"National regular meeting" re deployment of centralized drug procurement and use reform continued to deepen

On November 20, Premier Li Keqiang presided over the executive meeting of the State Council and pointed out that promoting the centralized purchase and use of drugs is an important part of deepening medical reform and plays a positive role in reducing the "virtual high" drug price and reducing the burden of the masses The meeting called for further promotion of this work from four aspects: first, to expand the scope of centralized procurement and use of drugs; second, to ensure the stable supply and quality safety of centralized procurement of drugs; third, to formulate and implement national drug administration measures; fourth, to promote the reform of medical insurance payment mode Experts in the industry believe that with the continuous deepening of medical reform, drug procurement in the future will present a "national, provincial and municipal" three-level pattern In the face of the "all-round flowering" of volume procurement at the national and local levels, pharmaceutical enterprises can only win vitality and take the initiative in the environment of industry upgrading and industry shuffling acceleration if they recognize the situation, improve quality and innovation, train talents and reduce costs Xu Yuanhu, special observer of this newspaper, general manager of Hubei Guangji pharmaceutical Jikang Pharmaceutical Co., Ltd and innovation and entrepreneurship tutor of Wuke University Yang Tao, special observer of this newspaper and management consultant of pharmaceutical enterprise of Rito Management Consulting Co., Ltd Wu Gaozhuo, Bidding Engineer of sinopharma Co., Ltd Zheng Pei, senior consultant of Henan Auto Marketing Enterprise Management Consulting Co., Ltd Medical Observer: the executive meeting of the State Council requires that the varieties with large price difference between the original research drugs and generic drugs, as well as the essential drugs through the consistency evaluation of the quality and efficacy of generic drugs, be included in the centralized procurement, so as to promote the substantial reduction of drug price by purchasing in volume Why emphasize these two "priorities"? What's the point? Wu Gaozhuo: the two "priorities" are to further expand the range of drugs purchased in volume on the basis of the success of the original "4 + 7" pilot drug volume purchase, reduce the "virtual high" drug price in a larger area, and reduce the burden of the masses to a greater extent The original drugs and generic drugs with large price difference are obviously the main factors affecting the drug price The quality and efficacy of over evaluated essential drugs are the same as those of the original drugs, and they cover the main clinical diseases These two aspects are the "key few" that affect the price and quantity of drugs If they are well controlled, the "ox nose" of centralized purchase of drugs will be grasped, which is more conducive to the common people's use of more high-quality and cheap drugs Zheng Pei: both "priorities" emphasize "generic drugs" It is inevitable that the value of generic drugs will return The R & D cost of generic drugs is far lower than that of the original research drugs By replacing the original research drugs with generic drugs and purchasing with quantity, the price of generic drugs can be greatly reduced, so as to promote the rapid implementation of the medical insurance variety "cage lifting and bird changing", which is of practical significance to save medical insurance funds, reduce the burden of medical insurance and the burden of drug use for the common people At the same time, it can also promote the research and development of innovative drugs by encouraging the over evaluated generic drugs to enter the scope of national collection Xu Yuanhu: first, in order to reduce the price of the drugs with large clinical use, especially the drugs with high price of the original research drugs by centralized purchase, reduce the pressure of medical insurance payment, and reduce the burden of drug use of the common people; second, the priority of the evaluated basic drugs is to ensure that the price drops, but also to ensure the quality of the drugs, so as to truly achieve high quality and low price Yang Tao: the varieties with large price difference between the original research drugs and generic drugs are preferred, and the price reduction is large, which is more meaningful for the reduction of medical insurance expenditure; the basic drugs that pass the consistency evaluation of generic drugs are preferred because of their wide coverage and large dosage The core of the two priorities is to reduce health care spending Medical Observer: in addition to the varieties with large price difference between the original research drug and the generic drug, as well as the basic drugs through the consistency evaluation of the quality and efficacy of the generic drug, which varieties are expected to be shortlisted for purchase? When is it possible to start the purchase of a new tire quantity? Yang Tao: the products with high price, large consumption and more medical insurance payment will trot into the era of centralized purchase It is estimated that the state will collect products in batches and once in a batch, which eventually becomes a normal situation Instead of collecting thousands of varieties together as before, the workload is heavy and too rough Instead, they are divided into multiple batches For example, there are 200 varieties in each batch, once a quarter, 800 varieties in a year, 1200 varieties in a month, and one standard period and one cycle They are leisurely Zheng Pei: in addition to the generic drugs that have passed the consistency evaluation, the drugs in the new 685 base drug catalog are also expected to be shortlisted and purchased in volume This will take a certain time, mainly through the implementation of the new medical insurance catalog in January 2020, and also according to the standard time of 685 base drug catalog used in public medical institutions According to the notice of the leading group of the State Council on deepening the reform of the medical and health system on further promoting the experience of deepening the reform of the medical and health system in Fujian Province and Sanming City released by the national health and Health Commission on November 15, the new round of belt procurement will be started no later than June 2020 Xu Yuanhu: there is a large amount of clinical use The top 200 products will be included in the belt quantity procurement first It is expected that the new belt quantity procurement will determine the product catalog and complete the negotiation and bidding before June next year, and enter the implementation stage in the second half of the year Wu Gaozhuo: some commonly used emergency medicine and emergency medicine urgently needed in clinic are expected to be shortlisted and purchased in quantity It is expected that the purchase of a new tire volume will start as soon as this winter and next spring Medical Observer: the meeting also proposed to build a national centralized procurement platform for drugs, relying on provinces (districts, cities) to build a unified and open procurement market nationwide "National centralized procurement platform" can be said to be a new formulation How is its nature different from the relying platform for volume procurement organized by the state health insurance bureau? What's the difference with the nature of provincial sunshine procurement platforms? Wu Gaozhuo: it is an inevitable trend and imperative to build a "national centralized procurement platform" It is different from the current support platform for volume procurement organized by the State Health Insurance Bureau in that one is a pilot project, which is only a "small trial of NiuDao", with fewer varieties; the other is to expand, which is "broad-minded", with a wider coverage of natural varieties Compared with provincial sunshine procurement platforms, "national centralized procurement platform" can unify relevant management at the national level, improve management efficiency, cover more areas, produce more products and have greater impact, realize resource sharing, solve the problem of "independent" and different standards of provincial bidding platform, effectively reduce the disadvantages of large human and material investment and repetitive work of bidding enterprises It has a demonstration and leading role for the provincial drug volume procurement Before the provincial bidding enterprises had different specifications and different packaging products, they were often dozens of product specifications, paper materials were a large box, and a variety of electronic secret keys were a dozen In order to avoid the conflict between secret keys, computers should be equipped with at least five or six, which made the bidding class become a spectacular computer "machine room" Zheng Pei: in April this year, the state has launched the national medical insurance information system project, which is a set of system, a set of coding, two-level platform and three-level operation The purpose is to solve technical problems for the national centralized procurement platform The national centralized procurement platform conducts centralized bidding, volume procurement and price negotiation in a wider range According to the variety classification, some of the imported varieties shall be unconditionally implemented on provincial and municipal platforms The provincial platforms are mainly in the mode of network hanging, and there are many kinds of centralized mining methods The municipal platform is mostly based on the provincial standard to carry out the bargaining work, and has the role of undertaking the pilot of the new model The biggest difference between national platforms is that the volume is larger and the price is lower Xu Yuanhu: the national centralized procurement platform is under the centralized construction and management of the state, which belongs to the direct leadership and management of the state health insurance bureau The management is more flat and the rights are more centralized, which is more conducive to the development and implementation of the centralized procurement work Different from provincial procurement platforms, centralized procurement by the state makes it easier for drug control enterprises to be shortlisted in the bidding, and there is more room for drug prices to fall, which is conducive to unifying drug prices, reducing the pressure of medical insurance, improving drug quality and ensuring drug safety Medical Observer: the meeting proposed to establish an emergency reserve, inventory and capacity reporting system for winning manufacturers, strengthen the sampling inspection of winning drugs, and implement the market clearance system What is the significance of establishing these two systems? Can we fundamentally guarantee the quality and supply of the winning drugs? Yang Tao: since the mode of national centralized mining is adopted, these two systems must be introduced in a complete set to avoid the situation that bad money drives out good money, and the supply cannot be guaranteed after the enterprises with insufficient strength win the bid The market clearance system needs to be combined with drug supervision Only strict supervision, strong supervision and strong punishment can guarantee the quality and quantity of products collected intensively Zheng Pei: because the national volume procurement is the sole or part of the manufacturers jointly winning the bid, it is more important to ensure the supply of pharmaceutical enterprises The establishment of an emergency reserve, inventory and capacity reporting system for bid winning enterprises can effectively guarantee the supply of drugs for centralized purchase by the state At the same time, we should strengthen the sampling inspection of drugs, implement the market clearing system, and effectively fight back some doubts about the quality problems caused by the low price of drugs for centralized purchase, which can fundamentally guarantee the quality and supply of drugs winning the bid Wu Gaozhuo: establish the emergency reserve, inventory and capacity reporting system of the winning manufacturer, strengthen the sampling inspection of the winning drugs, and implement the market clearance system The significance lies in ensuring the timely supply of clinical drugs and the stability and accuracy of drug efficacy, and better treating and saving patients Follow up the production supply and quality status of the enterprise regularly to prevent the production or quality problems of the winning enterprise and protect the interests of the patients In order to fundamentally guarantee the quality and supply of the winning drugs, it is necessary to establish a multi department linkage, establish a dynamic tracking inspection and standby drug database, timely discover, publicize and return the problematic drugs, and realize rapid supplement Xu Yuanhu: first, strengthen the production supervision of bid winning enterprises, ensure the supply of bid winning drugs, and meet the drug demand; second, strengthen the sampling inspection of bid winning drugs, mainly to strengthen the quality supervision of bid winning drugs Medical Observer: the meeting requires the formulation and implementation of national drug administration measures This is also a very new content What is the significance of formulating national drug administration measures? What factors need to be considered? Yang Tao: the national drug administration method is a big concept The current "basic drug administration method", anti drug restriction regulations, medical insurance drug catalog, clinical medication guidelines, medical insurance payment methods, etc all belong to the scope of the national drug administration method The proposal of the national drug administration measures is mainly to make a top-level design for the scattered drug administration measures, so as to avoid overlapping contradictions or loopholes not covered by the system Zheng Pei: the national measures for the administration of drug use is a new formulation for the supervision of the production, circulation and use of national drugs for centralized purchase The purpose is to protect the national drugs for centralized purchase in terms of the quality of production enterprises and the consumption of medical institutions, to promote the medical institutions to first use the national essential drugs and drugs listed in the medical insurance, to strengthen the management of hospital drug affairs, to investigate and deal with unreasonable drug use according to law, and to establish We will improve the regulatory value of the normalized drug prices, and steadily implement the reform of medical service prices on the basis of not increasing the burden on patients as a whole Wu Gaozhuo: to formulate and implement the national drug administration measures is a new measure for the benefit of the people, with far-reaching significance Before medical institutions used drugs, they had strong "autonomy" and weak policy influence The state's drug administration measures are to restrict some irregular behaviors of medical institutions