19 provinces and cities have responded! Change and change of drug collection and expansion

Drug collection and expansion of the "change and change"compared to the first round of "4 plus 7" with volume procurement, the national expansion of the siege will set off what kind of wind and waves?November 2nd, the afternoon of The Institute of Policy of the China Pharmaceutical Materials Association sponsored by the "National Drug Central Procurement and Expansion Policy Symposium", Professor Chen Wei of Huazhong University of Science and Technology pointed out that the purchase of 4 plus 7 band volume has solved the problem of the broad direction of drug price reduction, but to ensure the sustainability of the long-term supply of drugs, to take into account all stakeholders' demands, save more money without drugs is also a big problemZhang Lan, director of the pharmacy department atXuanwu Hospital, also noticed the problemShe shared data on the amount of a total of 4 plus 7 generic drugs purchased in 11 city hospitals before and after the official landing of a group of 4 plus 7Zhang Lan said that whether the winning bid, or not the winning ammonia chlorpyrifos, before the 4 plus 7, the patient utilization rate is 38%, after 4 plus 7 is 39%"From the data point of view is gratifying, before we worry that the implementation of the policy will bring a big impact on drug use; This data indicates that this is not the case, but the overall sales of ammonia chlorpyrifos is a significant decline, indicating that the market share of the winning varieties is relatively highZhang Lan also noted that after the official landing of the 4 plus 7, the entire purchase volume is a peak and troughPrices may cause dosage to change over time, but doctors' prescription behavior or patient drug use may return to a normal state based on the science of the drug after fluctuations in this policy"The first ones, because of the price advantage, went up in the quarter after the 4 plus 7 city pilot, with purchases rising from 26 percent to 31 percentBut as the implementation of the policy gradually came down, basically back to the policy before the implementation of the fluctuations"
classified into the 4 plus 7 band volume procurement, including the national expansion of 25 varieties, are from the conformity evaluation of generic drugs corresponding to generic drugs screened, and mostly for slow disease drugs and common drugsAs can be seen from the above data, the impact of the 4-plus-7 band purchase is more on a product of a single enterprise, and the impact on the same category will be smallerat the national level, all the starting points of the Health Insurance Administration, the core is to return to value health care, not just to consider the issue of health insurance fundsMost importantly, these policies have changed some patterns of medical care, changed doctors' prescribing behavior, and 25 varieties have seen changes in implementation is worth noting that according to the "Pilot Program for centralized procurement and use of drugs organized by the State Council" issued by the State Council on January 17, 2019, the amount of procurement is 60%-70% of the total amount of drugs used in each pilot year, while the remaining amount can still be purchased for other affordable hook-up varieties Alliance area centralized procurement documents also said that the first year of the 4 plus 7 area agreed to purchase up to 70% of the first year agreed procurement volume, of which the actual selection of enterprises for 1, the agreed procurement volume for the first year agreed to 50% of the purchase volume, that is, 25 4 plus 7 varieties still have 30%-50% of the surplus market with the official landing of the 4 plus 7 national expansion, how to deal with the residual market outside the agreed procurement volume in the purchasing area of the Alliance? Niu Zhengqian, executive vice president of the China Pharmaceutical Enterprise Management Association, said that in the reality environment of large differences in various parts of China, a one-size-fits-all policy is not desirable, and the provisions of the national volume procurement policy in which "residual market share" are taken into account the diversity and imbalance of market demand, giving hospitals, doctors, patients a moderate free choice, but the residual market mechanism must be a cost-effective mechanism The margin will also give non-successful enterprises the opportunity, at least through consistency evaluation Liu Junshuo, vice chairman of the Pharmaceutical Policy Committee of the China Pharmaceutical Promotion Association, said that the problem of residual seating is a patient's choice, and how the government can guide patients to choose the right thing is a very important issue for us now Japan has been doing generic alternative education for more than a decade, but we don't have this foundation, so we have some problems The purchase of the volume of 4 plus 7, including the expansion of a lot of technical difficulties will also involve, the national health insurance should give local health insurance a reform space, with an open attitude, based on the quality and quantity relationship, through the health insurance payment price to adjust 19 provinces and cities to respond to the national expansion of the amount of procurement in the According to the E drug manager incomplete statistics, up to now, Hainan, Guangdong, Hunan, Jilin, Henan, Gansu, Anhui, Hubei and other 19 provinces and municipalities or autonomous regions issued a letter to determine the implementation of the "4 plus 7" expansion results The provinces are intensively preparing for the procurement of carry-on stake, including the development of specific measures, the establishment of procurement platforms and the strengthening of training of medical personnel, and will fully implement the results of the national pilot expansion by the end of 2019 and early 2020 ensure the smooth admission of selected varieties and rational use is the key to determine whether the national expansion of the national expansion of the amount of the purchase is the key, a number of provinces and cities clearly give priority to the use of selected drugs, medical institutions may not be cost control, drug proportion, medical institutions with the number of drugs prescribed requirements, pharmaceutical committee evaluation and other reasons to limit the entry of selected drugs into the hospital The medical institutions that do not purchase or use medicines in accordance with the provisions and medical personnel who do not use the drugs in accordance with the provisions shall be punished for the amount of surplus other than agreed procurement, several provinces clearly stipulate that the relevant medical institutions can still purchase other affordable types of hanging networks through the provincial centralized drug procurement platform For the 25 generic drugs included in the pilot expansion, the same varieties of drugs through the quality and efficacy of consistency evaluation of the production enterprises reached more than 3, in the case of ensuring supply, the centralized procurement of drugs will no longer choose varieties that have not passed the consistent evaluation there are also some provinces based on localization, territorial management considerations, in the country's 4 plus 7 expansion policy on the landing measures, with the introduction of specific landing rules on November 1, , the Shanxi Provincial Medical Security Bureau issued a "Notice on the comprehensive promotion and implementation of the pilot expansion of the centralized procurement and use of drugs by the State Organization." According to the notice, Shanxi Province will fully implement the results of the "4 plus 7" national expansion and related supporting policies on December 1, 2019, with a procurement cycle of one year For the purchase and payment standards of non-selected varieties, Shanxi Province clearly stipulates that by the end of 2020, the purchase price of the original research drug, the reference formulation, the generic drug which has not been selected by the same generic name is higher than the selected price, belongs to the basic drugs, medical insurance Class A drugs and anti-cancer drugs, the purchase price is reduced by 10% as the payment standard; October 23, the Standing Committee of the Jiangxi Provincial Government considered the adoption of the "Jiangxi Province to implement the national organization of drug centralized procurement and use of the pilot pilot implementation program" and other important documents It was decided that all public medical institutions in the province should be included in the pilot project of centralized procurement and use of drugs organized by the state organization to expand the scope of the region Encourage voluntary participation of medical institutions and medical insurance-targeted retail pharmacies in terms of repayment, Jilin Province stipulates that, in order to ensure the timely return, the medical insurance fund in the total budget, by the municipal (state) medical insurance agencies with the medical insurance fund in accordance with the jurisdiction of the medical institutions agreed to purchase 50% of the required amount, pre-paid to the public medical institutions in the jurisdiction, the procurement cycle is more than half or the contract volume is executed more than half the amount of the pre-paid 45%, the last 5% of the working capital after the completion of the contract amount for liquidation.