OBJECTIVE：To improve the distribution rate of essential medicines，to meet the medication needs in primary health care institutions. METHODS： The in essential medicine distribution in primary health care institutions was analyzed， and combined with the current essential medicine policy regulations， problems existed in the bidding work program of distribution enterprises that made by health departments were summarized， and countermeasures were put forward. RESULTS & CONCLUSIONS： Resources in medicament circulation industry get further integration， the industrial structure is optimized and upgraded， and the distribution rate is comprehensively improved after the implementation of national essential medicine system in Qinghai province. But there are still some problems， including serious monopolies in wholesale and sales enterprises， insufficient supply of some biding drugs， low distribution rate， inadequate supervision of relevant authorities， unreasonable regional distribution of drug retail stores and low quality of distribution companies. For above-mentioned problems， relevant government departments should strengthen supervision and propaganda of relevant laws， regulations and policies for medicine distribution， intensity to supervise medical institutions， introduce competition mechanism， establish advanced pharmaceutical distribution and increase capital investment in drug sales in remote areas to effectively improve distribution rate of essential medicines and meet the needs of primary medical institutions.