Patients with stable clinical transition benefit the most-Observation in the first week of “landing” of centralized coronary stents
Xinhua News Agency, Beijing, January 8th. Title: Patients with stable clinical transition benefit the most-Observation of the first week of “landing” of centralized coronary stents
Xinhua News Agency reporters Qu Ting, Shuai Cai, and Ma Xiaoyuan
At 0:19 on January 1, the patient successfully implanted a coronary stent worth 590 yuan at the First People’s Hospital of Chenzhou City, Hunan Province. From 0:00 on that day, all 3 emergency operations at Fuwai Hospital of the Chinese Academy of Medical Sciences used centralized collection stents... As of the 7th, coronary stents that have fallen below 1,000 yuan have landed in 18 provinces, autonomous regions and municipalities including Beijing, Tianjin, Hunan, Shanxi, and Xinjiang (including the Corps).
The reporter learned that despite the sharp drop in the price of stents, the amount of percutaneous coronary intervention (PCI) performed by medical institutions in many places has not seen a significant increase. Clinicians generally report that the product transition is stable and patients benefit most.
How does the patient feel with the cheap stent?
Don't worry?
Uncle Li, 63, from Beihu District, Chenzhou City, was rushed to the "Chest Pain Center" of the First People's Hospital of Chenzhou City on December 31, 2020 due to sudden chest pain. He was sent to the catheterization laboratory at 23:55 for coronary angiography. , Was diagnosed with severe stenosis of the left anterior descending coronary artery, which requires surgical treatment as soon as possible.
After sufficient preparation, at 0:19 on January 1, 2021, Wang Zhonghua, the director of the Department of Cardiology of the hospital, implemented coronary stent interventional therapy for him.
The coronary rapamycin-eluting drill-based alloy stent system it placed was produced by Shanghai Minimally Invasive Medical Devices Co., Ltd., and the price was reduced from 7,200 yuan to 590 yuan after the national centralized procurement.
The operation was successfully completed, and Uncle Li became the first patient group to feel the benefits of the national medical reform in the New Year.
On New Year's Day alone, the First People's Hospital of Chenzhou City implemented "hundred-yuan" low-cost coronary stent interventional treatment for 8 patients.
"Five years ago, I implanted two stents in Changsha due to a heart attack. At that time, one stent was worth 10,000 yuan. This time I also put two stents. This alone saved 13,000 yuan." Li Uncle told reporters.
According to the centralized procurement rules, the 10 coronary stents selected in the first batch of national centralized procurements were set on January 1st.
The average price of this batch of selected brackets dropped from about 13,000 yuan to about 700 yuan, of which the highest quotation was 798 yuan and the lowest was 469 yuan.
The reporter learned from the National Medical Security Administration that as of January 7, centralized procurement stents have been deployed in 18 provinces, autonomous regions and municipalities including Beijing, Hunan, and Shanxi. The remaining provinces will also be deployed in January.
The local inventory of selected products in the first batch of 18 provinces, autonomous regions, and municipalities reached an average of 33% of the agreed procurement volume, which can meet the first month's use needs of medical institutions.
Regarding the quality of stents that patients are most concerned about, Zhang Tiejun, director of the Joint Procurement Office of High-Value Medical Consumables of the National Organization and deputy director of Tianjin Medical Security Bureau, said that there have been targeted "quadruple" safeguards for centralized procurement. The stability of the stent quality can be guaranteed".
The first guarantee is that as a "third-class medical device", any adjustments to raw materials and production processes must be submitted to the State Food and Drug Administration for approval and strict inspection; the second guarantee is that the national centralized procurement adopts "registered The “certificate” bidding is equivalent to clarifying the corporate responsibilities of each product; the third level of guarantee is the rapid action of the competent departments, and the key supervision of the entire process from production, sales, and use has been deployed; the fourth level of guarantee is the newly established price and The credit evaluation system for investment promotion and procurement links product quality with corporate credit evaluation. Therefore, the quality of centralized procurement stents has a long-term and stable regulatory closed loop, and patients can use it with confidence.
The clinician "sighed with relief" seeing the effect of centralized procurement
Coronary stents are cheaper, will they focus on releasing surgical needs?
The answer should be divided into long-term and short-term perspectives.
"The usage situation has not changed much in the past few days, including the patient rate and the amount of surgery." Wei Shoudong, director of the 15th Ward of the Department of Cardiology, Shanxi Cardiovascular Hospital, said that there are indeed some patients who had undergone surgery years ago. , It’s the case that waited until January 1, but this case must first meet the surgical safety indications. The clinician will communicate and explain with the patient, and the operation will never be delayed.
As the leading cardiovascular hospital in China and the world in the number of cardiac interventions and thoracotomy operations, Fuwai Hospital is one of the "windows" for observing the clinical use of centralized coronary stents.
"Of the 10 products that won the bid, our hospital has 7 types, which are basically used in our hospitals, both domestically produced and imported. The stent model is not an outdated product that everyone is worried about." Fuwai Hospital Vice President Yang Weixian said that in general, these batches of centralized procurement stents are products that are relatively mature in clinical use and can basically meet clinical needs.
"At present, the product switching is relatively smooth and the patients are satisfied. We are relieved." She said that since the centralized procurement stent has just begun to be fully used after New Year's Day, more feedback from clinicians is needed.
As for the release effect of low-cost stents on surgical demand, Yang Weixian believes that in the long run, it will not necessarily blow out.
Because there are many factors that cause the overall low proportion of coronary stents in my country, in addition to the price problem, they also include the lack of operation time conditions in remote areas and insufficient primary medical technology.
After landing, have the "two things" that the deans worry about smoothly?
"As a user, what we are actually most concerned about is whether the products that won the bid can meet our clinical needs, whether we usually use stents that are of good quality, and are better to use." Yang Weixian said, this time the collection "Basically met our expectations."
It is understood that the landing of the centralized procurement stent in the hospital is not as simple as changing the price tag, but has to go through procedures such as returning the original price product and repurchasing the new price product.
This means that the zero-point price switch on January 1st, the stocking of products, and the centralized procurement stents provided for patients are all new products. The hospital has to pay a lot of manpower and material resources to ensure that patients will not feel any changes or suffer any loss.
Obviously, there will be some hospitals that are unfamiliar with the selected products or have never used them, and there will be a lot of pressure to switch in a short time.
A number of deans told reporters that after the centralized procurement stent was put on the ground, the two things they were most worried about were whether the patient's needs could be met, and the second thing was whether the subsequent policy support for centralized procurement could keep up.
The core of purchasing with quantity is to really "carry quantity", otherwise the reform will not be sustainable.
The “quantity” of the centralized procurement stents covered more than 70% of the intended use by medical institutions in various regions, which is almost 1.07 million.
How to ensure that both the "quantity" is carried and the blade is used?
Yang Weixian said that Fuwai Hospital will adopt more accurate assessment methods, such as organizing clinicians and consumable management personnel to communicate with each other every one or two weeks, etc., to grasp which ones are used more and which ones are not used. On the premise of meeting the clinical needs of patients, the centralized procurement stent task is completed on schedule.
At present, conventional stent implantation surgery includes three medical service charges. The national average charge standard is: coronary angiography 2,240 yuan, balloon expansion 2,600 yuan, stent placement 3680 yuan, a total of about 8,500 yuan.
This does not include the cost of various inspections.
Therefore, as far as the charging standard for coronary stent implantation is concerned, it basically reflects the labor value of medical staff.
Of course, there are also some areas where the charging standards are lower and will be adjusted appropriately at the right time.
For example, the total price of the three medical services for coronary stent implantation surgery in Beijing was originally 5650 yuan, but it was raised to 6670 yuan from January 1 this year.