How will the anti-corruption in the field of pharmaceutical purchase and sale deepen?

The price of metformin hydrochloride tablets used to treat type 2 diabetes was as low as 1.5 cents per tablet, a decrease of more than 90%, and the antibiotic drug lynamine tablets used to treat pneumonia decreased from more than 300 yuan per tablet to less than 34 yuan, a decrease of 90% . . .On August 20, the third batch of state-organized drugs with a procurement scale of tens of billions of yuan was opened in Shanghai, and the results of the proposed election were produced. A total of 189 enterprises participated in the procurement, resulting in 125 enterprises to be selected, 191 drug products to be selected, an average price reduction of 53%, the highest decline of 95%. Open bid scene, a number of star drugs reported ultra-low prices.an important project to promote people's livelihood and well-being, the implementation of the national centralized drug procurement system has not only accelerated the transformation of China's pharmaceutical industry, but also brought about real changes for the masses to see a doctor. What are the advantages of centralized procurement over decentralized procurement? How to squeeze out the drug price falsely high moisture? Can the selected drugs enter the medical institution smoothly? How will the positive trend of anti-corruption in the field of pharmaceutical purchase and sale deepen?reshaping the drug price market discovery mechanism and crowding out virtually high moisture with volume procurement the pilot project on centralized drug procurement and use by the National Organization was launched in 11 cities in early 2019. The centralized procurement and use of medicines organized by the state is an important measure to deepen the reform of the medical and health system, mainly in the form of "national organizations, alliance procurement and platform operation", aiming to promote the linkage between medical, medical and pharmaceutical reform, break down and divide medicine, and further reduce the burden of drug use by the masses.October 2019, the State Health Security Administration and nine other departments issued a proposal on the implementation of the pilot expansion of the pilot of centralized procurement and use of drugs organized by the State, and expanded the scope of the pilot to the whole country. At present, the pilot and enlargement are progressing smoothly, and the expansion areas have begun to implement the results of the expansion procurement at the end of last year, and the effect of the reform has benefited patients throughout the country.the most immediate effect of the pilot and enlargement of the "Society" is to reduce the burden of patient costs. Most of the drugs selected are high blood pressure, mental illness, viral hepatitis, malignant tumors and other chronic diseases and major diseases, long-term drug burden is very heavy. By taking the purchase of significantly reduce the price of drugs, the original can not afford the medicine is now affordable, to solve the problem of access to treatment, which is the most direct benefit of ordinary people. "The head of the joint procurement office for centralized procurement and use of medicines by national organizations said.can a large reduction in drug prices be made by purchasing with a band? Reporters learned that the traditional "recruitment separation" model there is only the problem of price without volume, quantity price decoupling, because there is no commitment to purchase volume, the lack of sales expectations, resulting in drug prices difficult to return to a reasonable level. The national centralized organization of the volume procurement model requires the use of end-of-use medical institutions must complete the promised amount of drug use, and truly realize the volume of procurement, recruitment and one. Under the design of such a system, drug procurement, use, medical insurance payment, payment settlement formed a closed loop, the middle unreasonable link was cancelled.And in terms of absolute prices, a considerable number of drug prices have long been false high moisture, some generic drug prices are more than 2 times higher than the international price, circulation costs accounted for the main part of the price, which is the main space for centralized volume procurement price reduction.past, companies developed a new drug that could recruit two or three thousand marketing teams, with a high proportion of sales costs. Fu Gang, vice president of the China Pharmaceutical Business Association and chairman of Baiyang Pharmaceutical Group, said.Zhai Bo, director of the pharmaceutical price and tender procurement department of the Shanghai Medical Security Bureau, said that the above-mentioned circulation links may be gray income, promotional behavior, and even illegal acts,"with volume procurement can reshape the discovery mechanism of drug prices under the market mechanism, so that it can be changed in volume or price." In addition from the historical procurement data, some of the production costs are not high, full competition of the original price level of drugs is very low, but because of the circulation model, low-cost drugs are difficult to open the market, high-priced drugs "reverse elimination." After carrying out centralized procurement of drugs organized by the state, enterprises no longer need to sell public relations, which will help to re-deliver the original low-cost drugs to patients." need to note that centralized procurement extrudes unreasonable water that has long existed in the field of circulation, rather than production costs, and does not affect the quality of medicines. The head of the Joint Procurement Office introduced that in promoting the reform of centralized procurement of drugs, in order to avoid the phenomenon of "bad currency expulsion of good currency" in the competition, the relevant departments in the original accessories of drugs, production processes, quality testing and efficacy and other aspects of the formulation of strict standards, and in a contractual manner to strengthen the selection of corporate responsibility, clear breach of discipline and disposal mechanisms, while strengthening the selection of drugs supervision and inspection and product sampling, to ensure that price reduction does not reduce quality. From the situation in the pilot areas, the proportion of drugs used by the masses through consistent evaluation increased from about 50% to more than 90%, and the quality level of drug use increased significantly.with the centralized procurement of drugs in various places have landed, many patients enjoy the benefits of visible touch. Mr. Li, a resident of Jinan City, Shandong Province, who suffers from hepatitis B, found that the drug, which used to sell for 204.46 yuan, now costs only 27 yuan to buy a box when he buys Adelfowe ester tablets at Jinan City Center Hospital. Ms. Zhang, of Shenyang, Liaoning province, also said that the price of her long-term anti-sugar drug, Acapo, had dropped from 61.29 yuan a box to 5.42 yuan, "the cost of the drug in the past month is enough to eat now for a year." " to form a market brand effect, promote the transformation of national industry from generic drugs to innovative drugs Shanghai Sunshine Pharmaceutical Procurement Network released a list of procurement varieties shows that the third batch of centralized procurement work involving a total of 56 varieties, the number of close to the first two batches of drugs, including diabetes, hypertension, cardiovascular and other diseases, anatrofen, ibuprofen, amoxicillin, dichloretamine, oxycodone and other popular drugs are listed.in order to ensure the stable supply of winning drugs, this collection in the second batch of mining on the basis of fine-tuning optimization, the maximum number of selected enterprises from the original 6 to 8. On the opening day, 189 enterprises actively participated in a variety of drugs appear "floor price", of which, used to treat type 2 diabetes metformin hydrochloride tablets competition is the most intense, nearly 30 over-rated enterprises, the lowest price fell to 1.5 points per tablet, Qilu Pharmaceutical 25mg12 pieces of specifications of Xidana non also reported an average price of 2.08 yuan per tablet, a drop of 92%. In the end, 191 of the 55 drugs were included in the proposed selection." the third national collection once there are 55 kinds of drugs winning the bid, in the future to improve the concentration of pharmaceutical enterprises, regulate drug circulation links, improve the hospital drug catalog, improve the access of patients to drugs has played a great role. Hu Shanlian, a professor at Fudan University's School of Public Health in Shanghai, said.Chen Qiuxuan, deputy director of the Health Industry Development Research Center of the Chinese Academy of Social Sciences, said the collection also involved leukemia, anti-tumor, psychotic drugs, "these drugs are actually some of the drugs commonly used by patients, the people have a direct impact." Itnoteworthy that compared with the second collection at the beginning of the year, most foreign pharmaceutical companies did not follow the price reduction, the winning enterprises are mostly local generic pharmaceutical companies, only a small number of original research varieties winning the bid. Shi Weiwen, a professor at Peking University's School of Pharmacy, said that because of the fall in generic drug prices, quality assurance, patients after a period of time, more and more assured that the demand for generic drugs began to increase. "With the continuous expansion of consistent evaluation, domestic enterprises gradually form a market brand effect, more energy to focus on research and development, in the conditions of ensuring generic brand, to promote the transformation of national industry from generic drugs to innovative drugs." Reporters noted that the Joint Procurement Office issued at the end of July the national drug centralized procurement document (GY-YD2020-1) on the declaration of enterprise qualifications have been strictly restricted, requiring the declaration of enterprises to participate in the drug centralized procurement activities within two years, in the pharmaceutical production activities must not have a serious illegal record, and the quality of drugs to be responsible. Once selected, as the first responsible person for supply security, need to organize production in a timely and adequate manner as required, and send drugs to distribution enterprises. In addition, the reporting enterprise should fill in the national drug centralized procurement declaration commitment letter in advance, promise no interest relationship with the joint procurement office, will not make any improper contact with the purchaser for the project, do not collude with other enterprises to declare, negotiate quotations, do not have a direct holding, management relationship with other enterprises of the same variety or the enterprise head of the same person, do not interfere with the centralized procurement-related work order, will not have any illegal and illegal activities in the declaration process to ensure fair and just collection work. The Joint Procurement Office may also conduct an investigation into the pharmaceutical production and the quality of the drugs to be selected by the proposed enterprise in accordance with the needs of the work. " compared with the first two batches, the third batch of procurement volume is greater, enterprises have adapted to the existing collection mechanism, proving that the first two batches have taken good results. Chen Qiuxuan said that centralized procurement is not only in line with the laws of the industry, but also in line with the current reality, multi-party benefits, should be constantly improved, and continue to promote. continue to strengthen regulation to prevent corruption in centralized procurement processes drug procurement has long been a high-risk area of corruption. In the previous decentralized procurement model, some pharmaceutical enterprises do not pay attention to product innovation, quality and cost control, over-reliance on sales channels, so that drug sales staff and medical personnel face a greater risk of violations of the law. Influenced by performance, high commission and other factors, the term pharmaceutical representative is almost the same as "high-priced medicine", and the resulting drug rebates, over-medical treatment and other problems have become difficult to eradicate dysentery. According to industry insiders, in the hospital drug procurement catalog, if there are a variety of drugs can be used to treat the same disease, doctors will often choose a high percentage of rebates, resulting in patients have to bear more treatment costs. Sun Zhilong, a former party committee member and vice president of fuyang District Second People's Hospital in Hangzhou, Zhejiang Province, has received more than 16 million yuan in kickbacks for drugs 196 times, among which, a company's pharmaceutical representative Lin promised to Sun Zhilong rebate costs as high as 45% of the drug price, the high price of the drug can be seen. One of the advantages of centralized procurement and use of drugs by national organizations is that one of the advantages of the pilot and expansion is that under the premise of consistent quality and efficacy, different enterprises produce the same generic drug competition, so that the quality and efficacy of drugs from the industry to the attention of the whole society, operational space has been further compressed. " centralized procurement model, enterprise public relations behavior will be greatly reduced, inter-enterprise competition into open and transparent product quality and cost competition, under the surface of the gray operation into the sun under the fair competition, fundamentally improve the ecological environment of the pharmaceutical industry, is conducive to the pharmaceutical industry from marketing-driven to innovation-driven transformation. The head of the joint procurement office said. this, the drug collection model still faces many uncertainties in the process of implementation, such as enterprise default, hospital non-cooperation and abuse of power, and needs to further improve the mechanism and strengthen supervision. Reporters noted that the third batch of drug collection requirements to establish a declaration enterprise, selected enterprises, distribution enterprises in violation of the list. Violations include providing prescription kickbacks or other commercial bribes, illegal promotional activities, obtaining bribes from buyers, joint procurement offices, etc., and providing false supporting documents and documentation to defraud the selected candidates. Enterprises included in the list of violations will be disqualified from the selection, and enterprises or varieties will be disqualified from participating in centralized drug procurement activities in various places within 2 years from the date of inclusion in the list of violations, depending on the serious circumstances. can we ensure the smooth access of the selected drugs to medical institutions? The relevant person in charge of the Medical Administration of the National Health and Health Commission said that the requirements of medical institutions have been made and that the reasonable use and guarantee of supply of selected drugs should not be affected by requirements such as cost control, the proportion of drugs and the quantity of medical institutions' product regulations. At the same time, the health and health departments should strengthen the guidance and supervision of public medical institutions, and urge public medical institutions to give priority to the procurement and use of selected drugs in accordance with the agreed amount of procurement. the promotion of centralized procurement and use of drugs by state organizations, the same can not be separated from the protection of supervisory power. Dongguan Municipal Commission for Discipline Inspection and Supervision of the Municipal Health Insurance Bureau of Guangdong Province will focus daily supervision and probe on the field of centralized procurement management of drugs, urge the responsible subjects of the relevant business departments from the "job responsibilities" "business process" "system mechanism" "external environment" and other four aspects to investigate risks, establish and improve the key links of key posts integrity risk prevention and control system, and centralized procurement organizations, product selection, workflow, etc. " to the centralized procurement management of violations of discipline, we firmly and strictly deal with, strengthen the responsibility must be asked, accountability must be strict clear guidance. The relevant person in charge of the discipline inspection and supervision group said. , the National Health and Health Commission issued the "2020 Special Action Plan for the Construction of The Style of the Medical Industry", which calls for strengthening the comprehensive management of drug circulation, bidding, procurement, clinical use and other links, establishing a bad record of commercial bribery in the field of pharmaceutical purchase and sale, and handling the production and operation of pharmaceuticals, medical equipment and medical supplies included in the bad records in accordance with the law. With the deepening of medical reform, the field of pharmaceutical purchase and sale is also steadily advancing, tightening the red line of the system, continuous strengthening of supervision, in order to prevent the "central procurement" process of corruption, to ensure that the state organization of drug centralized procurement and use of pilot and expansion in the sun, and constantly consolidate the clean atmosphere of the industry. (China Discipline Inspection and Supervision Daily)