9 月11 日，国家试点联合采购办公室在上海召开工作座谈会，确定国家药品带量集采将在北京、上海、天津、重庆、广州、深圳、沈阳、大连、西安、成都、厦门11 个城市试点，以试点地区所有公立医疗机构年度药品总用量的60%-70%估算采购总量；此次带量采购涉及33 个通用名药品，包括27 个口服制剂和6个注射剂，入围企业包括原研厂家及通过一致性评价的仿制药企业。9 月12 日，A 股医药板块众多白马股出现急跌。此次带量采购征求意见稿的发布也被戏称为“医药行业911”。

We estimate the population at 207.7mn in 2016, the fifth largest in the world. Population growth is average for the Americas region at 0.8% per annum. Brazil has a relatively young population; around 8.2% of the population was aged 65 years or more in 2016, equal to 17.0mn people, although this segment is growing at a rate of 3.4% per annum. There are 2.7mn births and 1.3mn deaths each year, with an infant mortality rate estimated at 13.1 per thousand live births in 2016. Life expectancy is 71.5 years for men and 78.9 years for women. The fertility rate has fallen to 1.7, below the population replacement level. The Brazilian Institute of Geography and Statistics now anticipates that Brazil will begin the phenomenon of population reduction by 2030, a whole decade earlier than previously forecast. Conversely, the elderly population will continue to grow with the number of people aged 65 and over set to more than treble by 2050.

The bone grafts are used in surgical procedures for bone replacement and repair of bone fractures. Bone graft is helpful in spinal fusion surgeries ensuring new bone formation. Bone grafts are of several types which include allograft, autograft, and artificial graft. This report constitutes information about allografts, bone grafts substitutes, and cell-based matrices. Platelet concentrations and cost of autografts are excluded in this report. The bone graft market has witnessed remarkable growth and developments since last few years, owing to increase in incidences of musculoskeletal disorders and other bone & joint related disorders. Bone grafting is the emerging solution to musculoskeletal disorders. Furthermore, the advancements in medical technology has brought improvements in bone grafting methods by providing benefits in fixing bone, and other joints related problems.

A companion animal or a pet is an animal that is primarily bred to live as a companion to a person as well as to entertain and protect them rather than to serve as a working animal, laboratory animal, or livestock. Two of the most popular companion animals are dogs and cats. Companion animals play an important part in the lives of many people. They provide companionship and a sense of responsibility, demand care and attention, and respond with affection. Although somewhat controversial, a number of studies have shown that owning companion animals is associated with positive health benefits. Pets, especially dogs and cats, are always considered as companion animals and there has been an improvement in the way people treat their pets over the past decade. Around 70% of the pet owners said they would risk their lives for them. Apart from the growing interest to have a pet in the family, most families now consider pets as another family member.

The report covers the analysis of Asia-Pacific AWC market based on product type, application, end user, and region. Based on product type, the AWC market is segmented into infection management, exudate management, active wound care, and therapy devices. Based on application, the AWC market is bifurcated into chronic wound care and active wound care. AWC products find applications in many clinical areas, namely, burns, pressure ulcers, diabetic ulcers, venous ulcers, diabetic leg ulcers, and surgical wounds. Based on end user, the market is bifurcated into hospital and community health service centers.

The Brazilian pharmaceutical market is the largest in Latin America, a position we expect it to maintain and solidify over our forecast period and thus drive foreign investment in the market - despite drug pricing challenges. We calculate that pharmaceutical sales in Brazil reached a value of BRL78.7bn (USD24.7bn) in 2017, accounting for 1.2% of GDP and 12.6% of health expenditure. Patented drug sales represented the largest segment of the market at 47.4% of overall sales, with a value of BRL37.3bn (USD10.7bn). Medicine spending per capita was calculated to be just USD118 in 2017.

Highly centralised healthcare sector, controlled by the government. Smallest medical device market in the Americas region. • Other medical devices, consumables and diagnostic imaging have the highest market shares. Market heavily reliant on medical device imports, particularly from Europe, China and Japan. Lack of advanced medical device manufacturing capacity. Moderate medical device market growth over the forecast period. One of the smallest per capita medical device expenditures in the region.

卫健委发布2018版国家基药目录，动态调整与医保对接成为热点，整体来看未来基药目录的指导性将会进一步加强，建议重点关注产品新进入基药目录的相关企业。卫健委发布《全国流行性感冒防控方案（试行）》，要求提高流感疫苗接种率并鼓励应用中医药技术方法开展预防和治疗工作，建议关注华兰生物（002007.SZ）。

医药板块收入和利润增长的冰火两重天：2018Q3 医药上市公司合计实现营业收入10618.22 亿元，同比增长21.88%，远高于最近5 年同期14.02%的平均增速；然而，归母净利润901.99 亿元，同比增长9.62%，达到最近5 年同期的最低水平；扣非净利润815.89 亿元，同比增长23.42%。营业收入的高增长与归母净利润的低增速形成显著反差，行业内部正在经历剧烈的结构调整。

理论上，《完善国家基本药物制度的意见》由国办发文，具备部际协调机制。实际上，非医保品种进入基药目录2018 年并非首例，2012 版基药目录中也有祖卡木颗粒、消痛贴膏、多柔比星等非医保品种进入基药目录。医保报销政策的主要决定权仍在医保手中，但进入基药目录有望在下一轮医保目录遴选的过程中获得优先权。

2007年到2017年，美国仿制药的市场规模增速远高于同期专利药。仿制药不仅数量增长，平均价格也在快速提升。然而仿制药一旦上市通常会经历持续的降价，平均价格的提升是因为不断有更高价格的“新仿制药”加入带来的产品结构变化所导致的。

长期以来我国各级医疗机构之间提供的服务不具有协作性，导致群众看病贵、看病难。实际上，按照国家对医疗卫生机构的功能定位，二三级医院和社区卫生服务机构之间是互补而不是竞争关系。医院和社区卫生服务机构可以通过合理的分工协作，为患者提供连续性的医疗服务，实现共同发展。文章通过国内外卫生服务协作的理论和实证研究文献进行回顾分析，明确卫生服务协作的含义，结合国内外医院与社区卫生服务机构协作实践，总结医院与社区卫生服务机构协作体系的模式和内容，归纳目前研究的现状，指出存在的问题和需要进一步研究的关键点。

目的通过对某县一家二甲医院2017年门诊工作量变化情况进行分析，为加强医院门诊管理和改善门诊服务流程提供决策性依据。方法采用时间序列数据分析法等方法对该院2017年门诊工作量进行季度分析、周分析及时间段分析。结果通过对该院2017年门诊工作量进行季度分析，发现2017年第一季度门诊工作量最低，季节指数为96.33%，第三季度最高，季节指数为106.78%；通过对该院2017年门诊工作量周分析，得出周一是每周的最高峰，以后逐渐减少，周日降至最低；通过对该院2017年门诊工作量时间段的分析，得出门诊工作量主要集中在上午，上午门诊量占全天的74.11%。结论医院管理部门应根据门诊量季度、周、时间段等变化情况，制定相应的优化策略，如门诊预约，合理排班、合理轮休等应对门诊量高峰期造成的门诊拥堵，无效等待时间长等问题；通过制定相关门诊优惠政策来应对门诊量低谷期，吸引病人就诊，增加门诊量。以此合理配置和利用医疗资源，改善门诊服务流程和提高门诊服务质量，更好地满足患者的就医需求。

“两票制”改革正在全国层面逐步推开，作为政策落实的起始环节，如何将药品集中采购制度与“两票制”改革合理衔接是此项改革顺利实施的关键。本文将从目前“两票制”政策与药品采购环节的植入程度入手，重点讨论“如何应对生产企业提高出厂价”以及“企业处罚的合法、合理性”两大问题，以期为两项政策的优化衔接提出合理建议。

近几年来，逐步将医保对医疗机构服务行为的监管延伸到对医务人员个人服务行为的监管成为医药卫生体制改革的重点之一。文章在分析医保监管现状与监管模式转变必要性的基础上，总结了医保对医师个人医疗服务行为进行监管的难点与障碍，并提出完善医保监管政策支持、推进医保支付方式改革、全面开展临床路径管理、实现监管信息化等建议。

目的：了解我国31个地区基层医疗卫生机构的服务能力，推进我国基层卫生机构服务能力的均衡性发展。方法：从医疗人力资源、医疗服务设施和医疗服务量三个维度选取8项指标，综合应用熵权-TOPSIS法分析不同地区基层医疗卫生机构服务能力及其差异。结果：熵权法得到的各项指标的权重分别为0.0857、0.1091、0.1749、0.0967、0.0605、0.1463、0.0892、0.2377。我国基层医疗卫生机构服务能力排名前5名的地区为天津、宁夏、黑龙江、海南和吉林，排名后5名的地区为四川、西藏、湖南、山东和河南。结论：我国基层医疗卫生机构服务能力存在地区性差异，与经济发展水平存在非一致性，各维度发展不同步。我国应制定科学的基层区域卫生规划，缩小地区性差异，建立和完善多维服务能力指标体系，促进各维度均衡发展。

 目的：评价北京市医药分开综合改革的实施对于门急诊患者就医流向的影响。方法：对北京市卫计委信息中心收集的2016年1月—2017年10月的各级医疗机构门急诊就诊人次数据的变化趋势进行分析，并采用间断时间序列分析（Interrupted Time Series，ITS）方法分析北京市医药分开综合改革对其影响。结果：2017年4—10月，三级医院平均每家医疗机构门急诊人次同比下降12.11%；二级医院平均每家医疗机构门急诊人次同比下降2.10%；基层医疗卫生机构平均每家机构门急诊人次同比上升11.49%。结论：北京市医药分开综合改革通过医事服务费的调整和基层用药目录与三级医院对接等主要措施，使得门急诊患者就诊流向发生明显变化，长期下去需要引起注意的是基层是否有动力接收病人，以及能否接住病人的问题。