药品采购中的竞争性招标：来自中国的证据
Competitive Bidding in Drug Procurement: Evidence from China
American Economic Journal: Economic Policy · 2024 · [{"name": "Shengmao Cao", "affiliation": ["Kellogg's (Canada)"]}, {"name": "Lisa Xuejie Yi", "affiliation": ["Stanford University"]}, {"name": "Chuan Yu", "affiliation": ["Stanford University"]}]
中文摘要
我们研究了在药品采购中引入竞争性招标的均衡效应。2019年，中国在九个省份推出了一项竞争性招标项目，制药公司就预先设定的采购数量进行投标。基于双重差分(DID)设计，我们发现该项目使平均药品价格下降了47.4%。仿制药赢得了大多数投标，并将价格削减了75.0%。我们构建了一个均衡模型，以量化更低价格与潜在选择扭曲之间的权衡。如果政策制定者认为消费者应当同等看待品牌药与生物等效仿制药，竞争性招标将提高消费者福利。该项目还使政府的保险支出减少了19.8%。 (JEL D44, G22, I18, L13, L65, P25, P31)
Abstract
We study the equilibrium effects of introducing competitive bidding in drug procurement. In 2019, China introduced a competitive bidding program where drug companies bid for a prespecified procurement quantity in nine provinces. Using a difference-in-differences design, we show the program reduced average drug prices by 47.4 percent. Generic drugs won most bids and cut prices by 75.0 percent. We develop an equilibrium model to quantify the trade-off between lower prices and potential choice distortions. Competitive bidding increases consumer welfare if policymakers believe consumers should value branded and bioequivalent generic drugs equally. The program also reduced government expenditure on insurance by 19.8 percent. (JEL D44, G22, I18, L13, L65, P25, P31)