Objective: The paper explores the motivation of public medical institutions to complete the task of centralized procurement, analyzes the factors affecting the effect of centralized procurement, and provides a reference for the government to implement supervision and decision-making. Methods: Based on the game theory, the paper analyzes the first five batches of state-organized drug procurement in 14 provincial public hospitals by constructing the game model between government and hospitals. Results: In terms of the implementation of the centralized procurement policy in hospitals, there were problems such as insufficient government supervision, decrease of drug amount declaration in public hospitals and low participation enthusiasm. Conclusion: It is suggested optimizing the government supervision mechanism, strengthening the daily supervision, improving the incentive and restraint system, and improving the net revenue of medical institutions.