| Since the frequent occurrences of commercial bribe and rent seeking problem in the register, examination and approval processes of medicine, the unscientific management on medicine price-making and undemanding management on medicine bidding, the medicine circulation is in chaos, and medicine prices hike up. The rising prices of medicine not only hurt patients'benefits directly, but also sharpen social contradictions because it has been defined as social and political problem rather than management and economical problem. Government has adopted many measurements to solve the problem, such as price limitation, bidding centralization, reformations for price-making and register mechanisms and GMP & GSP certification. However, these measurements did not solve the problem effectively for failing to identify the particularity of medicine circulation and capture the origin of systematical flaw. This essay will try to identify the systematical cause of medicine price -rising by systematically analyzing the flaws in register, examination and approval, production and circulation processes of medicine, and to raise policy suggestions for government's reference.This essay reveals the particularity of medicine circulation as well as some premises in accordance with economical assumptions; reviews the history of medicine circulation mechanism, medical system, marketing and production systems of medicine and government supervision system in China; and compares the differences between the management modes of medicine ciculation in developed countries and some successful modes in China.By using system theory, SCP theory, transaction cost theory, rent seeking theory, game theory and regulation theory and creating game theoretical models with the different interest parties such as producer, seller, hospital, government and patient, the essay reveals the relationships of interest parties in medicine circulation and the origin of price-hiking problem and raises the way of solving this problem. The essay also indicats that the hiking price of medicine is not a pricing problem as it seems to be. The problem is actually induced by the synthetical action of system flaws including approval, production & circulation of medicine, health care and government regulation. It must be thoroughly solved by comprehensive reformation of foregoing systems with a systematical view.This essay is divided into 3 parts, totally 5 chapters: part 1 (introduction and Chapter I and II) is the basic part to illustrate research train and make a point. it will mainly elaborate the base of the point, introduce the progress of research on medicine circulation problem, reveal the author's train of thought, and summarize the theories used in the essay. Meanwhile, it will review the particularities of medicine circulation, the characteristics of medicine circulation models both nationally and abroad and the reformation history of circulation mechanism in China to establish the foundation of basic points.The second part (Chapter III and IV) is the main body of research. it will raise 3 economical assumptions on the summarization of the problems in China's medicine circulation. By establishing economical models and using transaction theory, rent seeking theory, channel relationship theory, market performance theory system theory and game theory, this part will analyze the register, approval, pricing and biding problems before medicine circulation and the low efficiency in the circulation, reveal the further contradiction in medicine circulation and the origin of hiking price.The third part (Chapter V and VI) is for conclusion and suggestions. This part offers the principles, methods, measures and theoretical base for solving the hiking price problem in medicine circulation, and raises policy suggestions for reformation and risk control.This essay has the following innovative views:1. Guided by system theory, this essay breaks the limitation of the existing single-link researches, analyzes systematically and comprehensively the flaws of all links in China's medicine circulation and management mechanism and raises the basic points and concrete measures about how to push the reformation in medicine circulation system systematically and ultimately. The essay divides the medicine circulation system into two parts, namely preceding stage and circulation process, and regards the circulation mechanism as a multi-link system comprised of government medicine supervision system of preceding stage, the sales and logistic channel of circulation process, and the related health care system and patients. By utilizing corresponding theories and methods, this essay analyzes the system flaws in preceding stage, circulation process and related parts, finds the systematic origin of hiking price and raises the pertinency measurements. The essay considers the hiking price of medicine is caused by system flaws in preceding stage, circulation process and related parts, and only systematical and synthetical measures can solve the problem.2. The essay raises the concept of"Medicine pricing paradox theory", the theory is defined as: when the supply of the medicine is over the demand, as well as the price is hiking, the higher price medicine with same quality will have better sales channels. With the supply and demand theory, SCP VS, the system theory and the government regulation failure theory, the essay analyzes the distortion of pricing mechanism and damage of circulation order caused by the hospital's monopoly under the irregulative situation. The essay also proposes that in order to solve the price hiking problem in circulation, it's necessary to reform the current medicine circulation mechanism in hospital and conduct the separation of the hospital and the pharmacy to force the doctors to prescribe reasonably; it's necessary to improve the transparency of the medicine market, credit level and transaction speed to avoid possible bribery; it's necessary to build up strict supervisory mechanism to smooth the registration, pricing and bidding processes of new medicine,. Meanwhile, it should build up reasonable financial rebating mechanism and relatively reform the medical system.3. The essay reveals the causes of price hiking both in interest mechanism and system. It divides the medicine circulation channels into prescriptive medicine circulation and OTC circulation, analyzes the two channels respectively and establishes the game models with the transaction cost theory, rent seeking theory, game theory and government regulation theory The essay points out that the government is maker of the confusion of medicine circulation, the doctor is both the victim and the gainer of the noneffective regulation, while the patient is the victim. So the essay proposes the policy suggestions to reform current unreasonable systems of medicine bidding, registration and pricing.4. The essay reveals the agency relationship between the doctor and the patient caused by the information asymmetry and analyzes the reasons: the doctor fully control the illness conditions and medicine informations under the monopoly of the hospital. the patient have to obey the doctor's authority of prescription and pricing due to the lack of related protection. The essay applies the economic model to analyze that the doctor made the patient suffer loss under the situation that the hospital is absent of supervisory, and gives the solution of improving the doctor's moral standard; and controlling bribery to enhance the supervision on pricing and quantity of the medicine.Due to my limited research ability and knowledge, there are still many aspects need to be improved for those problems in medicine circulation.
|
PDF Full Text Request