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The report pointed out that it is necessary to put the protection of people's health in a strategic position of priority development and improve people's health promotion policies
.
The Anhui Provincial Commission for Discipline Inspection and Supervision strengthened political supervision, consolidated the main responsibility, and urged the medical insurance department to vigorously promote the reform of the procurement method of drugs, high-value medical consumables and medical equipment; Adhere to the problem-oriented approach, and reduce the rent-seeking space in the field of pharmaceutical purchase and sales; Pay close attention to key links, standardize centralized procurement procedures, return more inflated drug consumables to a reasonable price level, and continuously reduce the burden of
medical treatment for the masses.
Ms.
Zheng, 67, underwent total knee replacement surgery at the Second Affiliated Hospital of Anhui Medical University on October 14 due to knee osteoarthritis
.
The high-value consumables "total knee replacement prosthesis" used in the operation cost 7200 yuan
.
"Before the reform of centralized procurement of medical consumables in 2019, the price of this consumable was 34,000 yuan, more than
four times that of now.
" Jing Juehua, vice president of the Second Affiliated Hospital of Anhe Medical University and professor of orthopedics, told reporters that three years ago, Ms.
Zheng's surgery and hospitalization expenses were reimbursed by medical insurance for more than 30,000 yuan, and now she only needs to pay about 10,000 yuan, "the money is mainly saved on consumables"
.
Behind the price plunge of "total knee replacement prosthesis", there is the continuous efforts
of the Anhui Provincial Commission for Discipline Inspection and Supervision to urge the provincial medical insurance department to promote the reform of centralized procurement of medical consumables.
Centralized procurement with volume, referred to as "centralized procurement", is organized by the medical insurance department, through the model of "volume for price, volume price linkage" directly negotiates with pharmaceutical manufacturers, centralized procurement of selected products "no middlemen to earn the difference", can greatly squeeze out inflated profits, reduce power rent-seeking space
.
In order to solve the problem of "difficult and expensive medical treatment" among the masses, since 2019, the Anhui Provincial Commission for Discipline Inspection and Supervision has played a good "combined fist" of supervision, continued to promote the reform of centralized procurement of medicines, accelerated and expanded the scope of coverage, deepened and down-to-earth, resolutely eradicated the soil for corruption/corruption breeding in the field of pharmaceutical purchase and sales, and continuously purified the political ecology
of the medical and health industry.
1 Focus on the concerns of the masses Breaking the "ice" of inflated prices of medical consumables, there are many circulation links of drug consumables, large profit margins, and long-term high prices, which increases the burden of medical treatment and medical insurance fund expenditure for the masses, and the masses have reacted strongly
.
The Party Central Committee has always attached great importance to this, and discipline inspection and supervision organs have also taken it as the focus of
supervision and discipline enforcement.
The Anhui Provincial Commission for Discipline Inspection and Supervision earnestly performed its political supervision duties, and shortly after the establishment of the Provincial Medical Security Bureau in 2018, it held regular consultations with the party group of the bureau to consolidate the main responsibility
of pharmaceutical procurement.
At the beginning of 2019, the Provincial Medical Insurance Bureau began to plan the centralized procurement of high-value medical consumables; In April, the supervisor of the Provincial Commission for Discipline Inspection sent a special investigation to the Provincial Medical Insurance Bureau, urged the performance of medical procurement duties, and explored the pilot
reform of centralized procurement of high-value medical consumables.
Reform is imperative, but there are many obstacles at the beginning
.
"The industry format is solidified, and the vested interests 'protect the plate', which is like a piece of solid ice, which is difficult to pry
.
" Jin Weijia, secretary of the party group and director of the Anhui Provincial Medical Insurance Bureau, introduced that under the promotion and guidance of the Provincial Commission for Discipline Inspection and Supervision, in July of that year, the Provincial Medical Insurance Bureau took the provincial hospital as the breakthrough point to select orthopedic spine and ophthalmic intraocular lens consumables with large clinical demand and high social attention for centralized procurement reform pilot, and took the lead in carrying out the "ice-breaking" action
of centralized procurement of high-value medical consumables in the country 。
According to reports, the Anhui Provincial Medical Insurance Bureau explored and innovated the centralized procurement method of "scribbling the bar, centralized procurement, group negotiation, and step-by-step price reduction", and through centralized procurement negotiation and negotiation, the average price of 86 spine products and 8 intraocular lens products was reduced by 53.
4%, breaking the "solid ice"
of inflated prices of high-value medical consumables.
Centralized procurement is the trend of the times, and "breaking the ice" should move forward
.
In August 2020, Anhui carried out the second batch of high-value medical consumables centralized procurement negotiations in the province, with an average price reduction of 82% for 240 orthopedic joint products and 46.
8% for 73 pacemaker products
.
In July 2021, the province carried out the two-year agreement expiration continuation work for orthopedic spine and ophthalmic intraocular lens products, and the spine category expanded to 845 products, with an average price reduction of 75%; The intraocular lens category expanded to 88 products, with an average price reduction of 52.
6%.
In view of the blocking points and difficulties encountered in the centralized procurement of high-value consumables, the Anhui Provincial Commission for Discipline Inspection and Supervision timely urged relevant departments to solve them, and tracked and supervised the successful products of centralized procurement to promote the implementation
.
"After the successful negotiation of centralized procurement, there is still a lot of work to be done, and finally promote the procurement and use of hospitals, so that patients can benefit and the benefits of medical insurance funds can be maximized
.
" Zhang Bogen, head of the discipline inspection and supervision team of the Anhui Provincial Commission for Discipline Inspection and Supervision stationed in the Provincial Health Commission, said that the Provincial Commission for Discipline Inspection and Supervision has repeatedly urged functional departments to strengthen supervision and institutional constraints, and at the same time carry out daily supervision and inspection of medical treatment, and vigorously promote the implementation
of centralized procurement results.
Following the "ice-breaking" action, Anhui has successively promoted the "unevaluated" drug "breaking the embankment" action, the "breaking the defense" action of clinical testing reagents and the "breaking the circle" action of large-scale medical equipment by means of centralized procurement, so that the prices of a large number of drugs, high-value consumables and medical equipment have dropped significantly and returned to a reasonable level
.
It is estimated that since 2019, Anhui has saved a total of 3.
098 billion
yuan in medical insurance funds.
2 Adhere to problem-oriented and explore the "deep water area" of centralized procurement of medicine
"Unknowingly, many medical bosses appeared in front of me.
.
.
In the sycophancy, I gradually fluttered and lost the bottom line
.
This is a confession
by Guan Moumou, the former director of the laboratory department of a provincial hospital in Anhui.
In March 2021, Guan was placed on file for review and investigation by the discipline inspection and supervision organs, and was later expelled from the party and public office
.
In November of the same year, Guan was sentenced to 9 years and 6 months
in prison according to law.
The judgment shows that during his tenure as the director of the laboratory department, Guan took advantage of his position to seek benefits for others in the business of instruments and equipment and reagents consumables of the laboratory department, and illegally accepted bribes and materials
from others.
"Guan's case has exposed problems such as inflated prices of clinical test reagents, middlemen earning price differences, and hospital personnel taking 'kickbacks', which are the hardest hit areas
of medical corruption/failure.
" Zhang Qiong, director of the Eighth Discipline Inspection and Supervision Office of the Anhui Provincial Commission for Discipline Inspection and Supervision, introduced that the Provincial Commission for Discipline Inspection and Supervision deeply analyzed the reasons for the case of Guan, studied and judged the industry ecology, sought a governance path, and urged the medical insurance department to base itself on the recruitment and procurement function, carry out the source control of the price of testing reagents, compress the space for power rent-seeking, and eradicate the soil
that breeds rot/corruption.
Practice has proved that centralized procurement is an effective way
to control the problem of inflated prices of medical consumables at the source.
However, the categories of clinical laboratory reagents are complex and the classification is not clear, coupled with the "special aircraft" type equipment and reagent sales bundle bidding and other reasons, the difficulty factor of centralized procurement is large, which is a difficult point and "deep water area"
in the field of pharmaceutical procurement.
Coupled with the resistance of vested interests to "protect the plate", some medical institutions are passively wait-and-see, making the centralized procurement work difficult
.
"Reform usually has to be easy first and then difficult, but clinical testing reagents are widely used and the public has a high degree of attention, so we decided to concentrate on tackling tough problems and steadily promote the reform of centralized procurement
.
" Kim Vega said
.
On the basis of full investigation and demonstration and clinical protection, the Provincial Medical Insurance Bureau highlights the key points, organizes targeted collective procurement of the same type of products involved in relevant cases, squeezes out inflated profits, and compresses the space for power
rent-seeking.
Before promoting centralized procurement, the Provincial Medical Insurance Bureau organized a discussion for relevant personnel of provincial public hospitals to analyze the shortcomings and integrity risks of the original procurement model and build consensus on reform
.
At the same time, innovate the procurement mechanism and solve the problems
such as "special aircraft" for clinical laboratory reagents.
On August 25, 2021, the Provincial Medical Insurance Bureau successfully organized the negotiation and negotiation of centralized procurement of clinical laboratory reagents in the province, and actively explored new areas
of centralized procurement reform of medical consumables.
After negotiation, 88 products of 23 projects in 5 categories, including tumor-related antigen assays, were successfully negotiated, and the average price reduction reached 47.
02%.
As a high-value consumable, single-use ultrasound heads are widely used in various surgical procedures
in medical institutions.
In June this year, when handling a clue about a problem, the Anhui Provincial Commission for Discipline Inspection and Supervision found that the ultrasonic knife head had not yet been collected and the price was high, and the public's desire to include it in the scope of centralized procurement as soon as possible was also very strong
.
Although the Provincial Medical Insurance Bureau has previously formulated a work plan and started the centralized procurement of ultrasonic blades, due to many factors, the progress has not been smooth
.
On June 22, comrades from the Eighth Discipline Inspection and Supervision Office of the Provincial Commission for Discipline Inspection and Supervision went to the Provincial Medical Insurance Bureau to carry out special investigations, urge the acceleration of the centralized procurement of ultrasonic blades, and help solve relevant problems
.
The Provincial Medical Insurance Bureau quickly enriched its personnel and accelerated the progress of the work——
On July 19, the collective procurement documents were released for public comments; On July 21 and 29, the Ultherapy Head Enterprise Seat was held twiceListen to opinions and suggestions at the seminar; On August 22, a centralized procurement announcement was issued; On August 29, organize negotiations and negotiations; After the announcement, on September 6, the official selection results were announced.
.
.
From the solicitation of opinions to the announcement of the winning results, it took less than 2 months
.
"We mainly consolidate the main responsibility, adhere to the problem-oriented, urge the reform of pharmaceutical centralized procurement to speed up and expand the coverage, further increase the frequency of centralized procurement, and broaden the coverage of
centralized procurement.
" Zhang Qiong said that the purpose of speeding up the expansion is to let the masses get more and more benefits, make the gray space in the purchase and sales of medicines smaller and smaller, reduce the integrity risk of medical staff, and continue to purify and optimize the political ecology
of the medical and health industry.
3 Pay close attention to key links to prevent and control the "risk points" of integrity in centralized procurement
On the morning of October 11, the Anhui Provincial Medical Insurance Bureau held the 25th party group meeting this year, and Zhong Ping, deputy head of the discipline inspection and supervision team of the Provincial Commission for Discipline Inspection and Supervision stationed in the Provincial Health Commission, was invited to attend as an observer
.
In the afternoon of the same day and the whole day of the 12th, the responsible comrades of the discipline inspection and supervision group carried out talks and investigations, covering 7 departments and 3 directly subordinate main responsible persons
of the Provincial Medical Insurance Bureau.
"This conversation and research is to prepare
for a special meeting with the Health Insurance Bureau at the end of the year.
Whether it is a special consultation or attending a party group meeting as an observer, it is a specific measure
for us to strengthen our contact and cooperation with comprehensive supervision and strengthen daily supervision.
Zhong Ping told reporters that the Anhui Provincial Medical Insurance Bureau is the leader of the Yangtze River Delta drug consumables recruitment and procurement linkage work, and the Provincial Commission for Discipline Inspection and Supervision has listed the reform of pharmaceutical centralized procurement as a key supervision content, urging it to continue to promote the normalization, institutionalization and standardization of pharmaceutical centralized procurement
.
In order to strengthen the supervision of pharmaceutical procurement, the Anhui Provincial Commission for Discipline Inspection and Supervision has set up a special supervision group in the office of the provincial leading group for centralized procurement work, which is responsible for the daily supervision of centralized procurement work, and timely accepts and handles relevant reports and complaints; Dispatch personnel to the Provincial Medical Insurance Bureau every month to consult and handle supervision and discipline-related work
in a timely manner.
Since the beginning of this year, the discipline inspection and supervision team stationed in the Provincial Health Commission and the Party Group of the Provincial Medical Insurance Bureau have made three special arrangements on the centralized procurement of medical consumables
.
Paying close attention to the formulation of the collective procurement work plan, the selection of centralized procurement varieties, the collection of social opinions, on-site negotiation and negotiation, and other key links, the "office group" of the Anhui Provincial Commission for Discipline Inspection and Supervision jointly followed up and supervised in a timely manner, urged relevant departments to record and video the negotiation process, announced the results of the selection to the public, accepted supervision and appeals, and ensured that the centralized procurement work was procedural, standardized and scientific
.
Before centralized procurement, key personnel such as the centralized procurement staff of the Anhui Provincial Medical Insurance Bureau, members of the negotiation expert group and other key personnel signed the "Integrity and Confidentiality Commitment" and the "Statement of Avoidance of Interests"
as required.
Before each negotiation, the Office of the Provincial Leading Group for Centralized Procurement will convene experts to interpret the regulations and policies of centralized procurement for training, and for important procurement activities, the Provincial Commission for Discipline Inspection and Supervision will send personnel to read out the disciplinary requirements for review and carry out integrity reminders on the spot, so as to educate and manage key personnel and promote the fairness, impartiality and compliance
of the collective procurement negotiation process.
"The reform of pharmaceutical procurement is moving illegal and non-compliant 'cheese', which affects the pattern of the pharmaceutical market and benefits the people
.
" The relevant person in charge of the Anhui Provincial Commission for Discipline Inspection and Supervision said that in accordance with the report's deployment requirements on deepening the reform of the medical and health system, promoting the coordinated development and governance of medical insurance, medical treatment and medicine, it will continue to supervise and promote medical insurance and other departments to adhere to the bottom line of legal and compliant reform, strengthen discipline, improve institutional mechanisms, and steadily promote the reform
of medical procurement.
(China Discipline Inspection and Supervision News)
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