The state health insurance bureau will optimize and perfect the bidding and purchasing system in response to the relevant suggestions on drug centralized purchase

On September 11, the State Health Insurance Bureau replied to the second session of the 13th National People's Congress recommendation No 6633 on improving the centralized bidding and purchasing of drugs in public hospitals, and the arterial network sorted out the relevant contents Expand the scope of centralized procurement pilot: the purpose of moderate bidding and multiple successful drug centralized procurement pilot is to explore and improve the mechanism of drug centralized procurement and market-oriented drug price formation mechanism, reduce the burden of drug costs of the masses, regulate the order of drug circulation, and improve the drug safety of the masses In 2018, the National Health Insurance Bureau, together with the Health Commission, the drug administration and other relevant departments, studied and drafted the pilot program According to the idea of "national organization, alliance procurement and platform operation", organize 11 cities in Beijing, Tianjin, Shanghai, Chongqing and Shenyang, Dalian, Xiamen, Guangzhou, Shenzhen, Chengdu and Xi'an to form a Procurement Alliance, promote the return to the original intention of "linking quantity and price, and integrating bidding and procurement", select varieties that pass the consistency evaluation, concentrate the drug consumption of public medical institutions, and ensure the quality and quality Under the premise of quantity and supply, we should really implement the procurement with quantity and reduce the false high drug price Among the 31 pilot varieties, 25 were selected, and the average price of selected drugs decreased by 52% compared with the lowest purchase price of the same kind of drugs in the pilot city in 2017 At present, the pilot operation is stable, the operation effect is better than expected, the burden of patients' medical expenses is significantly reduced, and the realization of generic drug substitution is promoted Recently, on the basis of summing up the experience of the pilot project, the state health insurance bureau, together with relevant departments, has studied and formulated a plan to expand the scope of the pilot project with the main idea of "moderate bidding and multiple winning bids", held a forum for pharmaceutical enterprises, listened to the opinions and suggestions, and generally agreed with the overall idea of the plan, and believed that the plan took into account the interests of all parties from the overall situation and insisted on fair development In principle, when the price has basically returned to a reasonable level, we should weaken the bidding, highlight the goal of ensuring long-term stable supply, and meet the requirements of industrial development Next, the relevant departments of the state will focus on the following three aspects: first, continue to do a solid job in organizing and implementing the pilot project We will strengthen the monitoring and guidance of the pilot areas, ensure the quality and supply of the selected drugs in the pilot areas, promote the priority use of the selected drugs, and enable patients to fully enjoy the dividends of the reform; we will start to expand the scope of the pilot implementation as soon as possible, so that the reform will benefit more people; we will optimize and improve the drug bidding and procurement system based on the evaluation results of the pilot and suggestions from all aspects Some provinces have formulated the payment standard of medical insurance drugs based on the actual situation In 2015, the national development and Reform Commission and other seven departments jointly issued the notice on printing and distributing the opinions on promoting drug price reform (fgjg [2015] No 904), reformed the drug price management mode, proposed to "gradually establish a market-oriented drug price formation mechanism" while canceling most of the drug government pricing, and required "the medical insurance department should In conjunction with relevant departments, on the basis of investigating the actual market transaction price of drugs, the payment standard of medical insurance drugs shall be formulated by comprehensively considering factors such as medical insurance fund and patient's bearing capacity Some provinces have formulated and issued relevant policies on drug payment standards in combination with local conditions Next, we will carefully sort out the relevant ideas, and gradually establish a medical insurance payment standard policy in line with the actual situation of China based on the in-depth summary of local experience and extensive consultation with all parties On the reform of the national basic drug system In 2018, the general office of the State Council issued the opinions on improving the national basic drug system (GBF [2018] No 88), which made it clear that the basic drugs should meet the basic medical and health needs, take meeting the basic drug demand for disease prevention and control as the guide, according to the disease spectrum and drug characteristics of China, pay equal attention to both Chinese and Western drugs, select appropriate number of basic drug varieties to meet the needs of common diseases, chronic diseases Emergency rescue and other major clinical needs, taking into account the needs of children and other special groups and public health prevention and treatment drugs The selection and adjustment of essential drugs catalogue can adjust the factors such as clinical application practice of comprehensive drugs, changes in drug standards, and new listing of drugs, and start the transfer in procedure in time for the drugs newly approved for listing and whose curative effect is significantly improved compared with the drugs already on the market and whose price is reasonable For the therapeutic drugs in the catalogue of essential drugs, when the medical insurance department adjusts the catalogue of medical insurance, it shall, according to the procedure, put the qualified drugs into the scope of the catalogue of medical insurance or adjust the classification of a and B Bidding and purchase of drugs in short supply According to the guidance of the general office of the State Council on improving the centralized drug procurement in public hospitals (GBF [2015] No.7), for non patent drugs, emergency (rescue) drugs, commonly used low-cost drugs and drugs with small clinical dosage in women's and children's specialty, the bidding will not be carried out any more, instead, the centralized network will be carried out and the hospital will directly purchase them, giving full play to the role of market mechanism and guiding the formation A reasonable price However, due to the low quality and efficiency of the supply of a few clinically necessary drugs, the insufficient refinement of the supply guarantee policy, and the lack of smooth connection of relevant links, some drugs are in short supply or even in short supply, affecting patients' medication, and the people's response is quite prominent In June 2017, the original health and Family Planning Commission and other nine departments jointly issued the implementation opinions on the reform and improvement of the supply guarantee mechanism of short drugs, adopting the establishment of nine departments' consultation and linkage working mechanism at the national and provincial levels, the establishment of the management system of the list of short drugs at the national and provincial levels, the construction of the national multi-source information collection and supply business collaborative application platform for short drugs, the implementation of fixed-point production and cooperation We will adjust emergency production and import, strengthen supply and demand docking and coordination, improve the shortage of drug reserves, crack down on violations of laws and regulations, and improve drug use policies for rare diseases, so as to effectively guarantee the shortage of drug supply in a package After the establishment of the State Medical Security Bureau, it attached great importance to the procurement and price related work of short drugs, guided local governments to implement the policy of direct online procurement of short drugs, and carried out the evaluation and analysis of drug price situation In the next step, the state will establish a monitoring and early warning mechanism for the price of short drugs and purchase information, and allow enterprises to quote directly on the Internet for the shortage drugs that are clinically necessary and have poor substitutability, as well as the shortage drugs that have significantly lower treatment costs in the same kind of drugs Medical institutions will purchase independently on the provincial drug procurement platform to ensure the reasonable profits of enterprises At the same time, we should improve the mechanism of drug purchase and price, and promote the return of drug prices to a reasonable level Source: National Health Insurance Bureau