What's the fate of Shanghai deep GPO's price reduction?

Source: detailed rules of Shenzhen GPO, which attracted great attention on August 8, 2016 of pharmaceutical economic news, finally came into effect On August 3, Shenzhen health and Family Planning Commission printed and distributed the notice of Shenzhen public hospital drug group procurement catalogue management measures (Trial), Shenzhen public hospital drug group procurement organization management measures (Trial), Shenzhen public hospital drug group procurement provisions (Trial) The three detailed rules and documents have made detailed regulations on the preparation and management of the group's drug purchasing catalogue, the selection and supervision of the group's purchasing organization, and how to promote the GPO of important participants such as production enterprises, distribution enterprises and public hospitals Since August 8, the document has been put into effect for two years, and it is still in the stage of making purchase catalogue GPO in Shanghai goes further: the drug group purchasing alliance established by 5 tertiary hospitals and 6 public medical institutions affiliated to districts and counties in Shanghai has been preliminarily explored The latest static data calculation results released recently show that after the first batch of anti microbial drugs were purchased by the group, the total purchase amount decreased by 20.8% Hu Shanlian, Professor of the school of public health of Fudan University and director of Shanghai Health Development Research Center, carefully compared the implementation details of GPO in Shenzhen and Shanghai, and pointed out the significant difference between them: from the organizational form, Shanghai is a procurement alliance jointly formed by public medical institutions, and Shanghai Pharmaceutical is entrusted Shanghai Medical and Health Affairs Service Center under the health development foundation is a third-party non-profit organization; Shenzhen GPO organization is a drug trading enterprise, not a medical institution Hu Shanlian believes that different organizational forms will lead to different ways of purchase Shanghai is the demander, and the medical group purchases directly; Shenzhen is the supplier, which is organized by the pharmaceutical enterprise, but needs to be selected and confirmed by the purchasing organization selection committee of the public hospital group, which belongs to indirect purchase From the perspective of economic nature, Shenzhen is "monopoly of suppliers" and Shanghai is "monopoly of demanders" If we speculate from the perspective of market mechanism that Shanghai has formed the purchasing power of medical group to ask for drug discounts from manufacturers and suppliers, it may be negotiated that hospitals will get more discounts on drug purchases and the price of drugs may be reduced even more The GPO organization in Shenzhen is a pharmaceutical enterprise, and the product quality and supply situation may be more advantageous "But the specific results will be determined after the pilot Different regions carry out GPO according to different situations There are differences, which are different modes of exploration with different characteristics Shenzhen, Shanghai model is also expected to be mature in the national promotion, GPO is the trend in the future " The expert told reporters Which varieties? The first batch of GPO drugs purchased in Shanghai are mainly anti microbial drugs According to the specific purchasing situation, the current results of the selection are basically consistent with the clinical use structure in 2015 78% of the drugs originally used by medical institutions have entered the list of selected drugs; the selection rate of basic drugs is 98.7% The participation of enterprises is also very high, with a total of 528 enterprises applying, including 89 foreign-funded and Sino foreign joint ventures, with a winning rate of 50.57%   In Shenzhen, the group purchasing organization, in accordance with the provisions of the group purchasing drug quality level formulated by the municipal public health administrative department, comprehensively considers the quality and price of drugs, clinical drug demand and public drug use habits, and consults the opinions of the pharmaceutical Expert Committee of the municipal public hospital organized by the Shenzhen public health administrative department, and determines the Shenzhen public medicine through bidding, negotiation, etc Drug supply and supply price (including distribution price) specified in the purchasing catalogue of the hospital drug group It is worth mentioning that Shenzhen's method is to define the generic name, dosage form and specification of each drug The varieties of drugs with the same generic name, injection type and oral dosage form shall not exceed 2 respectively, and the prescription composition shall be similar to 1-2 kinds of compound preparations, and consideration shall be given to the medication needs of women, the elderly and children and other special groups, including the top 80% of the total purchase amount of public hospitals in Guangdong Province in the last year Drugs within the scope of, as well as commonly used low-cost drugs, women's and children's specialty drugs, emergency rescue drugs and drugs in short supply in the market The pressure of price reduction is a pilot GPO, one of the focuses of the industry is that the pressure of drug price reduction is too great In particular, concerns about the supply of drugs, especially some cheap ones, may lead to the disappearance of these varieties if prices are to be lowered again In addition, pharmaceutical companies pointed out that "if the price reduction is an important basis for purchasing, some special drugs and original research drugs can not be basically done." "In the drug bidding and purchasing platform, the drug price will generally be reduced by 20% - 30% GPO tends to further reduce the price by about 20% - 30% on the basis of bidding in the region Assuming that the price of a drug in the original bidding decreased by 30% and GPO decreased by 30%, the price of the drug decreased by 39% in the two previous price reductions; if the price of a drug decreased by 20% first and then by 20%, it would be 24% So generally speaking, the decline range of many varieties is about 24% - 40% In the interview, some authoritative experts in pharmacoeconomics calculated a sum of money for the reporter However, this is not the necessary price reduction threshold to enter GPO, because specific to a specific variety, some varieties may be reduced by less than 20% and some by more than 30%, which is related to the category of drugs In addition, in addition to reducing the cost of production and drug prices, we can also reduce the cost of circulation and distribution and reduce the price by shortening the circulation channels "For GPO organizations, the first thing to mention is price reduction." Hu Shanlian suggested: "but GPO is not limited to the work of simple price, but also should consider extending services, such as the provision of drug information by pharmaceutical companies; the improvement of supply chain links, the reduction of inventory by medical institutions, and the improvement of distribution efficiency." In addition, experts believe that competition should be promoted Multiple GPOs can exist at the same time, compete with each other, and accept the supervision of government departments At present, the establishment of drug group purchasing alliance by 5 tertiary hospitals and 6 public medical institutions affiliated to districts and counties in Shanghai has achieved preliminary exploration There are 16 districts in Shanghai, and other organizations can also come in, presenting diversified competitiveness