From "Prisoner's Dilemma" to "Normative Balance"--Explore the new ecology of centralized drug procurement in 2021

Between 2018 and 2020, the state implemented three rounds of centralized four-round drug procurement, with the average price of 112 drugs falling by 54%.
the local level, taking 2020 Shandong drug collection as an example, the average decline of more than 60%, the highest decline of 98.58 percent.
These three years, in the seemingly well-resourced medical circle, pharmaceutical people in order to limited market share, compete with each other, preempt price reduction, there is an irreversible suspicion between each other, the idea between each other is: I am not sure you have hostility; Just like in the cinema, the first row somehow stood up, the second third row in order to see the screen had to stand up, and then the whole scene stood up, the result became everyone has a seat but seems to have bought a station ticket to watch the movie! In such an infinite cycle of passive suspicion chain, and finally each other were forced to helpless, each other raise a gun, bayonets see red, kill each other - in this case, it is better to take the first step to reduce the price of the opponent dry down.
in such a zero-value mindset, every enterprise involved in the collection is both a hunter and a prey.
in the light silence of the clouds, the spring breeze of the eyes, everyone is lying in the trenches of the light, who revealed their position, who will suffer the risk of extinction.
"prisoner's dilemma", the benefits can indeed be seen, drug prices have dropped significantly, fee control targets have been achieved, consumers have benefited.
but the problem is also obvious, again and again continued to reduce prices, "a meal of operation like a tiger, bottle prices are not as good as soil"! A place responsible for recruitment officials once frankly told the author: and then such a price reduction so that drug prices fell to the cost line not only does not help to save health insurance, but also may cause drug shortages, to combat the enthusiasm of enterprise development.
Therefore, in 2021, centralized procurement of drugs, from the "prisoner's dilemma" to "standard balance", will be the general trend, mainly reflected in the following eight aspects: adjustment from the 2018 4-7 exclusive selection to the current third batch of national volume procurement of a number of selected, including the current provincial volume procurement are not the same to encourage a number of Selected and the provinces generally set aside 20-30% of the standard outside the hospital market can be seen that the drug collection organization's thinking is gradually from low prices to reasonable prices to ensure the supply of changes, especially in the chemical drug price belt procurement to a certain extent, the large probability of the collection organization will not be on this basis again large prices, replaced by price linkage, shortlisted renewal.
the same time, the direction of collection and harvesting to adjust to Chinese medicine, do not exclude individual places in insulin, bio-similar drugs to carry out pilot.
Integrity The "Guidance on the establishment of a pharmaceutical price and credit evaluation system" issued by the State Administration of Medical Security last year means that pharmaceutical companies in the drug factory, promotion, access, procurement of a series of processes, the need to regulate their own marketing behavior, if the drug filing system is a precision strike, then relying on drug prices as the basis, directly spread the radiation surface to the enterprise's terminal procurement link, will directly pinch seven inches.
if found to be a disrepair, it is the entire enterprise and all of its drugs that are punished.
the strength of such penalties enterprises should carefully measure.
the fourth batch of Chinese medicine, there were rumors that Chinese medicine should be included in the national harvest.
the fact is that Chinese medicine has not entered a new batch of national mining vision.
not surprised, in 2021, local volume procurement, will include Chinese medicine.
In November 2020, in response to a proposal on the procurement of Chinese medicines, the State Health Insurance Administration stated: "Next, we will continue to guide local procurement of centralized drug strips, improve procurement methods according to clinical drug demand, reasonably determine the scope of collection, ensure drug quality and Supply, meet the demand for drug use by the masses, establish an open and transparent market competition mechanism, guide enterprises to conduct fair competition on the basis of cost and quality, improve the mechanism for market price discovery, and promote the return of drug prices to a reasonable level by clarifying the quantity of procurement, changing prices by volume, ensuring use, and smooth procurement, use and settlement."
, in 2021, Chinese medicine into the local volume procurement, is basically a nail in the coffin.
big probability, will continue the same variety, the same dosage form, the same specification as the same procurement unit way, no longer distinguish the auction grouping (quality layering), the relevant grouping advantage score reflected in the comprehensive evaluation score of the quality score.
500 the author once again stressed that 500 varieties are not fixed without change.
the relevant center point in 2021, will be 500 varieties as the center, rapid diffusion, direct radiation to the current clinical use of all varieties.
the present point of view, the basic standard action of the provinces is, first dynamic adjustment of price reduction round, the finalist price, reference price, hanging network price, purchase price lower.
, large quantity, full and insufficient competition, with volume procurement.
small amount of water, limited price hanging network.
is that the 500 species that will circulate in 2020 are believed to be only a relatively solid range for the corresponding time period.
2021 and 2022, 500 varieties are expected to enter and go, with factors such as national volume procurement and over-evaluation progress leading to changes in clinical drug use.
2021, the pattern of the three-power differentiation of centralized procurement of local drugs will become more and more obvious.
The policy organization is responsible for the research and judgment of the policy, the formulation of the program rules, the division of the collection varieties, the implementation of the procurement volume, the return and other aspects of the guarantee;
third parties (technical learning) are responsible for data collection, platform operation and construction.
the new form of the three-power division under the new situation, we can not only give full play to the relevant advantages of all parties, but also make up for each other's strengths and weaknesses, and carry out organic coordination under unified command.
but will the key link of platform executives change as local health insurance bureaus continue to pocket purchasing rights? It deserves close attention.
can be seen that the original local centralized procurement of drugs pilot, especially at the municipal level with volume procurement pilot, will be more and more focused on the provincial level.
possibility of carry-on procurement at the municipal level will become less and less likely.
2021, the provincial collection and mining departments will be integrated planning and deployment of the province's volume procurement work.
is divided into two, the provincial level can carry out the collection of varieties, organized by the provincial level.
the provincial level is not convenient to carry out the varieties of collection, will be under the guidance of provincial organizations, authorized at least three or more cities at the local level to carry out collection.
the original home ignition, village smoke irregular pilot collection action, will be phased out.
not surprisingly, in 2021, the national base drug adjustment will be officially launched and announced results, anecdotal rumors, in the second half of the year, the national base drug catalog will be officially launched.
into the national base medicine, is basically a functional treatment clear, clinical reporting complete, effective and safe, dosage form easy to take varieties.
the new version of the national base drug species centralized volume procurement, is undoubtedly both the correct route and reasonable thing.
the implementation of the relevant policies of the 1 x will be helped to carry out a volume purchase of the national base drug species.
incremental market increment is a headache for every business.
to the beginning of the year, the family under the task, household difficulties.
indicators are not completed to supplement the indicators.
the indicator to be completed to repress the indicator.
especially some three non-varieties (non-state-harvested, non-over-evaluation, non-base drugs), these varieties are in fact the most difficult situation, not the base drugs, facing restrictions at all levels of medical institutions.
has not been commented on, in the provinces to hang up the net to see the face of the review.
not a national variety, but also face the selection of clinical drug use in medical institutions.
but the task is too high, do not pay attention, but also into the local volume of procurement vision.
the local belt procurement and is not 500 actually do not have much to do with, if the procurement volume rose, naturally will enter the relevant belt procurement vision.