Li Xiujuan, Xu Jiachun
Economics and Management School, Wuhan University, Wuhan, China.
School of Economics, Jinan University, Guangzhou, China.
Front Pharmacol. 2024 Jun 27;15:1392239. doi: 10.3389/fphar.2024.1392239. eCollection 2024.
The national volume-based drug procurement policy initiated in China since 2018 represents a significant reform in China's pharmaceutical distribution system. It has largely squeezed out the price bubble of low-end generic drugs, making competition in the pharmaceutical sales segment more intense and transparent. This policy intervenes in the distribution link of the pharmaceutical industry by intensifying market competition, thereby enhancing the innovation willingness and R&D capabilities of pharmaceutical companies.
Taking the national volume-based drug procurement policy as the policy shock, we used the multi-period difference-in-difference method to study the impact of the policy on innovation input, innovation output quantity and innovation output quality of listed pharmaceutical companies and its impact mechanism.
We found that the volume-based policy can significantly promote the pharmaceutical companies' innovation input and the innovation output quality, but significantly reduced the innovation output quantity. For innovative and generic drug companies, this policy has limited impact on innovative drug companies, but force generic drug companies to pay more attention to cost control and market positioning, and the quality and cost-effectiveness of R&D output to ensure competitiveness in the market. For bid-winning and non-winning companies, the policy has a greater innovation incentive for non-winning companies than winning companies, by imposing greater survival pressure on non-winning companies, forcing them to increase R&D investment intensity and adopt the innovation strategy of preferring quality to quantity.
The results show that the national volume-based drug procurement policy should be expanded to lower drug prices and lighten the medical burden on patients, with enhanced quality and safety supervision. Additionally, it suggests cautious application of such policies to innovative and high-end generic drugs to encourage continued pharmaceutical innovation and industry advancement.
自2018年起在中国推行的国家药品集中带量采购政策是中国药品流通体制的一项重大改革。它在很大程度上挤出了低端仿制药的价格泡沫，使药品销售环节的竞争更加激烈和透明。该政策通过强化市场竞争干预药品行业的流通环节，从而增强制药企业的创新意愿和研发能力。
以国家药品集中带量采购政策作为政策冲击，采用多期双重差分法研究该政策对上市制药企业创新投入、创新产出数量和创新产出质量的影响及其作用机制。
我们发现带量政策能够显著促进制药企业的创新投入和创新产出质量，但显著降低了创新产出数量。对于创新药企业和仿制药企业而言，该政策对创新药企业影响有限，但迫使仿制药企业更加注重成本控制和市场定位，以及研发产出的质量和性价比以确保市场竞争力。对于中标企业和未中标企业，该政策对未中标企业的创新激励大于中标企业，因为未中标企业面临更大的生存压力，迫使它们提高研发投入强度并采取质量优先于数量的创新策略。
结果表明，国家药品集中带量采购政策应扩大实施以降低药价并减轻患者医疗负担，同时加强质量和安全监管。此外，建议谨慎将此类政策应用于创新药和高端仿制药，以鼓励制药行业持续创新和发展。
