Transcript of the briefing held by the office of the people's Republic of China on measures to ensure the supply of commonly used drugs and stabilize prices

The Information Office of the State Council held a regular policy briefing for the State Council at 10 a.m on Thursday, August 22, 2019 Zeng Yixin, deputy director of the national health and Health Commission and Chen Jinfu, deputy director of the State Medical Security Bureau, were invited to introduce relevant information on measures to strengthen the supply guarantee and stabilize prices of commonly used drugs, and to answer questions from reporters Xi Yanchun: Good morning, ladies and gentlemen Welcome to the regular policy briefing of the State Council Recently, the executive meeting of the State Council studied and determined measures to strengthen the protection of commonly used drugs and stabilize prices, so as to ensure the demand for drugs and reduce the burden on the masses In order to help you better understand the relevant situation, today we are very pleased to invite Mr Zeng Yixin, deputy director of the national health and Health Commission, and Mr Chen Jinfu, deputy director of the National Medical Security Bureau Ask them to introduce the relevant information to you and answer the questions of the reporters Now let's welcome Mr Zeng Yixin to make an introduction Zeng Yixin: dear friends from the media, thank you very much for your attention to health care, especially the supply and guarantee of commonly used drugs The establishment and improvement of a long-term mechanism for the supply and price stabilization of basic drugs, emergency (emergency) drugs, medicines in short supply, APIs and other commonly used drugs is of great concern to the people's health and safety The leading comrades of the Central Committee have made important instructions and instructions for many times; the Standing Committee of the State Council has made special studies and arrangements The health and Health Commission, together with relevant departments, conscientiously implemented the decision-making and deployment of the Party Central Committee and the State Council Since April this year, it has taken a series of policies and measures to do a good job in related work The first is to strengthen the monitoring and grading response to the shortage of drugs The notice on promoting the direct reporting of information on short drugs and the technical guide for classification, classification and alternative use of short drugs in medical institutions have been printed and distributed for reference by local health administrative departments and medical institutions in dealing with drug shortage Since this year, departments at all levels have taken the lead in dealing with more than 20000 pieces of drug shortage information reported by medical institutions Second, we need to organize and ensure the supply of key drugs We will actively promote the resumption of production and marketing of clofazimine on July 10, which is an essential drug for the treatment of MDR-TB We will also actively coordinate domestic enterprises to expand the production capacity of cytarabine, deal with the shortage caused by production suspension abroad, and guide local governments to solve the problem of nitroglycerin production We will formulate the third batch of drugs to encourage research, development and application for children and the first batch of drugs to encourage imitation List of pharmaceutical products Third, we will promote the implementation of policies on the allocation and use of essential drugs 24 provinces have specified the proportion of basic drugs equipped and used The proportion of basic drugs used in medical institutions, especially in tertiary hospitals, has increased significantly We will promote medical institutions to equip them with anti-cancer drugs for medical insurance negotiations Last year, the medical insurance bureau organized negotiations on 17 kinds of anticancer drugs, and finally reached a relatively good purchase price In the first half of this year, the purchase volume of 15 kinds of drugs has exceeded that of the whole year of last year, of which 9 kinds of drugs are more than 5 times of that of the whole year of 2018, and ibutini is 18 times of that of the whole year of 2018 Fourth, investigate and deal with the illegal acts of the monopoly of APIs, and investigate four kinds of APIs Fifthly, the SFDA issued the announcement on further improving matters related to the review, approval and supervision of drug association to simplify the listing process of APIs Sixthly, we should refine the tasks and measures of each department, study and do a good job in ensuring the supply and price of drugs in short supply At present, with the gradual establishment and improvement of the security system for the supply of drugs in short supply, the contradiction of drug shortage in China has been alleviated, and there are few large-scale and long-term shortages, mainly temporary and local shortages This year, more than 10 varieties are proposed to be disposed by the state, each of which is limited to a specific province, which is not universal Next, the health and Health Commission will work together with relevant departments to carry out the following work: first, to study and formulate policies and measures to further ensure the supply and price stability of drugs in short supply Second, we will improve the mechanism for monitoring, early warning and response to drug shortages, implement the system for reporting drug production suspension, promote medical institutions to set up warning lines for emergency (emergency) rescue and other inventories, and establish and improve the normal reserve mechanism for drugs in short supply Third, we need to work out standardized drug use management documents in medical institutions and strengthen drug use management in medical institutions We will promote medical institutions at all levels to form a drug use model dominated by essential drugs, and increase the proportion of varieties of essential drugs in government office hospitals Fourth, improve the drug purchase policy Enterprises are allowed to reasonably price and directly purchase the varieties in the national and provincial drug shortage list For the short supply drugs with poor substitutability and unstable market supply, centralized purchase and other methods shall be adopted to ensure the supply We will study and increase policies and measures for the import of urgently needed drugs Fifth, we will strengthen law enforcement, and seriously investigate and deal with drug monopoly, market manipulation and other violations Sixthly, we should coordinate the organization, implementation, publicity and guidance I'll give you a brief introduction Thank you Xi Yanchun: Thank you for Mr Zeng Yixin's introduction Let's welcome Mr Chen Jinfu to make an introduction Chen Jinfu: Good morning, friends from the media The stability of drug supply and price is closely related to people's health and safety, and is also a high concern of the society The Party Central Committee and the State Council attach great importance to it According to the deployment of the State Council, the medical insurance bureau, together with the development and Reform Commission, the Ministry of finance, the health and Health Commission, the General Administration of market supervision and other departments, has taken a series of measures to solve the problem of rising prices of commonly used drugs, including: improving the monitoring and early warning mechanism of drug price supply; carrying out special price cost investigation on key varieties, carrying out accounting information quality inspection in the pharmaceutical industry; promoting quality consistency To evaluate and promote the pilot projects of centralized drug procurement and use organized by the state, to carry out negotiations on anticancer drugs; to expand the medical insurance catalogue, to promote the reform of medical insurance payment mode; to strengthen the price supervision and inspection in the field of drugs and the anti-monopoly law enforcement of APIs, to seriously investigate and deal with the cases of glacial acetic acid and Chlorphenamine monopoly, and to investigate the suspected monopoly of some APIs Through the above measures, the drug price has remained stable on the whole, especially for some drugs with important clinical value Through volume purchase and access negotiation of medical insurance, the price has dropped significantly It has played a positive role in ensuring the basic drug use needs of the masses and reducing the burden of drug use The monitoring data shows that since 2015, 70% of the prices of commonly used drugs have been reduced or even, and the average price of high-priced drugs such as anti-cancer drugs has dropped by 18% About 30% of the commonly used drugs have increased in price, and some varieties have increased greatly From the reasons of drug price rise: first, the mechanism of market regulation is not sufficient Most of the drugs with high price have the characteristics of small market capacity and insufficient competition, which are often clinically necessary and lack of substitution, so it is easy to appear the situation of "pushing up with shortage" The second is the monopoly price increase of upstream API Some drugs or API production links are highly centralized, the distribution channels of API are easy to be controlled, and the purpose of illegal profit-making is achieved through monopoly control Third, there are objective cost factors For example, the increase of labor cost input, product quality level and environmental protection input also lead to the increase of reasonable cost, which has a great impact on the drugs with low historical price In view of the current outstanding problems, according to the deployment of the State Council, the medical insurance bureau and relevant departments will earnestly implement the requirements of the 60th executive meeting of the State Council, do a good job in stabilizing drug prices, and strive to ensure the supply stability and reasonable prices of clinical drugs First, we should actively deal with the rapid rise of drug prices For unreasonable price increase, the company will be urged to take the initiative to correct Take measures such as public exposure, suspension of Internet connection, punishment for breach of trust, etc., until punishment is carried out according to laws and regulations Second, we should establish and improve a long-term regulatory mechanism, comprehensively use measures such as monitoring and early warning, cost investigation, correspondence and interview, credit evaluation, information disclosure, suspension of Internet access, and illegal punishment to guide enterprises to make reasonable pricing and consciously regulate their behaviors Third, deepen the reform with a view to the fundamental policy Including deepening the reform of centralized drug purchase mechanism, accelerating the pilot of centralized drug purchase and use organized by the state, establishing credit evaluation and incentive and disciplinary measures for price and bidding procurement, and promoting the formation of a fair, healthy and orderly competition market order Finally, I would like to thank the friends from the media for their support to the work of medical insurance and medical price management I hope that you will continue to care about and support our work, actively and objectively reflect the changes in drug prices, guide social expectations, and provide strong support for the government's decision-making Thank you Xi Yanchun: Thank you for Mr Chen Jinfu's introduction Let's go to the Q & a section Please inform your news agency before asking questions Please ask questions CCTV reporter: what are the problems in the field of drug supply and security in China? What further measures will the relevant departments take to solve these problems? Thank you Zeng Yixin: from the current situation of multi department research, with the establishment of the security system for the supply of drugs in short supply, the contradiction between drugs in short supply has been alleviated Just now, Chen also said that the large-scale and long-term shortage is not the mainstream, but the short-term and partial shortage It is reflected in several aspects: why is there a shortage? We think there are several outstanding problems First, the timeliness and sensitivity of drug shortage monitoring and early warning need to be enhanced We need to discover the shortage of drugs in time, and both sensitivity and timeliness need to be improved We have established a direct reporting system for the information of short drugs covering public medical institutions, but the information of the production, purchase and use of raw materials and preparations has not been connected and shared, and the system of reporting the production suspension of drugs has not been implemented, so we have not collected the information in time For example, if a pharmaceutical factory stops production for some reasons, it will surely cause a shortage of downstream drugs We should collect the information about the suspension of production of pharmaceutical factories In this way, it will be very helpful for us to monitor and early warn in time and find out the possible shortage as soon as possible We should further improve these problems Second, the policies for purchasing and storing drugs in short supply also need to be improved In some places, too much emphasis is placed on the price factor in the procurement, and the historical price or the lowest price in the surrounding areas is used to limit the price of procurement, which leads to the fact that enterprises are unable to guarantee reasonable profits and are unwilling to supply In remote areas, the consumption is small, the distribution route is long, the cost is high, and the enterprises are not willing to distribute, all these are the reasons for the shortage of drugs Moreover, most of the drugs in short supply are drugs with small dosage such as emergency (rescue) drugs The economic cost of ensuring supply is not high, but the social benefit is great Therefore, when the market mechanism fails, the government's reserve role needs to be played, and the normal reserve strength needs to be further increased Third, the problem of market monopoly of APIs and preparations that are in short supply needs to be solved with more efforts At present, it is found that capital penetration into the shortage drug market is obvious, the phenomenon of monopoly of marketers is increasing, and there is a trend of spreading from API to preparation and other fields, becoming an important driver of drug shortage or unreasonable price rise At present, the anti-monopoly fine is still difficult to play an effective role in punishment and deterrence Some lawbreakers are confident, and it is also difficult to investigate and obtain evidence The current punishment measures are not very strong, so they cannot play a sufficient deterrent role These are one of the reasons for the short-term or partial drug shortage The next main measures: first, we need to improve the monitoring and early warning and response mechanism for drug shortage, and promote the solution to the problem that the monitoring and response are not timely and sensitive enough We have found this problem, such as the shutdown of pharmaceutical plants,