Centralized procurement of inter-provincial alliances accelerates, and pharmaceutical consumables usher in a new round of price cuts Author: Guo Jinhui
At the moment when the fifth batch of national centralized procurement of pharmaceuticals and the second batch of national centralized procurement of consumables are steadily advancing, the centralized procurement of inter-provincial alliances across regions is also accelerating.
Under the joint efforts of National Procurement and Alliance Procurement, some medicines and consumables will usher in a new round of substantial price cuts.
According to industry news, the Guangdong Medical Insurance Bureau recently issued a document to form a regional group procurement alliance, and sincerely invites Shanxi, Fujian and other provinces to join in the joint procurement of provincial-level medicines and consumables ultrasonic cutter heads.
After the formation of the 16-province alliance led by Guangdong, it will be the largest inter-provincial alliance procurement in my country.
According to media statistics, in addition to the 16 provincial alliances led by Guangdong, there are currently 12 inter-provincial alliances for centralized drug procurement in my country.
Chen Hao, a senior economist at Tongji Medical College of Huazhong University of Science and Technology, told CBN that the alliance’s bargaining power lies between the national centralized procurement and the provincial level, with strong bargaining power, relatively few constraints, flexible mechanism, flexible operation, and flexible frequency. , Procurement content close to hospital use, close to the market, cross-regional volume procurement will become the main mode of drug and consumables volume procurement.
Alliance procurement accelerated in May
Since entering May, the alliance's procurement has accelerated significantly.
In addition to the industry-mentioned Guangdong Medical Insurance Bureau issued a document to form a 16-province alliance, Chongqing took the lead in establishing two alliances for shortage of medicines and centralized procurement of commonly used drugs. Among them, the alliance for commonly used drugs has 8 provinces and regions, and the alliance for shortage of drugs has 9 provinces and regions.
On May 21, the centralized procurement network for medicines and medical consumables in Liaoning Province issued a notice, absorbing Guizhou and Qinghai into the alliance, and expanding the original "six provinces and two districts" into "eight provinces and two districts" alliance procurement.
The notice requires that two batches of centralized procurement of medicines and medical consumables be carried out in the name of "eight provinces and two districts" every year, and the "eight provinces and two districts" inter-provincial consultation linkage mechanism will become an important brand of the national regional alliance procurement mechanism .
On May 22, the Xinjiang "2+N" Alliance Joint Procurement Office announced the results of the proposed selection for this volume purchase, and a total of 53 varieties were proposed to be selected.
This is less than one month after the release of the "2+N" alliance drug centralized procurement document on April 27.
According to CBN, one of the reasons for the accelerated procurement of the alliance is the guidance and supervision of the National Medical Insurance Bureau.
From May 11th to 12th, the National Medical Insurance Administration held the "National Medical Centralized Procurement Policy and Practical Training Course" in Nanning, Guangxi. The main content was policy interpretation and special lectures. At the same time, 7 provinces had experience exchanges.
Chen Jinfu, deputy director of the National Medical Insurance Administration, emphasized in the training class that it is necessary to fully affirm the breakthrough results of the reform of centralized procurement of drugs and consumables, comprehensively summarize the successful experience of pilot exploration, and promote the normalization of centralized procurement with the tenacity to grasp the iron.化.
According to statistics, in addition to the 16 provincial alliances led by Guangdong, there are currently 12 inter-provincial alliances for centralized drug procurement.
Including Sanming Alliance, Shaanxi Leading 11 Provincial Alliances, Shaanxi Leading Anticancer Drugs 14 Provinces (Regions) Alliance, Chongqing Leading 5 Provincial Alliances, Sichuan Leading 6 Provinces and 2 District Alliances, "Shanghai, Jiangsu, Zhejiang, Anhui and Fujian" Four Provinces and One City Alliance, Guangdong Leading 10-provincial alliance, Beijing-Tianjin-Hebei “3+N” alliance, Xinjiang “2+N” alliance, Heilongjiang Province eight provinces and two district alliances, Chongqing leading the 8 provinces and regions common medicine alliance, Chongqing leading 9 provinces and regions shortage medicine alliance, Guangdong Take the lead in 16 provinces and autonomous regions.
In addition, the Yangtze River Delta Alliance is also brewing.
Xia Kejia, Secretary of the Party Leadership Group and Director of the Shanghai Municipal Medical Insurance Bureau, revealed in an interview with the media that Shanghai will strengthen linkages with brother provinces and cities to jointly increase the exploration of drug recruitment mechanisms.
For varieties that are not included in the scope of national centralized procurement, combined with the integrated construction of medical insurance in the Yangtze River Delta, explore regional alliance procurement and group procurement.
The Guangdong alliance has aroused widespread concern in the industry. Chen Hao believes that cross-regional procurement can achieve most of the goals that are difficult to achieve in national or provincial centralized procurement.
"Guangdong Province has a large body, occupying 1/10 of the country's share, with a larger alliance and half of the country. There are many types of purchases this time, covering nearly 1/4 of the hospitals."
According to data from Mi Nei.com, Guangdong Province is an important drug sales area in China. The size of its drug market has been rising all the way, and it exceeded the 30 billion yuan mark in 2019.
After national procurement in 2018, the overall sales growth of terminal chemical drugs in public hospitals in Guangdong Province has slowed down. In 2020, terminal chemical drug sales in public hospitals in Guangdong Province were 29.3 billion, a year-on-year decrease of 4.63%.
As early as 2016, Chen Hao suggested to the Guangdong Pharmaceutical Trading Center to promptly initiate cross-provincial and regional joint procurement in order to solve many problems in provincial procurement and in response to the institutional challenges initiated by the prefectural and municipal GPO (group purchasing organization).
An article titled "Practice and Thinking of Cross-Region Procurement of Drugs and Consumables" published by Chen Hao and others in the second issue of "China Health Resources" pointed out that mass procurement can be divided into national centralized procurement and non-national procurement. Collectively.
The drugs collected by the state in my country are mainly original research drugs and over-rated drugs (referring to drugs that have passed the consistency evaluation), and the non-over-rated drugs will be the main targets of non-national centralized procurement of drugs in the future.
However, it is difficult for a single province (city) to carry out drug purchase in a single province (city) as a unit to reflect the purchase effect. Therefore, cross-regional drug purchase will become the mainstream non-national centralized procurement model in the future.
Greater efforts to cut prices in cross-regional centralized procurement
The "Opinions of the General Office of the State Council on Promoting the Normalized and Institutionalized Development of Drug Centralized and Volume Procurement" issued in January this year proposed to realize the interconnection of information on centralized drug procurement between provinces and accelerate the formation of a unified and open national drug centralized procurement market.
Improve the alliance procurement mechanism, and promote the construction of a regional and national alliance procurement mechanism.
Chen Jinfu once said that the above opinions emphasized that there must be alliances in local recruitment and procurement, and must be centered on provincial platforms. It is recommended to advocate regional and cross-regional alliances in order to reduce the huge transaction costs caused by enterprises after multiple bids. , As much as possible to increase the market capacity and competition specifications for centralized bidding and procurement.
Liao Cangyi, a researcher at the Medical Service Governance Research Center of Tsinghua University, told CBN that the scope of national centralized procurement is relatively small. To achieve the goal of "all sources should be collected" as required by the opinions, the role of cross-regional alliance procurement must be played. Alliance procurement can Doing a lot, negotiating with pharmaceutical companies can talk about the price cuts second only to the state's centralized procurement.
Price linkage is a feature of cross-regional volume procurement of medicines and consumables, and it is also an important mechanism that affects the national price system.
The price formed by the purchasing alliance will inevitably affect the purchasing price of pharmaceutical consumables in cities within the alliance.
Affected by the price linkage mechanism, all provinces (autonomous regions, municipalities directly under the Central Government) across the country's restrictions on winning bid prices will affect the national drug consumables price system.
"Alliance procurement is a direction in the future. It has formed a set of central and local joint treatment drug prices with the centralized procurement of the country, which will force enterprises to innovate and upgrade." Liao Cangyi said.
Chen Hao said that cross-regional (provincial) volume procurement of medicines and consumables can cover a wide range of varieties, achieve volume procurement, increase the volume effect, and achieve the goal of price reduction.
The cross-regional (provincial) volume procurement of medicines and consumables also brings opportunities to enterprises, especially mainstream enterprises.
Only by implementing cross-regional (provincial) volume procurement can the demand for high-quality products of specific, large and high-quality medical and health institutions be effectively guaranteed, and mainstream enterprises can gradually become the main suppliers of the market. This is also in line with the supply-side reform and regulatory governance. direction.
At the same time as the alliance's procurement efforts, the national centralized procurement is also advancing.
On May 8, the National United Procurement Office issued the fifth batch of notifications for the declaration of national centralized procurement information, and the release of procurement documents and the opening of bids are just around the corner.
CBN also learned from the National Medical Insurance Bureau that the second batch of national consumables is ready to go, and orthopedic consumables will become the key varieties for the next batch of consumables.