Further lighten the burden of medication for the masses (authorized release)

  The General Office of the State Council has recently issued the "Opinions on Promoting the Normalized and Institutionalized Development of Drug Centralized and Volume Procurement" (hereinafter referred to as the "Opinions").

At the State Council’s regular policy briefing held on the 29th, Chen Jinfu, deputy director of the National Medical Security Administration, Wang Xuetao, head of the Department of Pharmaceutical Affairs of the National Health and Medical Commission, and Cui Hao, head of the Department of Drug Administration of the State Food and Drug Administration introduced the "Opinions". And the relevant issues were interpreted.

  The first three batches involved a total of 112 varieties, and the average price of selected products fell by 54%

  Centralized procurement of drugs in quantities has been carried out in my country for more than two years.

In November 2018, the National Medical Insurance Administration, in conjunction with the National Health Commission, the State Drug Administration and other relevant departments, organized a pilot project for centralized drug procurement, starting in 11 cities including Beijing and Shanghai.

Since then, it has expanded to the whole country, and has successively carried out the second and third batches of centralized procurement of drugs.

The fourth batch of centralized procurement has already begun.

  In the past two years, centralized drug procurement has explored the market price formation mechanism of "combination of recruitment and procurement, linked to volume and price". Companies independently participate in, offer independent quotations, and hospitals report volumes. The procurement volume and volume of each selected product are determined in the form of contracts. price.

Adhere to the working mechanism of state organization, alliance procurement, and platform operation.

Through the coordination of medical insurance fund advance payment, medical insurance payment and the selected price, and comprehensive measures such as incentives for the retention of medical insurance fund balances, an incentive and restraint mechanism for medical institutions and manufacturing enterprises has been established.

Combined with the corresponding monitoring, supervision and assessment mechanism, it ensures that the selected products are supplied in a timely manner, smoothly used, and reliable in quality.

  Chen Jinfu introduced that the first three batches of state-organized centralized drug procurement involved 112 varieties, and the average price of selected products fell by 54%.

As of 2020, the actual procurement volume has reached 2.4 times the agreed procurement volume, and the overall cost savings have exceeded 100 billion yuan, effectively reducing the burden on patients and improving the availability of medicines for the masses.

In accordance with the basic rules of centralized procurement by the state, local governments have also carried out centralized procurement of drugs. The provincial centralized procurement has reached 259 varieties, which can save 24 billion yuan each year.

  While reducing the burden of patients on medication, centralized drug procurement has improved the industry's ecology, facilitated the reform of public medical institutions, and improved the modernization of medical price management.

  "The new procurement system has effectively eliminated the disadvantages of sales with gold by means of mass procurement, squeezed out the gray cost space in the drug circulation process, and guided companies to transform marketing models. Some companies have significantly increased their R&D investment, which is conducive to the formation of a healthy atmosphere. The drug circulation and use links are also conducive to promoting the high-quality development of the pharmaceutical industry." Chen Jinfu said that centralized drug procurement has reduced drug costs, promoted the revenue structure of medical institutions, and promoted rational drug use.

  All public medical institutions participate in centralized procurement, gradually covering all kinds of drugs

  Promote the centralized and volume purchase of drugs in a normal and institutionalized manner, improve the price formation mechanism, and guide the return of drug prices to the benefit of the general public.

The "Opinions" make it clear that the focus is to include drugs with large amounts and high purchase amounts in the basic medical insurance drug catalogue into the procurement scope, and gradually cover all kinds of drugs.

All public medical institutions should participate in centralized procurement, and companies that meet the requirements in terms of quality standards, production capacity, and supply stability can participate.

  The procurement rules adhere to the integration of recruitment and procurement, and the linkage between volume and price. The medical insurance, health care, drug supervision, and industry and information departments have established a working mechanism of overall coordination and close cooperation, clarified national and local responsibilities, and carried out centralized drug procurement work in different levels.

Specifically, medicines that have passed the consistency evaluation enter the national organization for centralized procurement. Products other than the national organization are organized by local provincial platforms that meet the requirements for centralized procurement, including prefectures and cities in alliances organized under the guidance of the provinces.

  Chen Jinfu said: "There are strict rules for triggering the national organization of centralized procurement. Basically, the original research drug plus generic drugs that have passed the consistency evaluation can be included in the national centralized procurement scope. The focus of selection is the medical insurance catalog , Clinically necessary, high-dose and high-value varieties."

  In the future, with the normalization of centralized procurement, inter-provincial centralized drug procurement information will be interconnected and the formation of a unified and open nationwide centralized drug procurement market will be accelerated.

  Recently, my country has launched the fourth batch of nationally organized drug collection bids and implementation work. It is expected that the masses will be able to use the fourth batch of selected drugs in centralized procurement in May this year.

At the same time, the National Medical Insurance Administration will guide local governments to focus on large-scale and concentrated purchases of products that are expensive and widely used other than the centralized procurement of national organizations. Through national and local double-tier operations, the problem of clinical medicine and the price return of large varieties will be gradually solved. .

  Ensure the quality of selected Chinese medicines at reasonable prices and encourage medical institutions to use them first

  The "Opinions" clarified that medical institutions should give priority to the use of selected drugs based on clinical drug needs, and complete the agreed procurement volume in accordance with the procurement contract.

How to ensure that the selected drugs are given priority in medical institutions?

  To strengthen management and assessment, medical institutions set procedures in the doctor's prescription information system to preferentially recommend the selection of centralized purchases.

The "Opinions" put forward that "when there are many types of drugs covered by centralized procurement, the amount of money is large, and there are many medical institutions involved, it is necessary to carry out dynamic adjustment and evaluation of medical service prices, and adjust the prices of medical services in a timely manner if conditions are met." Centralize the procurement of saved medical insurance funds, and give medical institutions an incentive to retain the remaining balance in accordance with relevant regulations, so as to arouse the enthusiasm of medical staff to participate in the reform.

  Wang Xuetao introduced that all localities should seize the window period for lowering drug prices through centralized procurement and carry out the adjustment and evaluation of medical service prices. Those who meet the conditions should adjust and optimize medical service prices in a timely manner.

In this regard, Sanming City in Fujian Province has set out a path for reference.

  Chen Jinfu said: “The incentive policy for retention of surplus is basically reserved for medical institutions in accordance with the five-year plan for their internal income distribution and salary incentives. As far as I know, some large top three hospitals in Beijing give incentives in the amount of one million yuan. the above."

  Previously, the price of selected drugs from the national centralized procurement has dropped significantly. How to ensure that the quality of selected drugs is reliable and guaranteed?

Cui Hao said that the drug regulatory department implements key supervision on all drugs selected in centralized procurement, compacts the main responsibility of the enterprise, strengthens the responsibility of territorial supervision, and carries out full-coverage supervision and inspection and sampling inspection to ensure the quality and safety of the entire drug chain.

  In 2020, my country has also launched a centralized procurement of high-value medical consumables for coronary stents, saving an estimated cost of 11.7 billion yuan.

In the follow-up, mature products, competitive products, and products with quality control will be selected, one product, one policy will be adopted, election rules will be optimized, and centralized procurement will be gradually carried out in the field of medical consumables.

Our reporter Li Hongmei