管制与企业并购行为：基于两票制背景下的医药企业并购行为 研究 摘要 “健康中国”作为我国的重要战略目标，与全中国人民的切身利益都息息相 关， 只有民族健康才有国家的强大。“十三五”以来，医疗体制改革一直以来都是每年政 府工作的“重中之重”，如何持续完善我国的医疗卫生体系，不断提升我国医疗水平 服 务质量，将医疗的福利充分的覆盖到更多的人等方面都是国家想要实现的长远目标。 与人民直接相关的问题除了看病难之外，就是药品价格虚高，使得人民的医疗支出费 用中一 直存在不合理的“水分”，为挤干这部分“水分”，国务院办公厅于2016年4 月，在印发的《深化医药卫生体质改革2016年重点工作任务的通知》中就明确要推 行“两票制”，压 缩中间环节，降低虚高价格。随后，又在同年12月由国务院改办会 同国家计生委等八部门联合下发《关于在公立医疗机构药品采购中推行“两票制”的实 施意见(试行)的通知》 进一步对“两票制”的实施做了进一步说明，并强调要争取2018 年在全国推开。 政府作为市场的监管者，要确保市场的有序进行，通过政策这双“无形的手”影 响着行业的发展 与转变。“两票制”作为医药行业的一项重要政策，对整个医药产业 链都存在着不同程度的影响，其中冲击最大的就是医药流通行业。政策的目的就是通 过缩减开具发票的次数 ，加强对药品物流过程的监控，减少流通过程的层数，并且更 是要净化医药市场环境、打击“过票洗钱”、防止偷税漏税的现象，清理那些影响市 场环境的医药流通企业，逐步 规范行业运行。但是在“两票制”政策对医药流通企业 明确的指向性，以及两年的政策时间要求影响下，原先大量的医药流通企业是否存在 利用其他方式规避政策要求，政策又 究竟是否对医药流通行业起到的实质性的作用， 以及起到了哪些作用都将是本文研究的内容。 本文采用文献研究法、案例研究法和实证研究法对医药流通行业做研究分析。一 是 采用文献研究法，查阅与两票制相关的期刊、杂志、论文以及互联网的资料，并对 与本文研究内容相关信息进行整理与研究，在前人的研究成果的基础上，深入分析两 票制前后 的“医药产业链”情况，对各类医药流通模式比较分析，挖掘医药流通环境 存在的主要问题，并初步得出“两票制”对医药流通企业的主要影响。二是结合本文 的理论基础，分 析医药流通企业并购的动因以及行为。三是以案例研究法为主，实证 研究法为辅，以“中国医药”在政策推行期内（2016年-2018年）的投资并购事件作 为研究对象，分类归纳分 析中国医药各类投资事件的情况，就不同类别的投资并购行 摘要 为做比较分析，并总结相关成因。同时，通过结合实证研究法，对投资事件对中国医 药股价的显著性分析研究。 经本文研究发现，第一，“两票制”政策确实会导致行业集中度的提升，政策有 助于中大型医药流通企业并购区域龙头，渠道下沉的中小型医药流通企业，强化自身 的市场竞争 力，扩大辐射区域，但是也存在如“中国医药”合资新设的企业出现，以 集团内企业的形式对冲两票制政策的影响，所以判断行业集中度不会提升太多，但长 期趋势不变。第二 ，未来医药流通行业将有向“职能化”的趋势，原先部分医药流通 企业转型为专业的合同销售组织（CSO）或者是第三方医药物流公司，承担整个医药 流通环节的专职工作，达到 职能的规模效应。第三，两票制在推动医药流通环节优化 的过程，行业内基本借着政策要求，并购延伸至纯销渠道，缺乏考量与自身战略的契 合度；第四，医药流通企业在并购 过程中，虽明确了投资并购目的，但缺乏并购协同 效应的评估分析，实际并购所能带来的效果可能无法实现。 目前，学术界主要以“两票制”政策对医药流通行业的整体影响研 究居多，偏重 于宏观方面，很少对具体医药流通企业的并购行为研究，本文正是从“中国医药”的 投资并购行为出发，以微观的视角，分析两票制对具体公司的投资并购行为的 影响， 从而分析政策的实际影响效果，进而反推医药流通行业的发展趋势，并与前人的研究 成果做对比，对相关研究结果有所印证或反驳。最终对医药流通企业的并购行为提出 观点，以及行业未来的发展趋势。 关键词：两票制，医药流通企业，并购，竞争 Abstract Regulation and mergers and acquisitions: study on mergers and acquisitions of pharmaceutical enterprisers under the two-invoice system. Abstract "China Health"，as an important strategic goal of China, is closely related to the vital interests of the whole Chinese people. Since the 13th five-year plan period, the medical system reform has always been the "top priority" of the government's work every year. How to continuously improve medical and health system of China, continuously improve the quality of Chinese medical service, and fully cover medical benefits to more people are the long-term goals of our country. In addition to medical treatment the problem directly related to people, is the artificially high drug price, which makes people undertake the unreasonable "bubble" medical expenses. To break the bubble of the drug price, in April 2016, the General Office of the State Council issued “Circular of deepening priority task of the medical health reform in 2016”,which ordered certainly to implement the "two invoices system", reduce artificially high prices. Then, in December 2016, the General Office of the State Council uniting with other eight department jointly issued “ Circular of the implementation plan on the implementation of the invoices system in drug purchase”, which gave more details and asked for implementing in the whole country before the end of 2018. The government, as the market regulator, should ensure the orderly development of the market and influence the development and transformation of the industry through policy, "the invisible hand". "Two invoices system", as an important policy in the pharmaceutical industry, has different impacts on the whole pharmaceutical industry chain. The pharmaceutical circulation industry undertook the biggest impact. The policy goal is by reducing the number of invoices, to strengthen the monitoring of drug logistics process, and to reduce the circulation process layers. For purifying the medical market environment, the policy can prevent the phenomenon of "money laundering" and tax evasion, reduce those medicine circulation enterprises which affected the market environment ,and gradually standardize market operating. But base on the "two invoices system" policy pointing to medicine circulation enterprises directivity, and two years requirement to implement the policy fully, there were a lot of questions maybe happening such as whether medicine circulation enterprises use other ways to evade the policy requirements, whether Abstract the policy make a substantial influence on the medicine circulation industry, and what the fluence was. All these questions are this dissertation to study. This dissertation adopts literature research, case study and empirical study to analyze the pharmaceutical circulation industry. First, under the literature research, I read the journals, magazines, papers, and Internet information, and collect the information from the material. Based on the predecessors' formal research, I analyze deeply the situation of "pharmaceutical industry chain" before and after the “two invoices system” and analyze and compare different kinds of medicine circulation modes, excavate the main problems of the pharmaceutical circulation environment. And then I got the initial conclusion of what the influence on the medicine circulation by the two invoices system. Secondly, combining with the theoretical basis of this dissertation, I analyze the motivation and behavior of medical circulation enterprises' M&A. Thirdly, by using case study as the main method and empirical study as the auxiliary method, and choosing the policy implementation period (2016-2018) as the research object, I collect the investment and merger events of "China meheco group co.,ltd ", classify and analyze the situations of various investment events of China meheco group co.,ltd. I make a comparative analysis on different types of investment and merger behaviors, and summarizes the related causes of these behaviors. At the same time, by combining with empirical research method, I test whether the significance of investment events and Chinese pharmaceutical stock price had the significant relationship. Through this paper study, I have four point. First, "the two invoices system" actually lead ascension of medical industry concentration degree. The policy helped the large or