目的：为完善国家基本药物制度提供参考。方法：对国家基本药物制度下的药品流通环节存在的问题进行分析，并提出

应对策略。结果：由于存在区域经济环境、行业发展水平等差异，在执行国家基本药物制度时，在行政监管方面存在地方政策与国

家法律法规冲突，监管缺乏制度依据，药品集中招标采购部门责任弱化等问题；在市场化方面存在流通配送能力弱化，流通企业内

部管理不规范，基本药物贮藏和配送过程存在质量安全隐患等问题。针对以上问题，应建立健全国家基本药物制度总体实施方案

和区域实施方案；整合药品流通市场，探索建立现代化医药物流体系；加大药品流通监督管理力度；帮扶流通企业转型发展以降低

社会风险；进一步完善招标采购机制以降低流通成本。结论：只有深入推进医药卫生体制改革，完善国家基本药物制度，才能逐步

解决现阶段药品流通环节存在的问题。

OBJECTIVE：To provide reference for improving the policies and countermeasures for national essential medicines.

METHODS：The existing problems of medicine distribution under essential medicine system were analyzed and countermeasures

were put forward. RESULTS：Due to the regional economic environment and industry development level differences，local policy

had conflict with national laws and regulations，lacking of systembasis in regulatory process and drug centralized bidding and purchasing

department weakened responsibility in terms of administrative supervision when performing national essential medicine system；

distribution distribution capability had weakened，distribution enterprise internal management was not standard，the essential

medicine storage and distribution process quality showed safety hidden risks in terms of marketization. It is suggested to establish

and improve the national essential medicine system overall implementation programs and regional implementation programs，integrate

medicine distribution market，explore and establish modernized pharmaceutical logistics system，intensify supervision and

management of distribution，support distvibution transformation development to reduce social risk and further improve bidding and

purchasing mechanism to reduce distribution costs. CONCLUSIONS：The existing problems in distribution can be gradually solved

only by further promoting the medical and health system and improving the national essential medicine system.