The list is out!

142 drugs were included in the list of key monitoring of abnormal price and supply fluctuations by the National Medical Insurance Bureau, and the provincial drug collection platforms are responsible for monitoring

1.

In the above notice, the "Notice of the Office of the National Medical Insurance Administration on the Monitoring of Unusual Changes in Drug Prices and Supply" was also made public

In the notice, the National Medical Insurance Bureau stated that it has decided to rely on the provincial centralized drug procurement platform to trial the monitoring of abnormal changes in drug prices and supply

Monitoring of abnormal changes in drug prices and supply is mainly to serve medical and health institutions to carry out diagnosis and treatment drugs in an orderly manner, maintain the normal price order of drug purchases and timely distribution and supply of drugs, accurately grasp the abnormal changes in drug purchase prices and supply, and understand the reasons for abnormal changes.

According to the requirements of the National Medical Insurance Administration, the provincial-level centralized drug procurement platform will include all drugs traded on the Internet into the scope of routine monitoring, and will focus on monitoring some drugs that have a concentrated clinical response

In Attached Table 3, the National Medical Insurance Administration has delineated a "list of drugs with key monitoring of abnormal price and supply fluctuations" involving 142 varieties, involving-arubicin injection, cytarabine injection, atropine injection , Aminophylline tablets, allopurinol tablets, low molecular weight heparin sodium injections, digoxin tablets, diazepam tablets, dexamethasone injections, dopamine injections, cyclophosphamide, inosine injections, methotrexate injections, ray Nitidine injection, ribavirin injection, lidocaine injection, norepinephrine injection, mitomycin, protamine injection, vincristine injection, metahydroxylamine bitartrate injection, and other common ones that are prone to clinical shortages Medicine

2.

Regardless of whether there are any abnormal changes in prices or supply of the drugs that are to be monitored for key monitoring, the monitoring results shall be reported quarterly according to the information requirements of Schedule 1 and Schedule 2

It can be seen from the attached table that the price of pharmaceutical preparations increased by 10% or more over the previous month/the same month of the previous year, increased by more than 100% over December 2015, and increased by 50% or more over December 2018, all in several cases.

In the same way, the price reduction of pharmaceutical preparations in accordance with the above-mentioned range also requires the completion of the "Monitoring Table for Abnormal Changes in Drug Prices" based on the changes in abnormal price reductions

In the column of the reasons for the increase in drug prices, the National Medical Insurance Bureau gave the options: rising cost of raw materials, rising costs of materials such as excipients and packaging materials, rising technical quality standards leading to increased production costs, market monopoly or price collusion; the original winning bid price was biased.

As for the possible reasons for the decline in drug prices, there are overcapacity, market competition, the listing of generic drugs, the linkage of medical insurance negotiation volume and price, and the implementation of specific centralized procurement policies

In addition to price abnormalities, the abnormal supply of medicines can also be divided into supply cuts, shortages, and abnormal increases

The possible reasons for the shortage of medicines include: failed or rejected bids, no company supply; raw material shortage; raw material monopoly; enterprise production line adjustment and transformation, insufficient production capacity; low transaction prices, and enterprises unwilling to produce; price-fixing transactions, enterprises unwilling to supply; geographical remoteness, companies do not want distribution; small clinical dose, enterprises are unwilling to supply; increased clinical demand, etc.

It is not difficult to see that, unlike the key drug monitoring system recommended by the National Health Commission and implemented in many provinces across the country, under the key monitoring drug system, the monitoring is mainly for those drugs that are used in large quantities and account for a large amount of money.
The monitored index is mainly the clinical dosage, and the main body to be monitored is the medical institution
.

The monitoring of drug prices and supply abnormalities carried out on a pilot basis by the National Medical Insurance Bureau mainly focuses on the price and supply of drugs, and uses centralized drug procurement platforms in various provinces as the main monitoring body.
The focus is on the price and consumption of drugs.
Few drugs have the problem of unstable clinical supply to a certain extent
.

3.
The cost of pharmaceutical production gradually surfaced

In the notice, the National Medical Insurance Bureau requires that, in the case of abnormal changes in prices and supplies found in monitoring, all regions should check whether the information is true and eliminate error interference
.

For drugs produced by enterprises in the province with large price changes, surveys on production and operation and price costs should be carried out in accordance with the principle of territoriality, and manufacturers should be required to fill in the "Table of Production and Operation of Drugs and Price Composition" to explain the reasons for the large price changes, and Submit necessary auxiliary materials such as copies of ex-factory price value-added tax invoices
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According to Cyber ​​Blue, in the "Table of Production and Operation of Drugs and Price Composition", the cost of drugs is specific to each item, including-medicinal raw materials, main excipients, main packaging materials, fuel power, direct wages, manufacturing costs, selling expenses, management fees, finance charges, taxes and so on
.

In addition, the source of medicinal raw materials, the price of main excipients, the price of main packaging materials, and the specific taxes and fees are all within the scope that pharmaceutical companies need to report
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According to the work arrangements of the National Medical Insurance Administration, in addition to monitoring drug prices and supply, each province’s centralized drug procurement agencies must also do a good job in the use and sharing of information.
If drug shortages, monopoly price increases, or price violations may be involved, they should promptly report to the Provincial Office of the Consultation and Interaction Mechanism for Supply of Shortage Drugs, and promptly transfer relevant clues to relevant functional departments
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The schedule for this work is as follows: starting from October 2019, the provincial drug procurement agency shall submit the routine monitoring results of the previous month before the 8th of each month (postponed on holidays)
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There are no abnormal price changes and no shortage of medicines on the platform
.
The production and operation status and price cost surveys undertaken by the province of origin should be submitted within 5 working days of the routine monitoring results
.
The quarterly report of key monitored drugs shall submit the monitoring results of the previous quarter before the 8th of the first month of each quarter
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Since the establishment of the National Medical Insurance Administration, the action of lifting the veil of drug costs has gradually become normal
.

Whether it is the joint Ministry of Finance to implement accounting information quality inspections on 77 pharmaceutical companies-the scope of inspection includes pharmaceutical companies' sales expenses, invoice flow, authenticity of income, authenticity of costs, salary payments for marketing staff and sales rebates of medical staff and so on
.

Focus on the cost and expense structure of pharmaceutical products, analyze the cost and profit structure of pharmaceuticals from production to sales, and reveal the mechanism of drug price formation
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It is also clearly stated in the Medical Security Law (Draft for Comment) that the medical security administrative department is responsible for conducting cost and price surveys of drugs and medical consumables, implementing a credit evaluation system for drug prices and bidding procurement, and intensifying infringements against price monopoly and price bidding in accordance with the law.
Supervision and inspection of illegal activities of the medical security fund
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They all conveyed the policy orientation of the National Medical Insurance Administration to promote the return of drug prices to a reasonable level by paying attention to the cost of drug production
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In a "Response of the National Medical Insurance Administration to Recommendation No.
1339 of the Third Session of the 13th National People's Congress" on November 12, 2020, the National Medical Insurance Administration pointed out that while purchasing drugs in quantities, the price of medicines should return to a reasonable level.
The National Medical Insurance Bureau also comprehensively uses monitoring and early warning, letter inquiries and interviews, reminders and warnings, cost investigations, credit evaluations, information disclosure and other means to establish and improve the normalization of drug price supervision mechanisms, and promote operators to strengthen price self-discipline
.

And promote the construction of the national medical insurance information platform drug and medical consumables recruitment management subsystem and the national drug centralized procurement data rapid collection subsystem, and establish and improve the monitoring mechanism for abnormal changes in drug prices and supply
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In the future, with the strengthening of the medical insurance information system, the interconnection of information and the orderly sharing of data will be further promoted
.
However, under the comprehensive measures such as volume procurement and cost investigation, the price of medicines will face a further downward trend
.