As the function and R&D level of in vitro diagnostic reagents continue to improve, the need for hospitals for in vitro diagnostic reagents in clinical diagnosis also keeps increasing. However, under the influence of management, process, technology, equipment, materials, employees, and other unexpected disturbing factors, the output of reagents often has random uncertainty, and it is difficult to provide the finished products required by orders on time, in quality and quantity. A secondary supply chain consisting of reagent manufacturers, distributors, and hospitals is constructed, and the inventory control models of in vitro diagnostic reagent supply chain under three strategies of centralized decision-making, hospital-owned inventory, and reagent distributor-managed inventory are established, respectively, and the maximum expected returns of the supply chain system under different strategies are analyzed to achieve the optimal production decision of reagent manufacturers and the optimal procurement decision of hospitals. The results show that reducing the random output probability and patient demand uncertainty has a significant effect on improving the expected return of in vitro diagnostic reagent supply chain, and as the random output probability of reagent manufacturers and patient consumption demand uncertainty increase, the strategy of managing inventory by distributors in collaboration is always better than the strategy of managing inventory by hospitals' own warehouses, which can achieve higher expected return and better inventory quantity, but when the out-of-stock cost of hospitals is too high above a certain threshold, the hospital will tend to adopt the self-inventory strategy.