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.