限价政策与公益性影响下药品双渠道供应链定价与协调策略
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摘要
针对当前网上售药渠道与传统售药渠道产生的矛盾冲突,在考虑我国药品限价政策与医疗机构公益性的基础上,构建了药品双渠道供应链模型分散式与集中式决策下的理论模型,分析、比较了限价政策、公益性等因素对均衡价格和系统绩效的影响;并针对药品双渠道供应链的特点,从渠道合作角度出发,设计了"指导定价+固定支付"及"政府补贴+指导定价+固定支付"的协调契约。研究发现:最高限价管制下,降低最高限价有利于提高供应链利润和社会整体福利;当药品价格不受管制时,增加医疗机构公益性有利于提高药品供应链利润和社会整体福利。当医疗机构公益性较低时,分散式决策供应链利润小于集中式决策,"指导定价+固定支付"契约可协调药品双渠道供应链;当医疗机构公益性较高时,分散式决策供应链利润大于集中式决策,"政府补贴+指导定价+固定支付"契约可协调药品双渠道供应链。
The rapid development of pharmaceutical e-commerce provides a convenient and efficient way for self-medication. More and more pharmaceutical suppliers are distributing drugs through both medical institutions and online channels to increase profit. However, adding a new channel will damage the profit of medical institutions, which will cause channel conflict between the medical institutions and online pharmaceutical channel. Therefore, how to alleviate or eliminate channel conflict and realize supply chain coordination, as well as the win-win situation of supply chain members, is a serious problem needing to be solved.Aiming at the channel conflict in the pharmaceutical dual-channel supply chain, we establish theoretical models in the decentralized decision and the centralized decision of pharmaceuticals dual-channel supply chains respectively by taking into account China's pharmaceutical supply chain characteristics,such as the influence of price cap policy and public welfare. Then, we analyze the impacts of some parameters including price cap policy and public welfare and self-medication on the equilibrium results. From the perspective of cooperation between medical institutions and pharmaceutical suppliers, we proposed coordination contracts to realize the win-win situation between supply chain members and improve the social welfare under the dual-channel strategy of pharmaceutical suppliers. Finally, combined with the current pharmaceutical policy, we claimed the feasibility of coordination contracts and verified the effectiveness of the model on pharmaceutical dual-channel supply chain by the numerical examples.Firstly, we obtained equilibrium solutions of pharmaceuticals dual-channel supply chain under decentralized decision-making and analyzed the influence of the price-cap policy and public welfare on pricing strategies and systems performance. The result shows that when there exists a lower price cap, the optimal pricing of pharmaceuticals of medical institutions equals the price cap, and the price cap won't influence the online channel price. At this point, reducing price cap may reduce the profit of medical institutions, but it can increase the profit of pharmaceutical suppliers and enhance patient's surplus effectively. As a whole,reducing the price cap can not only increase the profit of the pharmaceutical supply chain but also improve social welfare. When there exists a higher price cap,the pharmaceutical price of medical institutions has not been regulated, and public welfare becomes the main factor to influence pricing. A relatively high public welfare will decrease the marginal profit and pharmaceutical price of medical institutions while enhancing the patient's surplus. Meanwhile, a relatively high public welfare can increase the wholesale price of pharmaceutical and then increase the pharmaceutical supplies' profit. As a whole, increasing public welfare can not only increase the profit of the pharmaceutical supply chain but also improve social welfare.Then, we compared the performances of the system between the decentralized decision-making and the centralized decision-making. We found that the price of pharmaceutical institutions and online pharmaceutical price in the decentralized situation are always higher than those in the centralized situation. The profit of pharmaceutical supply chain in decentralized decision-making is less than that in the centralized decision-making when public welfare is low, at this point, the coordinated pharmaceutical dual-channel supply chain can transfer the system profit to realize win-win and maximize the social welfare. However,when public welfare is high, the profit of the pharmaceutical dual-channel supply chain is higher in the decentralized supply chain than that in the centralized supply chain. However, the social welfare in a decentralized system is always less than a centralized system. At this point, the coordinated pharmaceutical dual-channel supply chain cannot satisfy the participation constraints of supply chain members. The pharmaceutical supply chain should receive external subsidies to obtain more social welfare.Finally, to achieve a win-win situation and obtain optimal social welfare, we put forward the coordination strategies to alleviate the channel conflict of the pharmaceutical dual-channel supply chain. When the public welfare is relatively low, the "directiveness price combined with fixed payment" contract can achieve coordination of the pharmaceutical dual-channel supply chain. When the public welfare is relatively high, the "government subsidies + directiveness price + fixed payment" contract achieves pharmaceutical dual-channel supply chain coordination.
The rapid development of pharmaceutical e-commerce provides a convenient and efficient way for self-medication. More and more pharmaceutical suppliers are distributing drugs through both medical institutions and online channels to increase profit. However, adding a new channel will damage the profit of medical institutions, which will cause channel conflict between the medical institutions and online pharmaceutical channel. Therefore, how to alleviate or eliminate channel conflict and realize supply chain coordination, as well as the win-win situation of supply chain members, is a serious problem needing to be solved.Aiming at the channel conflict in the pharmaceutical dual-channel supply chain, we establish theoretical models in the decentralized decision and the centralized decision of pharmaceuticals dual-channel supply chains respectively by taking into account China's pharmaceutical supply chain characteristics,such as the influence of price cap policy and public welfare. Then, we analyze the impacts of some parameters including price cap policy and public welfare and self-medication on the equilibrium results. From the perspective of cooperation between medical institutions and pharmaceutical suppliers, we proposed coordination contracts to realize the win-win situation between supply chain members and improve the social welfare under the dual-channel strategy of pharmaceutical suppliers. Finally, combined with the current pharmaceutical policy, we claimed the feasibility of coordination contracts and verified the effectiveness of the model on pharmaceutical dual-channel supply chain by the numerical examples.Firstly, we obtained equilibrium solutions of pharmaceuticals dual-channel supply chain under decentralized decision-making and analyzed the influence of the price-cap policy and public welfare on pricing strategies and systems performance. The result shows that when there exists a lower price cap, the optimal pricing of pharmaceuticals of medical institutions equals the price cap, and the price cap won't influence the online channel price. At this point, reducing price cap may reduce the profit of medical institutions, but it can increase the profit of pharmaceutical suppliers and enhance patient's surplus effectively. As a whole,reducing the price cap can not only increase the profit of the pharmaceutical supply chain but also improve social welfare. When there exists a higher price cap,the pharmaceutical price of medical institutions has not been regulated, and public welfare becomes the main factor to influence pricing. A relatively high public welfare will decrease the marginal profit and pharmaceutical price of medical institutions while enhancing the patient's surplus. Meanwhile, a relatively high public welfare can increase the wholesale price of pharmaceutical and then increase the pharmaceutical supplies' profit. As a whole, increasing public welfare can not only increase the profit of the pharmaceutical supply chain but also improve social welfare.Then, we compared the performances of the system between the decentralized decision-making and the centralized decision-making. We found that the price of pharmaceutical institutions and online pharmaceutical price in the decentralized situation are always higher than those in the centralized situation. The profit of pharmaceutical supply chain in decentralized decision-making is less than that in the centralized decision-making when public welfare is low, at this point, the coordinated pharmaceutical dual-channel supply chain can transfer the system profit to realize win-win and maximize the social welfare. However,when public welfare is high, the profit of the pharmaceutical dual-channel supply chain is higher in the decentralized supply chain than that in the centralized supply chain. However, the social welfare in a decentralized system is always less than a centralized system. At this point, the coordinated pharmaceutical dual-channel supply chain cannot satisfy the participation constraints of supply chain members. The pharmaceutical supply chain should receive external subsidies to obtain more social welfare.Finally, to achieve a win-win situation and obtain optimal social welfare, we put forward the coordination strategies to alleviate the channel conflict of the pharmaceutical dual-channel supply chain. When the public welfare is relatively low, the "directiveness price combined with fixed payment" contract can achieve coordination of the pharmaceutical dual-channel supply chain. When the public welfare is relatively high, the "government subsidies + directiveness price + fixed payment" contract achieves pharmaceutical dual-channel supply chain coordination.
引文
[1]新浪网.去年网上药店销售规模增长71.4%.[EB/OL].[2015-08].http://finance.sina.com.cn/chanjing/cyxw/20150812/143722945812.sh tml.
[2]刘小鲁.管制,市场结构与中国医药分离的改革绩效[J].世界经济,2011(12):53-75.
[3]网易新闻“密码”处方背后可能藏着私心[EB/OL].[2014-11]http://news.163.com/14/1106/04/AABFJUQ500014Q4P.html
[4]Hu QJ,Schwarz LB,Uhan NA.The impact of group purchasing organizations on healthcare-product supply chains[J].Manufacturing&Service Operations Management,2012,14(1):7-23.
[5]Zhao H,Xiong C,Gavirneni S,et al.Fee-for-service contracts in pharmaceutical distribution supply chains:Design,analysis,and management[J]Manufacturing&Service Operations Management,2012,14(4):685-699
[6]Kouvelis P,Xiao Y,Yang N.PBM competition in pharmaceutical supply chain:Formulary design and drug pricing[J].Manufacturing&Service Operations Management,2015,17(4):511-526.
[7]杜少甫,谢金贵,刘作仪.医疗运作管理:新兴研究热点及其进展[J].管理科学学报,2013,16(8):1-19.
[8]Quon BS,Firszt R,Eisenberg M J.A comparison of brand-name drug prices between Canadian-based Internet pharmacies and major USdrug chain pharmacies[J].Annals of Internal Medicine,2005,143(6):397-403.
[9]Fittler A,LankóE,Brachmann B,Botz L.Analysis of patients who purchase medicines on the internet:can hospital pharmacists facilitate online medication safety?[J].European Journal of Hospital Pharmacy.2013,20:8-12.
[10]Levaggi R,Orizio G,Domenighini S,et al.Marketing and pricing strategies of online pharmacies[J].Health Policy,2009,92(2):187-196.
[11]Desai K,Chewning B,Mott D.Health care use amongst online buyers of medications and vitamins[J].Research in Social and Administrative Pharmacy,2015,11(6):844-858.
[12]David A,Adida E.Competition and Coordination in a Two-Channel Supply Chain[J].Production and Operations Management,2015,24(8):1358-1370.
[13]Li B,Hou P-W,Chen P,et al.Pricing strategy and coordination in a dual channel supply chain with a risk-averse retailer[J].International Journal of Production Economics,2016,178:154-168.
[14]申成然,熊中楷,晏伟.网络比价行为下双渠道定价及协调策略研究[J].中国管理科学,2014,22(1):84-93
[15]Geng Q,Mallik S.Inventory competition and allocation in a multi-channel distribution system[J].European Journal of Operational Research,2007,182(2):704-729.
[16]赵金实,段永瑞,王世进,等.不同主导权位置情况下零售商双渠道策略的绩效对比研究[J].管理工程学报,2013(1):171-177.
[17]朱恒鹏.医疗体制弊端与药品定价扭曲[J].中国社会科学,2007(4):89-103.
[18]Pan K,Lai KK,Leung SC,Xiao D.Revenue-sharing versus wholesale price mechanisms under different channel power structures[J].European Journal of Operational Research,2010,203(2):532-538.
[19]Chen X,Wang X.Free or bundled:Channel selection decisions under different power structures[J].Omega,2015,53:11-20
[20]Eggleston K,Yip W.Hospital competition under regulated prices:application to urban health sector reforms in China[J].International Journal of Health Care Finance and Economics,2004,4(4):343-368.
[21]Godager G,Wiesen D,Profit or patients’health benefit?Exploring the heterogeneity in physician altruism[J].Journal of health economics,2013,32:1105-1116.
(1)《互联网药品交易服务审批暂行规定》规定,拥有线下连锁药店的药品供应商才可获得申请开办网上售药业务的资格。
(2)我国药品实行分类管理制度,非处方药品(OTC)患者可以直接网上购买;对于处方药,患者必须凭借医生处方购买,但对于部分慢性病或多疗程治疗疾病,由于医生诊断明确,且已经开具处方,患者往往通过线上下单,线下实体药店配送的方式获得处方药。例如,阿里健康、药急送等。
(3)国家发改委2006年发布《关于进一步整顿药品和医疗服务市场价格秩序的意见》,规定“县及县以上医疗机构销售药品,以实际购进价为基础,顺加不超过15%的加价率作价。
(1)在我国,药品供给过程中,往往采取先供货后回款的支付机制。因此,在契约签订中,药品供应商一般不会在意签署的批发价格,而更在意回款时的总收益。
(2)当供应链达到协调后医疗机构获取的消费者剩余恒大于协调前,因此,当医疗机构协调后的利润大于协调前,其总效用也恒大于协调前,所以只用讨论医疗机构利润。
[2]刘小鲁.管制,市场结构与中国医药分离的改革绩效[J].世界经济,2011(12):53-75.
[3]网易新闻“密码”处方背后可能藏着私心[EB/OL].[2014-11]http://news.163.com/14/1106/04/AABFJUQ500014Q4P.html
[4]Hu QJ,Schwarz LB,Uhan NA.The impact of group purchasing organizations on healthcare-product supply chains[J].Manufacturing&Service Operations Management,2012,14(1):7-23.
[5]Zhao H,Xiong C,Gavirneni S,et al.Fee-for-service contracts in pharmaceutical distribution supply chains:Design,analysis,and management[J]Manufacturing&Service Operations Management,2012,14(4):685-699
[6]Kouvelis P,Xiao Y,Yang N.PBM competition in pharmaceutical supply chain:Formulary design and drug pricing[J].Manufacturing&Service Operations Management,2015,17(4):511-526.
[7]杜少甫,谢金贵,刘作仪.医疗运作管理:新兴研究热点及其进展[J].管理科学学报,2013,16(8):1-19.
[8]Quon BS,Firszt R,Eisenberg M J.A comparison of brand-name drug prices between Canadian-based Internet pharmacies and major USdrug chain pharmacies[J].Annals of Internal Medicine,2005,143(6):397-403.
[9]Fittler A,LankóE,Brachmann B,Botz L.Analysis of patients who purchase medicines on the internet:can hospital pharmacists facilitate online medication safety?[J].European Journal of Hospital Pharmacy.2013,20:8-12.
[10]Levaggi R,Orizio G,Domenighini S,et al.Marketing and pricing strategies of online pharmacies[J].Health Policy,2009,92(2):187-196.
[11]Desai K,Chewning B,Mott D.Health care use amongst online buyers of medications and vitamins[J].Research in Social and Administrative Pharmacy,2015,11(6):844-858.
[12]David A,Adida E.Competition and Coordination in a Two-Channel Supply Chain[J].Production and Operations Management,2015,24(8):1358-1370.
[13]Li B,Hou P-W,Chen P,et al.Pricing strategy and coordination in a dual channel supply chain with a risk-averse retailer[J].International Journal of Production Economics,2016,178:154-168.
[14]申成然,熊中楷,晏伟.网络比价行为下双渠道定价及协调策略研究[J].中国管理科学,2014,22(1):84-93
[15]Geng Q,Mallik S.Inventory competition and allocation in a multi-channel distribution system[J].European Journal of Operational Research,2007,182(2):704-729.
[16]赵金实,段永瑞,王世进,等.不同主导权位置情况下零售商双渠道策略的绩效对比研究[J].管理工程学报,2013(1):171-177.
[17]朱恒鹏.医疗体制弊端与药品定价扭曲[J].中国社会科学,2007(4):89-103.
[18]Pan K,Lai KK,Leung SC,Xiao D.Revenue-sharing versus wholesale price mechanisms under different channel power structures[J].European Journal of Operational Research,2010,203(2):532-538.
[19]Chen X,Wang X.Free or bundled:Channel selection decisions under different power structures[J].Omega,2015,53:11-20
[20]Eggleston K,Yip W.Hospital competition under regulated prices:application to urban health sector reforms in China[J].International Journal of Health Care Finance and Economics,2004,4(4):343-368.
[21]Godager G,Wiesen D,Profit or patients’health benefit?Exploring the heterogeneity in physician altruism[J].Journal of health economics,2013,32:1105-1116.
(1)《互联网药品交易服务审批暂行规定》规定,拥有线下连锁药店的药品供应商才可获得申请开办网上售药业务的资格。
(2)我国药品实行分类管理制度,非处方药品(OTC)患者可以直接网上购买;对于处方药,患者必须凭借医生处方购买,但对于部分慢性病或多疗程治疗疾病,由于医生诊断明确,且已经开具处方,患者往往通过线上下单,线下实体药店配送的方式获得处方药。例如,阿里健康、药急送等。
(3)国家发改委2006年发布《关于进一步整顿药品和医疗服务市场价格秩序的意见》,规定“县及县以上医疗机构销售药品,以实际购进价为基础,顺加不超过15%的加价率作价。
(1)在我国,药品供给过程中,往往采取先供货后回款的支付机制。因此,在契约签订中,药品供应商一般不会在意签署的批发价格,而更在意回款时的总收益。
(2)当供应链达到协调后医疗机构获取的消费者剩余恒大于协调前,因此,当医疗机构协调后的利润大于协调前,其总效用也恒大于协调前,所以只用讨论医疗机构利润。
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