Author: Guo Jinhui
The eighth batch of state-organized drug centralized procurement will open on March 3 in Lingshui County, Hainan Province, according to the price reduction range of the previous seven batches, about 29 kinds of drugs collected this time will usher in a price reduction of about 40%.
The National Health Insurance Administration put forward a clear requirement in early March that by the end of 3, the cumulative number of national and provincial centralized procurement drugs in each province should reach 2023, of which 450 should be provincial-level centralized procurement drugs, and chemical drugs, proprietary Chinese medicines, and biological drugs should be covered. According to the relevant plans of the 130th Five-Year Plan, by 2025, centralized procurement will become the leading mode of public hospital procurement.
Liao Zangyi, associate professor of the School of Politics and Public Administration of China University of Political Science and Law, told First Finance and Economics that the National Health Insurance Administration continues to expand the coverage of centralized drug procurement, and is currently carrying out and implementing the eighth batch of state-organized drug centralized procurement (hereinafter referred to as "national procurement"), as well as proposing to promote the centralized procurement of new batches of drugs in a timely manner and explore the ninth batch of centralized procurement. Judging from the first eight batches, relevant policies are gradually refined and tend to improve.
Nearly 5 drugs have reduced their prices by more than 300% in 50 years
In early March, the State Organization Drug Joint Procurement Office issued the relevant documents of the National Drug Centralized Procurement Document. The document said that the eighth batch of national procurement will begin to receive application materials at 3:3 a.m. on March 29, make the declaration information public at 7 a.m., and confirm the supply area at 30 p.m.
Relevant procurement documents show that 40 drugs have been included in the eighth batch of national procurement, covering anti-infection, cardiovascular and cerebrovascular treatment and other fields, and the varieties declared by enterprises must obtain valid domestic registration approval before March 3 (inclusive). According to data from Minai.com, in 24, the total sales of the eighth batch of state-procured drugs in China's urban public hospitals, county-level public hospitals, urban community centers and township health centers exceeded 2021 billion yuan.
In the past four years, the National Health Insurance Administration has continued to promote the centralized procurement of extruded drug consumables, with an average price reduction of more than 2018% in 11 batches of 4 drugs, and an average price reduction of more than 7% in 7 batches of four types of consumables, superimposed on local alliance centralized procurement, reducing drug consumption costs by more than 294 billion yuan.
Jiang Changsong, assistant dean of the National Institute of Medical Security of Capital Medical University, wrote that each batch of drug procurement will be accompanied by the continuous optimization and improvement of rules. For example, the number of selected enterprises of the same variety has been selected from the initial exclusive selection to the current multiple selections, the first batch of "4+7" city pilot exclusive selection, and the first batch of national expansion 3 selections; the second batch of 6; the third batch of 8; 10 in the fourth and fifth batches; The sixth batch of insulin was specially collected by 11 companies.
Liao Zangyi said that from the first batch to the eighth batch, it can be seen that the time from the issuance of the bid opening announcement to the announcement of the results of the national procurement is gradually shortening, from about one month to less than one month; The execution cycle of the contract is gradually extended, from the initial contract period of 1 year to 1~1 years, which is also important for stabilizing the price expectations of enterprises, and the rhythm of two batches a year is basically maintained. At the same time, with the increasing number of selected varieties in centralized procurement, drug renewal is gradually normalized, and 3-1 renewals per year in the future may become the norm.
"We can see that the price reduction expectation, the number of selected enterprises, and the proportion of selected enterprises gradually tend to mature and stabilize, considering that the work is relatively mature, it is expected that the later policy will only be fine-tuned, and there will be little change." Liao Zangyi said.
The notice of the Office of the National Medical Security Administration on doing a good job in centralized procurement and price management of pharmaceuticals in 2023 proposes to standardize the continuation of the expiration of the agreement on centralized procurement of drugs organized by the state, guide Shanghai, Jiangsu, Henan and Guangdong to take the lead in carrying out the continuous procurement of the alliance, encourage the same variety to be selected by multiple enterprises, promote fair and reasonable price differences, and unify the procurement cycle; The varieties with high prices selected in the previous round of collective procurement should continue to squeeze the price moisture, and the varieties with low prices selected in the previous round of collective procurement after changes in market conditions will form a new winning price after full competition.
At the beginning of the year, the National Medical Insurance Work Conference said that China's drug price index has declined for five consecutive years. The proportion of patients using high-quality drugs in centralized varieties has increased from 5% to more than 50%. While the sense of gain of the vast number of insured people continues to increase, the space for "gold sales" of drugs continues to be compressed, and more and more pharmaceutical manufacturers embark on a new road of development that emphasizes innovation and quality.
Accelerate the expansion of procurement with volume
China's procurement with volume has moved towards the stage of speeding up and expanding. The above notice proposes to continue to expand the coverage of centralized drug procurement, and this year will focus on guiding Hubei to take the lead in expanding the procurement varieties and regional scope of the interprovincial alliance of proprietary Chinese medicines, Jiangxi to lead the procurement of interprovincial alliance of interferon, and Guangdong to lead the procurement of interprovincial alliance for drugs prone to shortage and emergency rescue.
Due to the large number of exclusive products and the difficulty of unifying the quality evaluation system, proprietary Chinese medicines are considered to be difficult in centralized procurement, and officials of the National Health Insurance Administration have clearly stated that the inclusion of biosimilars and proprietary Chinese medicines in centralized procurement is an institutional requirement. From the perspective of progress, the centralized procurement of proprietary Chinese medicines has made obvious progress.
On March 3, the National Proprietary Chinese Medicine Joint Procurement Office held a communication meeting for procurement enterprises of the National Alliance of Proprietary Chinese Medicines in Wuhan to introduce the relevant procurement rules of the National Alliance of Proprietary Chinese Medicines and solicit opinions and suggestions from enterprises. In September last year, the Hubei Provincial Medical Insurance Bureau issued the "National Procurement Announcement of the Alliance of Proprietary Chinese Medicines", and 23 proprietary Chinese medicines in 9 categories will enter the first batch of proprietary Chinese medicines.
Liao Zangyi said that at present, the centralized procurement of drugs has covered chemical drugs, proprietary Chinese medicines, and biological drugs; While doing a good job in the landing of spinal consumables and the start of artificial joints, through the procurement cooperation of provincial alliances, it is recommended that the pharmaceutical industry needs to prepare for response and expected management in advance, and reduce the price at a reasonable price in exchange for the corresponding market share.
Jiang Changsong believes that the centralized procurement system of drugs has developed to a volume-based procurement model with the general idea of "national organization, alliance procurement, and platform operation" and the basic principles of "procurement with quantity, linking volume and price, integrating recruitment and procurement, ensuring use, ensuring quality, ensuring supply, and guaranteeing payment", which will become the most mainstream drug procurement model in China before 2025.