New Thinking on Drug Purchase in Volume: From Encounter to Tug of War

Author: Shandong Fengqing

The bulk purchase of medicines has undergone five batches and six rounds of national baptism, and has experienced the tempering of local alliances and provincial procurement.

1.

This starting point has been extended to all chemical medicines that have not been reviewed from the original focus on proprietary Chinese medicines with unclear procurement rules

National procurement with volume is like an encounter battle, starting from scratch, with rushing waves and violent waves

It is worth mentioning that the topic of how to carry out mass procurement of proprietary Chinese medicines last year, along with the fruitful results of local mass procurement, directly extended "how to merge" into a new thinking on "how to merge and reduce prices most effectively"

2.

According to incomplete statistics, in the 500 catalog, 279 varieties have been purchased by local and national quantities, which means that there are still 221 varieties that are not covered by centralized procurement

3.

In the past two years, we have repeatedly seen that in some places, there are often cases of non-supply or abnormal supply of pharmaceutical companies due to various factors such as higher volume purchases and conventional online drugs that have won the bid.

1.

For national procurement with a large amount, the author can understand that the double envelope is opened, and the qualification for over-evaluation is equivalent to the realization of all economic and technical standards, and the quotation is the selection of business objectives

Since the original intention of the 14th Five-Year Plan for mass procurement has been successively introduced in various places to make the pharmaceutical industry more healthy and sustainable development, before we make the first move, we should actually consider at least three or five moves

4.

Among the third batch of nationally selected varieties, the packaging of metformin hydrochloride tablets, celecoxib capsules, montelukast sodium chewable tablets, valsartan tablets (40mg) and other varieties are packaged in bottles, and the number of packaging particles is relatively compared.
Large, there are no other packaging capsules available, such as metformin tablets (100 capsules/bottle), celecoxib capsules (30 capsules/bottle)
.
In this way, the dispensation, distribution and inventory of the outpatient pharmacy all increase the workload, and it is not inconvenient for patients to use and store the drugs
.
It is hoped that companies will adopt boxed packaging or the number of capsules suitable for adjustment to clinical medicines
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The above statement comes from a suggestion or appeal from a certain hospital in the south to the provincial level not long ago
.
This situation actually reflects the helpless and embarrassing status of the hospital
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On February 9, 2017, the General Office of the State Council issued the "Several Opinions on Further Reforming and Improving Policies for the Production, Circulation and Use of Pharmaceuticals" (known in the industry as the Pharmaceutical "National Seventeen Articles")
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In terms of improving drug procurement mechanism, "National seventeen" pointed to "the implementation of the drug classification procurement policies, openness and transparency in accordance with the principle of fair competition, set up scientific assessment factors
further increase the participation of medical institutions in the centralized procurement of drugs"
.
"Further increase the participation of medical institutions in centralized drug procurement".
This sentence actually has a dual meaning: First, look at the background at the time: the role of provincial platforms in centralized drug procurement will gradually diminish, from "price determiner" to " The identity of the "price intervener" began to change
.
The second is to look at the procurement subject: with the emergence of "medical consortia", "medical community", "specialist alliances", and "purchasing groups" in various regions, especially with the advancement and implementation of total prepaid projects in various regions, medical institutions bargaining prices The dominant position will be further improved
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But a year and a half later, the Medical Insurance Bureau was formally established, and medical institutions basically returned to their pre-2017 status
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There is a view that actually cannot stand scrutiny, that is, who trades and who pays the bill
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That is to say, the medical insurance department should pay for the medical insurance department's procurement, but don't forget that professional people do professional things, and the real purchaser is the medical institution.
The medical insurance department itself has set its own position very clearly: a strategic buyer! You can't expect a strategic buyer to become a pharmaceutical buyer! Just like in a company, you can't expect the paying finance department to work in the purchasing department that costs money
.

Just like the selection of many pharmaceutical companies with volume procurement, it seems to take care of all aspects of the interests, but the exclusive selection in each region forces the formation of clinical drug substitution, especially because many hospitals cut off the original clinical varieties due to indicator pressure and give priority to using volume procurement Drug behavior deprived doctors of clinical prescription rights and patients' right to choose to a certain extent
.
The hospital medication still faces confusion
.

5.
Conclusion

During the previous inspection of Sanming, the top leader emphasized that people's health is an important symbol of socialist modernization
.
Sanming's medical reform embodies the people's supremacy and the courage to take the lead, and its experience is worthy of reference to local conditions
.

The author understands that learning the essence of Sanming's experience is to adapt measures to local conditions, and to put it bluntly is to emancipate the mind and seek truth from facts
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Without "adapting measures to local conditions", the spirit of understanding Sanming cannot be fully implemented
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Therefore, quantity procurement is not a mechanical method.
It is not a normalized document issued by the state.
How to combine its own characteristics with the actual medical market, and carry out targeted procurement with quantity, which can not only warm up the medical institutions and patients.
The heart can bring the distance of the enterprise closer, and do good things well.
This will test the wisdom of decision-makers
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*Author's note: This article was written on July 5th, and July 6th is the Sanming Medical Reform Experience Introduction Conference
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Hereby explain!