风险防控体系、同步优化医保支付与临床使用的协同机制,从而系统提升血液制品的供应安全与可及性。
Abstract
Objective:The paper explores the differentiated design logic of centralized procurement rules for special categories of pharmaceuticals using blood products as an example, providing empirical references for improving China’s centralized volume-based procurement system. Methods:The study employed a combination of desk research, field visits, data analysis, and expert interviews. Results:Blood products are characterized by scarce raw materials, inflexible cost structures, and long production cycles. Centralized procurement faces challenges such as mismatches between rigid volume commitments and dynamic clinical demand, conflicts between price reduction pressure and high cost structures, and limitations on clinical payment affecting accessibility. In response to these challenges, various regions have adopted differentiated approaches in the design of centralized procurement rules, forming distinct policy approaches. Among them, the differentiated centralized procurement rules implemented by the Guangdong Alliance have achieved moderate price reductions, effectively ensuring market stability and supply resilience. Conclusion:Centralized procurement of blood products should adhere to a clinical value-oriented approach and establish a refined governance system that balances cost management goals with supply resilience. This includes developing a flexible volume commitment mechanism, optimizing price formation mechanisms, improving a risk prevention and control system centered on “quality assurance and stable supply”, and simultaneously enhancing the coordination between medical insurance payment and clinical use, thereby systematically improving the supply security and accessibility of blood products.
关键词
血液制品 /
集采规则 /
差异化设计 /
弹性报量机制
Key words
blood products /
rules of volume-based drug procurement /
differentiated design /
flexible volume commitment mechanism
江依帆, 陈子礼, 姚童, 孙巧, 王钾鑫, 宣建伟.
血液制品集采规则现状分析与政策优化[J]. 中国医疗保险. 2026, 0(4): 42-51 https://doi.org/10.19546/j.issn.1674-3830.2026.4.004
Centralized Volume-Based Procurement Rules for Blood Products: Current Situation Analysis and Policy Optimization[J]. China Health Insurance. 2026, 0(4): 42-51 https://doi.org/10.19546/j.issn.1674-3830.2026.4.004
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