Abstract: The nation-organized centralized drug procurement is an important part of the deepening development of China's medical reform. Analyzing the relevant policy texts and discussing the evolution process of the policy will help to provide a reference for the formulation and optimization of relevant policies in our country in the future. Using Fairclough's three-dimensional discourse analysis framework, this paper analyzes the policy of nation-organized centralized drug procurement, and finds that the proportion of command discourse in the text is much higher than that of the other four types of discourse, and the policy experiences the discourse evolution mode of "local self-help-nation organization-optimization of alliance", showing the characteristics of discourse construction such as fairness and public welfare, government leadership and multi-subject cooperation. Therefore, it is suggested to carry out subsequent policy optimization from the aspects of adjusting the discourse information structure, optimizing the argumentation mechanism of policy discourse propositions, giving play to the leading role of the government based on the social context, establishing the concept of collaborative governance of multiple discourse subjects, taking into account multiple stakeholders, and attaching importance to the discourse expression of policy stakeholders.