The medical insurance bureau encourages the implementation of "one vote system" with 70% of consumables price changes involving a large number of hospitals

On January 13, Fujian Medical Insurance Bureau, provincial health committee and Provincial Drug Administration issued the notice on carrying out the pilot work of centralized procurement of medical consumables in public medical institutions From the perspective of the main body involved in the document, it involves the provincial medical insurance bureau, health committee, market supervision bureau and other local departments, as well as the relevant medical institutions, medical consumables production, business circulation (distribution) enterprises; It is reported that the main purpose of this document is to promote the reform of the medical consumables procurement system, reduce the purchase price of medical consumables, and pilot the centralized procurement of medical consumables in public medical institutions (screenshot source: Official Website of medical insurance bureau) In the scope of the pilot project: the first batch of five types of consumables, such as cardiac stent, artificial joint, indwelling needle, ultrasonic knife, analgesic pump, will be selected to carry out the pilot project of provincial belt procurement These consumables will be included in the pilot scope of three-level public medical institutions in the province and gradually extended to other public medical institutions in the province according to the pilot situation We will encourage medical institutions of the Fujian army and the armed police to participate How to implement it? For the negotiation with volume, the notice made clear Within the scope of pilot consumables, products with high market share shall be selected and included in the negotiation scope According to 70% of the total quantity of consumables used in the pilot medical institutions in the previous year, the basic procurement quantity is estimated; At the same time, the centralized belt purchase is carried out under the condition that the basic purchase quantity is completed within the pilot purchase cycle Through negotiation and negotiation, the successful products and the centralized belt purchase price are determined through multiple selection methods The pilot procurement cycle is one year from the formal implementation of centralized procurement How to ensure procurement and use? (screenshot source: Official Website of medical insurance bureau) The notice pointed out that for the negotiated consumables, the total purchase volume of all negotiated consumables of each pilot medical institution shall not be less than 70% of the consumption of similar consumables of the institution in the previous year, and the purchase volume of negotiated consumables shall not be less than 50% of the consumption of the institution in the previous year in principle, and the purchase volume of the pilot purchase cycle shall be reported There are also requirements for machinery enterprises and distributors The health care Commission and the medical insurance department shall organize pilot medical institutions to sign volume purchase and sale contracts with production enterprises and distribution enterprises The pilot medical institution is the main body responsible for the completion of the contracted purchase volume It should give priority to purchase and use the negotiated consumables products according to the clinical needs to ensure the completion of the purchase volume within the pilot purchase cycle For the medical institutions that fail to complete the procurement and use as agreed in the contract, they shall be handled in accordance with the relevant provisions of the notice of the general office of the people's Government of Fujian Province on printing and distributing the implementation plan for the comprehensive implementation and follow-up of the pilot work of centralized procurement and use of drugs organized by the state in Fujian Province To ensure payment settlement It is pointed out in the document that the medical insurance agency will settle the payment for consumables products after negotiation All the pilot medical institutions shall purchase the consumables successfully negotiated through the provincial drug purchase platform, and the local medical insurance agency shall pay the product payment of the previous month to the enterprise according to the contract before the 15th of each month (screenshot source: Official Website of medical insurance bureau) The document states that for the purpose of supervision and management It will strengthen the interconnection of the management systems of medical insurance, hospitals, procurement and distribution enterprises, and the provincial medical insurance bureau will strengthen monitoring and analysis by using the provincial pharmaceutical machinery procurement platform, and implement integrated supervision on the procurement, transaction, use and settlement of consumables products negotiated successfully Strengthen the supervision and management of "two vote system", encourage the implementation of "one vote system", and list the production and distribution enterprises that do not comply with the provisions in the list of dishonest enterprises in the supply of medical consumables The provincial health insurance bureau shall focus on monitoring the relevant products of the production enterprises that are included in the scope of negotiation but do not participate in the negotiation Two vote system, one vote system in the medical device industry has become an indisputable trend According to Everbright Securities, it has sorted out the progress of the national two vote system for consumables and zero addition of consumables According to the information of Everbright Securities, many provinces in China have started or fully implemented the two vote system for consumables (authorized: Everbright Securities Research Institute) According to the analysis of the insiders, the two ticket system of consumables has not completely cut off the interest chain After the previous method of "the ticket does not go away with the goods", the machinery enterprises will distribute the interests through the way of high opening At the same time, the unreasonable expenses will be legalized through the false opening of value-added tax invoices The relevant departments seize this point of the false opening of invoices after the two ticket system, concentrate their efforts and manage the consumables On November 15, 2019, the leading group of the State Council for deepening the reform of the medical and health system issued the notice on further promoting the experience of deepening the reform of the medical and health system in Fujian Province and Sanming City (hereinafter referred to as the "notice") to release major signals The circular pointed out that by the end of December 2019, all provinces should fully implement the purchase and use policies of 25 drugs under the pilot reform of centralized purchase and use of drugs organized by the state In 2020, according to the national unified deployment, expand the scope of centralized procurement and use of drugs by national organizations Comprehensive medical reform pilot provinces should take the lead in promoting medical insurance agencies to directly settle payments with drug production or circulation enterprises, and other provinces should also actively explore (screenshot source: Official Website of national health and Health Commission) From the content of the document, we can see that the medical insurance department directly settles accounts with enterprises, which means that the one vote system has come, and it should be gradually promoted not only in the comprehensive medical reform provinces, but also in other provinces On September 30, 2019, nine departments, including the State Medical Insurance Bureau, jointly issued the implementation opinions on the pilot project of centralized drug purchase and use organized by the state to expand the regional scope, explicitly encouraging the regions with conditions to directly settle the drug payment between the medical insurance fund and the enterprise In addition, the document also requires all regions to actively adopt independent or cross regional alliance and other ways to carry out volume and budget procurement for drugs not included in the centralized procurement and use of national organizations in accordance with the requirements of volume procurement, integration of bidding and procurement, quality priority, quantity assurance and payment collection.