Drug kickbacks hit hard

September 17, the State Health Insurance Administration disclosed that the Supreme People's Court and the State Health Insurance Administration had recently signed a Memorandum of Cooperation on the Exchange and Sharing of Information on Commercial Bribery Cases in the Pharmaceutical Sector. The main content is to establish a regular notification system of commercial bribery cases in the field of medicine, actively expand the application of judicial results in commercial bribery cases in the field of medicine in the field of pharmaceutical prices and recruitment, jointly promote information exchange and sharing at all levels of the system, and continuously deepen cooperation in the management of commercial bribery in the field of medicine.In addition to the previous day's "guidance on the establishment of pharmaceutical prices and credit evaluation system" (hereinafter referred to as "guidance"), all places must establish and implement the credit evaluation system by the end of this year. During the 83rd National Drug Fair, the time node of the national gathering of medics, with pharmaceutical commercial bribery as the starting point of the two documents have been disclosed, which conveys the signal especially fine products.

case source information more timely, accurate and completeIn accordance with the deployment of the Guidance, the medical security department guides the provincial centralized procurement agencies to establish a credit evaluation system, and the provincial centralized procurement agencies set up a platform for the operation of the system. Among them, the first item listed in the list of medical prices and mis-trusted matters (2020 edition) is the purchase and sale of medicines, giving rebates or other improper benefits to various medical institutions at all levels, centralized purchasing agencies and their staff (hereinafter referred to as "pharmaceutical commercial bribery"), which requires court decisions or administrative penalties from relevant law enforcement departments to determine the facts of the case.“ Whether it is the medical security department, or the provincial centralized procurement agencies, they do not investigate, qualitative and investigate violations of laws and regulations such as pharmaceutical rebates, mainly relying on court decisions and administrative penalties determined by the fact of breach of trust. Of course, if the facts of the loss of trust established by the judgment are changed or revoked, the provincial centralized purchasing agency will also adjust the credit rating results in a timely manner. "In response to a reporter's question, the relevant person in charge of the price recruitment department of the State Medical Security Administration stressed that in order to obtain the information of the source of the case in a timely, accurate and complete manner, the State Health Insurance Administration will actively promote the overall cooperation of the departments and explore the establishment of exchanges and policy linkage mechanisms with the courts, taxation, market supervision and other departments."Some members of the legal profession have pointed out that the online publication of Chinese adjudical instruments is only a part, not all of them, so it is particularly important to establish a mechanism for sector linkage.In accordance with the requirements of the Guidance, provincial centralized procurement agencies regularly comb and summarize the relevant departments open or shared adjudication documents, administrative penalty decision documents, etc., to collect and verify the information of the pharmaceutical enterprises' failure to trust and record them, but also need to grasp and record the information of the pharmaceutical enterprises' misconstition in pricing, bidding, performance, marketing and so on through monitoring and receiving reports in the daily operation.To this end, the Open Supreme People's Court and the State Health Insurance Administration signed the Memorandum of Cooperation on the Exchange and Sharing of Information on Commercial Bribery Cases in the Pharmaceutical Field, and established a regular notification system for commercial bribery cases in the pharmaceutical field, which will provide a more complete source of information for all regions to set up a credit evaluation platform for recruitment.

"don't dare, can't, don't want"“ To root out the problem of pharmaceutical rebates, we must first adhere to the system of governance, governance according to law, comprehensive governance, source governance, multi-sector linkage, comprehensive policy, to build a pharmaceutical enterprises 'dare, can not, do not want' to give rebates of the governance system. "The above-mentioned National Health Insurance Bureau price recruitment department responsible for pointing out that the pharmaceutical sector to give rebates, monopoly price increases and other outstanding problems for a long time. The person in charge gave a set of data: according to the publicly available court judgment document statistics, between 2016 and 2019, more than half of the country's 100 compulsory drug enterprises were found to have given or indirectly given kickbacks, of which the most frequent enterprises involved in more than 20 cases in three years, a single case rebate amount of more than 20 million yuan;In fact, on the issue of the authenticity of sales costs, the relevant departments have been deployed for a long time. Last year, the Ministry of Finance issued a "penetrating" inspection of accounting information of 77 pharmaceutical companies, which is one of the key points. At that time in the document listed a lot of need to focus on the content of inspection, including whether the sales expenses are fully relevant, whether the real occurrence, whether there is consulting fees, meeting fees, accommodation fees, transportation costs and other types of invoices to withdraw large amounts of cash phenomenon, whether there is a multi-frequency from the same unit, a large number of invoices, if necessary, should extend the inspection of invoices The unit to be issued, whether the payment of conference fees is true, whether the contents of the invoice are consistent with the meeting schedule, participants, meeting places and other factors, whether there is a phenomenon of medical institutions passing on conference fees, office expenses, equipment acquisition costs, etc. to pharmaceutical enterprises, whether there is a phenomenon of paying rebates to medical personnel through expert consultation fees, research and development fees, publicity fees, etc.And in June this year, the National Health and Wellness Commission and other nine departments jointly issued the "2020 correction of the field of pharmaceutical purchase and sale and medical services in the wrong wind work points" also made it clear that before the end of the year will be led by the National Health And Wellness Commission, member units in accordance with the division of responsibilities to cooperate, regulate the way of cooperation and exchanges between medical and business.In addition to regulatory issues, "supervision" from the market is also continuous, industry compliance pressure is increasing. According to media reports, this month in Anhui, Shanxi and other hospitals posted an anonymous report letter, pointing directly to the issue of gold sales.In the view of the medical insurance sector, pharmaceutical companies are often insensitive to the fines in kickback cases, but giving kickbacks can lead to the loss of access to the centralized procurement market, which will have a strong deterrent effect, thus forming a system of governance effect.Analysts pointed out that the "guidance" clearly requires the implementation of the pharmaceutical enterprises to take the initiative commitment system, pharmaceutical enterprises to participate in the procurement need to submit a written commitment, commitment matters include the establishment of a compliance review system, put an end to bad faith behavior, regulate their employees (including employment relations) or have a proxy relationship with the distribution enterprises to sell their own drugs or medical supplies, bear the corresponding responsibility for failure of trust, accept disposal measures. And require pharmaceutical enterprises to take the initiative to report the loss of trust information to the provincial centralized purchasing agencies where the mis-trust occurred. Supplemented by regular briefings from the legal system, it is expected to further curb the trend of pharmaceutical purchase and sale at the source and regulate the marketing practices of pharmaceutical suppliers and their pharmaceutical business personnel. (Medical Economics)