Objective To estimate the impact of volume-based procurement on relevant indicators of health,wealth and equity to determine whether the policy can effectively solve the trilemma of health policy.Methods A dynamic stochastic general equilibrium model that incorporate drugs into the production function of medical institutions as well as auxiliary estimation procedures were constructed.The rationality of the model setting was determined by using the mixed frequency data Bayesian estimation method,the short-term effect of volume-based procurement was estimated by using the impulse response method,and the long-term impact of volume-based procurement policy on the relevant economic and health indicators was determined by using the numerical simulation method.Results When the average decrease of all drug prices increased from 10.00％to 60.00％,the proportion of health expenditure to GDP decreased from 7.69％to 4.77％,the stock of health human capital increased from 1.908 6 to 1.956 7,and the incidence of catastrophic health expenditure decreased from 6.93％to 6.02％.Conclusion On the basis of ensuring the quality and efficacy of drugs,it should continue to promote the volume-based procurement policy,and at the same time,strengthen the scientific research and innovation capacity of the pharmaceutical industry and provide targeted medical assistance to low-income groups.
关键词
带量采购/卫生政策/三难权衡/动态随机一般均衡模型
Key words
volume-based procurement/health policy/trilemma/dynamic stochastic general equilibrium model
万方数据