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Recently, the official website of the National Medical Insurance Bureau has taken the initiative to publish a large number of replies to the proposals and suggestions of NPC deputies and CPPCC national committee members
.
It reveals a lot of information, with quantity procurement, medical equipment and so on is the focus
.

The Reply of the National Medical Insurance Bureau shows that purchasing with quantity will become the mainstream way of public hospitals
.
In the reply, the National Medical Insurance Bureau also revealed that in the procurement and assessment rules, the state will gradually improve the convergence of centralized procurement policies and the basic drug system, and promote medical institutions to give priority to the procurement and use of selected drugs
on the basis of medication.
Does this not only raise speculation: will the selected products be included in the essential medicines list? Because of the expansion of the basic drug list, many innovative drugs are included in the essential drug list, according to the statement of the Medical Insurance Bureau, innovative drugs are temporarily not included in the procurement of quantity, so according to the industry insiders, the convergence of the collection and the basic drug system may be the most likely to be the collection of selected products into the basic drugs
.
Of course, this is all industry conjecture, and how to connect has yet to be further revealed by national policies
.

In terms of specific categories worth paying attention to, in addition to dentistry, cardiac electrophysiology is also the next focus
of collection.
Sichuan will lead the dental collection, while Fujian has established the Cardiac Electrophysiology Collection Alliance
.

The procurement of proprietary Chinese medicines with quantity is also the focus of attention of the industry, for similar products of proprietary Chinese medicines, exclusive varieties and even new products, Chinese medicine formula granules should be purchased from the National Medical Insurance Bureau for a detailed explanation
.
Among them, Hubei is aimed at the procurement of non-exclusive varieties, while the Guangdong Provincial Proprietary Chinese Medicine Procurement Alliance explores exclusive varieties, while chinese medicine formula granules, as a new thing, are temporarily safe, and have not revealed the trend of volume procurement, and are still in the stage
of reasonable hanging nets.

More than 130 enterprises were taken, including domestic and foreign enterprises

According to the National Medical Insurance Bureau, in August 2020, the National Medical Security Bureau issued the "Guiding Opinions on the Establishment of a Credit Evaluation System for Pharmaceutical Prices and Procurement" and a list of untrustworthy matters in pharmaceutical prices and procurement, requiring the comprehensive establishment of a drug price and procurement credit evaluation system
with the province as the main body and the centralized pharmaceutical procurement agency as the main body.

After the implementation of the system, collection and procurement institutions at all levels conscientiously grasp the implementation, and promptly give ratings and disposals to enterprises that have untrustworthy behaviors such as giving kickbacks, monopoly control and sales control, and price violations and violations, and adopt corresponding disposal measures
.
Up to now, a total of more than 130 enterprises have been taken corresponding restraint measures due to price dishonesty, and domestic and foreign-funded enterprises have been involved
.
In the next step, our bureau will combine the new situations and new problems that appear in the process of system practice, continue to improve the enterprise credit evaluation system, refine the operating rules, and guide enterprises to set fair and reasonable pricing
.

Improve the accuracy of hospital reports, and the Medicare Board does this

The proportion of centralized procurement with volume is 50%-80%, and antibiotics can further reduce the proportion of
belt volume.
Hospital reporting is a key factor affecting the purchase of the amount of the
belt.

In order to ensure the accuracy of the reporting of the hospital, the National Medical Insurance Bureau said that the medical institutions need to report the amount according to the previous year's usage, clinical use and medical technology progress, and signed and confirmed
by the hospital leaders.
After the medical institution submits the data on the amount of collection and reporting, the local medical insurance department and the joint drug procurement office verify the reporting data of the medical institution, and if there is an abnormality in the reported data, the medical institution is required to verify the adjustment or make an explanation
.

At the same time, the balance retention policy is implemented, and the medical insurance funds collected and saved are assessed and retained by the balance of medical institutions according to
a certain proportion.
Medical institutions that do not report or underreport the amount will not pay or deduct the corresponding part of the surplus retained funds, so as to promote the accurate reporting of the amount by
the medical institutions.

The procurement and use of selected products has been included in the performance appraisal of public medical institutions and the assessment of the target responsibility of the heads of medical institutions, and has been used as an important basis for the formulation of total medical insurance indicators
.
In addition, in the procurement and assessment rules, gradually improve the convergence of centralized procurement policies and the basic drug system, and promote medical institutions to give priority to the procurement and use of selected drugs on the basis of drug use
.

Due to the impact of the epidemic and the adjustment of drug use policies, some medical institutions may not be able to successfully complete the agreed procurement volume of individual varieties, and we have made it clear in the seventh batch of "National Centralized Drug Procurement Documents (GY-YD2022-1)": "If there are drugs included in the national and provincial key monitoring and rational drug list or major changes in clinical needs due to public health events and other factors, the completion of the agreed procurement amount can be assessed according to the proportion of drugs selected in the same
。

Obviously, if it is because of the epidemic or the collection of drugs is included in the key monitoring, then the National Medical Insurance Bureau will no longer assess the amount, but will assess
the proportion of selected products used in all drugs.

Inter-provincial procurement division of labor and recent collection of key points

The National Medical Insurance Bureau said that at present, the centralized procurement of high-value medical consumables such as coronary balloons, intraocular lenses, and orthopedic trauma has basically covered all provinces across the country, and will focus on the interprovincial alliance procurement
of high-value medical consumables such as dental implants and cardiac electrophysiology in the near future.
Among them, Sichuan leads the Dental Implant Alliance, and Fujian leads the Cardiac Electrophysiology Alliance
.

In addition, the Medical Insurance Bureau has recently made further arrangements for the work of local inter-provincial alliances, requiring provinces to standardize the procurement of
inter-provincial alliances in accordance with the same standards as national organizations.
At the same time, Shanxi, Henan and other provinces have explored the procurement
of low-value medical consumables such as infusion tubes and indwelling needles.

At the same time, the National Medical Insurance Bureau encourages and guides provinces that have not participated in the procurement of the inter-provincial alliance to carry out the linkage
with quantity in a timely manner with reference to the results of the selection of other provinces or inter-provincial alliances.
They will further standardize interprovincial alliance procurement, make alliance procurement an important way of local collection, and reduce unnecessary duplication of bidding work by
enterprises.

Promote the unification of the national network and trading rules

On improving the mechanism
for hanging up the network of the collection and mining platform.
In order to promote the smooth hanging of new products, we are guiding the provinces to study and improve the rules for centralized procurement of medicines, and promote the establishment of a unified national network and trading rules
.

For the selected products, it is required to hang the network on the provincial platform according to the selected price, and organize medical institutions and selected enterprises to sign agreements to ensure that the results of the selection are landed
in a timely manner.
For products other than collection and procurement, optimize the process, timely response, openness and transparency when hanging up the network, reduce the relevant costs of enterprises, and help pharmaceutical companies to participate in market transactions
smoothly.
At the same time, we will strengthen the standardization, standardization and professionalization of the centralized pharmaceutical procurement platform, actively promote the provinces to rely on the platform for information sharing, and do a good job in the service work of
enterprises hanging on the network.

About the purchase of proprietary Chinese medicines and the granules of Chinese medicine formulas

Centralized procurement
of major non-exclusive proprietary Chinese medicines in Hubei Province.
Guided by clinical needs, the collection and collection of drugs with large dosage, high procurement amount and sufficient market competition are included in the scope of collection, and the collection method
that meets the characteristics of proprietary Chinese medicines is explored.

For the exploration of Hubei, the National Medical Insurance Bureau believes that the first is to merge bidding
.
There are many types and exclusive varieties of proprietary Chinese medicines
.
In order to promote competition, the drugs are combined and collected according to the route of administration, functional indications, and composition components, which solves the problem of fair competition of similar proprietary Chinese medicines
.
The second is to fully consider the selection and evaluation of
medical institutions.
Considering that there is no consistency evaluation of proprietary Chinese medicines, this collection introduces the recognition index of medical institutions, which reflects the recognition of drug quality and efficacy by medical institutions to a certain extent
.
The third is to use comprehensive evaluation to select the selected enterprises
.
Use indicators such as price decline, medical institution recognition, enterprise ranking, supply capacity, innovation ability, recruitment credit evaluation level, drug quality and safety and other indicators to comprehensively score enterprises, encourage high quality and good prices, and ensure stable supply
.

The procurement alliance led by Guangdong Province explores the centralized procurement rules for proprietary Chinese medicine exclusive products The exclusive products in this collection are implemented in a gradient with the amount according to the price reduction range of the average daily cost, so as to achieve the volume-price linkage, guide enterprises to carry out competition, and promote the return of drug prices to a reasonable level
.

Traditional Chinese medicine formula granules, the focus of work is on the provincial drug collection platform hanging network procurement
.
In accordance with the requirements of the State Medical Insurance Bureau and the State Administration of Traditional Chinese Medicine "Guiding Opinions on Medical Insurance Supporting the Inheritance and Innovative Development of Traditional Chinese Medicine" to "encourage the inclusion of Chinese medicine formula granules purchased by public medical institutions in the provincial centralized pharmaceutical procurement platform for online trading, and promote the openness and transparency of transactions", we actively guide and promote all localities to hang Chinese medicine formula granules on the provincial medicine centralized network, and public hospitals to purchase
through the provincial platform.

Three types of drugs are not included in the collection

The reply of the National Medical Insurance Bureau shows that there are three types of drugs that are not included in the
collection.

One is: innovative drugs
.
The National Medical Insurance Bureau said that the focus of centralized procurement will be large amounts, high procurement amounts, sufficient competition, and mature clinical use of drugs into the scope of procurement, innovative drugs due to unstable clinical use, insufficient competition, has not been included in the scope of
collection varieties.

The second is that drugs containing precious and endangered wildlife ingredients have limited raw material sources, less general supply, insufficient competition, and relatively few clinical uses, and will generally not be included in the scope
of centralized procurement according to existing rules.

Third, for "orphan drugs" and shortage drugs, due to the fact that most of them are products with small dosage and insufficient competition, the current centralized procurement mechanism based on competition between different enterprises is difficult to apply, and it is necessary to explore new procurement mechanisms
.
In 2021, Chongqing will lead 9 provinces to carry out centralized procurement of shortage drugs, which has achieved certain results and promoted supply and price
stability.

Source: Fun Academic