Single purchase or difficult implementation of medical institutions

Source: Medical Economic News March 18, 2016 This week, the national development and Reform Commission held a press conference on macroeconomic operation data Its spokesman pointed out at the conference that after the liberalization of drug pricing, from the perspective of market monitoring and social reflection, the overall situation is good, but there are indeed a few unreasonable problems of drug prices, mainly reflected in the coexistence of low and high prices The coexistence of false high and false low drug prices is a fact that no one can deny "But in the medical reform, the use of administrative coercion means, with the same way to reduce the price of drugs, not only the virtual high drug price can not be reduced, the virtual low price of drugs will be forced to stop production and cut off supply." In the interview, Guo Taihong, President of Zhejiang Pharmaceutical Industry Association, said What is high? What is low? The false high of drug price has been concerned by the industry for a long time Now relevant departments gradually pay attention to the problem of false low The spokesman said that the low price affects the normal production and supply of drugs, while the high price will increase the burden on patients To solve this problem, we should not only take practical measures, strengthen market supervision, but also further deepen medical reform This means that the solution to the problem of false high and low drug prices requires the cooperation of all departments to curb all unreasonable pricing behaviors We can also see the preliminary approach from the previous policies of relevant departments The national drug price negotiation pilot for patented drugs and exclusively produced drugs was officially launched last year At the just concluded national "two sessions", the national health and Family Planning Commission also said that after the national level negotiation, the price of relatively expensive patented drugs and imported drugs can be reduced to more than 50% on the whole, and the national negotiation for five drugs has made a breakthrough In addition to the fixed-point production of drugs in short supply in the virtual low price market, some experts in the interview think that these two approaches have undoubtedly opened a good beginning With the gradual implementation of the policy, I hope to produce and expand the positive role of the policy "The price of medicine is the economic burden for patients and medical insurance, and for pharmaceutical enterprises, it means maintaining simple reproduction and innovating to expand the reproduction capacity." The question then is how to judge the price of drugs? Gan Rongfu, senior consultant of Sinopharm, pointed out that "the false high price should be the price space left after eliminating the costs of human resources and R & D, which can be regarded as the false high At present, there is no limit to the virtual high price of drugs From setting a ceiling price to a new round of price reform, the functions of the national development and Reform Commission will be clearer and more attention will be paid to the regulatory level " On the other hand, in order to solve the problem of low drug price, Gan Rongfu thinks that we should take a long-term view For the situation that the bid price of drugs is too low and some drugs disappear, it is more necessary to strengthen the flight inspection of drug companies In the future, with the promotion of consistency evaluation, the quality of drugs is expected to be greatly improved Through quality supervision, competent departments will eliminate products that disrupt the normal order of the market, so as to provide a reasonable living space for products with real high quality and good price In Guo's view, although some drugs with low price and short supply will be produced at designated point, how to determine the price is not clear Whether the price is determined by bidding or negotiation? Whether the drug companies can accept and maintain the fixed price for a long time? We still need to wait and see Referring to the GPO conference of Shanghai Medical Association, the competent department also said that it is necessary to "reform the bidding and procurement mechanism, allow public hospitals to purchase individually or in groups, establish an Internet platform for direct transactions between hospitals and production enterprises, carry out procurement work in accordance with the principles of integration of bidding and procurement, linking volume and price, sign procurement contracts and strictly implement them We will ensure the production and supply of commonly used cheap drugs and drugs urgently needed in clinical practice by means of fixed-point production and online purchase " "Here's an idea, but it's very difficult for hospitals to carry out independent procurement, unless it's a very large hospital At present, there are many systems that are not sound Once the market is liberalized, a series of problems will easily arise " Gan Rongfu pointed out that the GPO model of Shanghai Medical Association could be used for reference It is reported that in the key points of deepening the reform of medical and health system in Shanghai in 2015, the city proposed to use the common practices of GPO abroad for reference and promote the reform of drug group procurement mode and separation of medicine On the one hand, medical insurance will continue to promote government led procurement with volume; on the other hand, GPO procurement of market mechanism will be explored, and a third-party hospital procurement service company will be established through the market main body All hospitals can entrust this intermediary service company for price negotiation Through the GPO organization, a larger procurement scale is formed, so as to obtain a better procurement price To this end, Gan Rongfu reminded that a medical consortium composed of several hospitals should be based on the pilot situation to promote the third-party procurement Such a third-party trading platform is different from the well-known Guangdong Pharmaceutical exchange platform At present, the model of the integration of bidding and purchasing and the linking of quantity and price has not been fully and effectively promoted in various regions The general office of the State Council previously issued the guiding opinions on improving the centralized procurement of drugs in public hospitals, which stipulates the main body of bidding procurement: "adhere to the principle of province (District, city) As the direction of centralized online drug procurement, the company implements one platform, up-down linkage, open and transparent, classified procurement, and takes measures such as bidding production enterprises, bidding procurement integration, quantity price linkage, double envelope system, and whole process monitoring We will encourage local governments to explore and innovate in combination with the actual situation, and further improve the participation of hospitals in drug procurement " From the perspective of local promotion, in addition to the exploration and practice in Shanghai, Tianjin bidding office issued the "2015 Tianjin medical institutions commonly used low-cost drug price negotiation management measures", which started the low-cost drug negotiation in the name of volume purchase The guiding opinions of Sichuan Medical Institutions on drug volume procurement (Draft for comments) pointed out that on the basis of the provincial procurement platform linked to the Internet, the participation of medical institutions in drug bidding and procurement should be enhanced, the role of market procurement should be played, and joint procurement and "double letter" should be adopted The way of bidding, purchasing with quantity and exchanging quantity for price can promote the reasonable price, reliable quality and timely supply of drugs It is suggested that the purchasing committee should be established by the representatives of health and family planning, human resources and social sectors and medical institutions Guangdong, Anhui and other places have also carried out the exploration of new models In the general trend, it is pointed out that in the future, the pharmaceutical industry will gradually form the mode of "integration of recruitment and acquisition, linking of quantity and price" On the one hand, the quantity demand of hospital is the advantage and price preference is sought; on the other hand, the winning enterprise organizes mass production and scale sales according to the quantity of varieties to be supplied, so as to realize cost reduction and efficiency increase "We hope that some implementation details of volume procurement can achieve fairness and justice In addition, it is necessary to prevent the "volume purchase" from evolving into an overcorrected "second bargaining" A government official from a pharmaceutical company said in an interview.