Analysis On The System Of Centralized Procurement On Chinese Essential Medicines

The way of government-lead centralized procurement (CP, for short) on essential medicines (EM, for short) has been stressed out in the Guidelines on Deepening the Reform of Health-care system issued in 2009. It is the first time that CP is used in EM purchase, but it is well-known in our country for its 20years of purchasing drugs in hospitals and its various problems. It is only when the problems are settled down that CP can be successfully used on EM procurement.An interview is planned from the literatures about the problems of CP to know the real problems it has, and the conclusion is that there are four main problems existing: the goals of CP, the main subject of CP, the problem about drug quality and the law protection problem.As to the goals, this study evaluates all the goals of CP by the way of literature review to fix the suitable aims. Regarding the main subject of CP, this thesis believes that it is an improvement when CP replaces the decentralized procurement. From the perspective of CP's development, this study analyzes the differences and disadvantages between two subjects: hospital and healthcare institutes. The study way of normative is also used to describe the agent relationships of patients with hospitals, healthcare institutes and insurance institutes. Concerning the problem of drug quality, this thesis puts the importance on the evaluation index of two ways of drug quality certification. Quality level, the common way to ease the problem is also discussed deeply. The clinical index including effect and safety evaluations is discussed to induce the import scientific way of pharmacoeconomic evaluation. As to the law protection on essential medicines missing, the rationality and feasibility on adding regulations about essential medicines into Drug Management Law are analyzed. At last, the international experience of procurement subjects and way of quality grasping is referred according to their different procurement subjects to give us some inspiration.The main views concluded through this study are as follows. First, it is not suitable to include the goal of easing disease burdens, and there are different procurement goals according to different reform stages. Second, the medical insurance institutes can be the main subject of CP in early time of our medical reform, and in the long-term, the subjects can be diversified. Third, our government should set up a common standard to support the evaluation of drug quality levels, and should implement pharmacoeconomic way of evaluation to build a scientific set of evaluation index to provide enough evidence for the procurement organizations to abide by. Add EM regulations into Drug Management Law.