Centralized procurement with quantity to reduce the burden of seeing a doctor

  Recently, the results of the fifth batch of nationally organized drug collections were officially announced. 61 drugs were successfully purchased, with an average price reduction of 56%.

These centralized procurement and price reduction drugs include drugs for common diseases such as hypertension, coronary heart disease, diabetes, and chronic diseases, as well as drugs for major diseases such as lung cancer, breast cancer, and colorectal cancer.

In October of this year, patients are expected to use this batch of reduced-price centralized medicines, and the burden of medical treatment will be further reduced.

  High-value medical consumables have also begun to be purchased in a centralized manner. Heart stents have become the first centralized procurement product, and the average price has dropped from 13,000 yuan to about 700 yuan.

At the same time, the medical insurance catalogue is adjusted every year, and some expensive new drugs and life-saving drugs enter the medical insurance through medical insurance negotiations.

These measures have reduced the burden of medication for the people by hundreds of billions of yuan each year, and at the same time instigated the "three-medicine linkage" reform, which greatly enhanced the people's sense of gain, happiness, and security.

  Centralized drug procurement, a cumulative reduction of 150 billion yuan in expenditure

  Uncle Hong, 76, from Xiamen City, Fujian Province, has been suffering from diabetes for more than 20 years and also suffers from high blood pressure. He started taking Baitangping more than 10 years ago. It costs 3 boxes a month and each box costs more than 90 yuan. It costs 3300 yuan a year. .

In August last year, when Uncle Hong went to the hospital to prescribe the medicine, he found that the price of the medicine was cheaper, only 5.42 yuan per box.

"I couldn't believe it at the time. It was so cheap. Thanks to the country's good policies, which helped us diabetic patients save money." Uncle Hong said.

  Baitangping is a commonly used hypoglycemic drug, but its price is relatively high. Diabetic patients need to take it for a long time, and the cost burden is relatively heavy.

In January last year, the second batch of centralized drug procurement organized by the state successfully purchased the drug, which greatly reduced the burden of medication for diabetic patients.

  Like Baitangping, there are many drugs that benefit the people through centralized procurement, such as the original drug gefitinib for the treatment of non-small cell lung cancer, and the original drug oxaliplatin injection for the treatment of colon cancer.

Many large varieties of clinical drugs have achieved substantial price cuts, such as metformin, a commonly used diabetes drug, budesonide inhalation for bronchial asthma, entecavir tablets for chronic hepatitis B, and ceftazidime injection for anti-infective drugs.

The sharp price cuts of these drugs have benefited a large number of patients, especially patients with chronic diseases and tumors.

  Since December 2018, the state organized the “4+7” 11 cities to conduct pilot centralized drug purchases. my country has organized 5 batches of drug centralized purchases, and a total of 218 drugs have been successfully purchased.

A large number of medicines have reduced their prices through centralized procurement, with an average drop of more than 50%. The cumulative savings in medicine costs has exceeded 150 billion yuan.

The recently launched fifth batch of centralized procurement has set the record for the number and amount of drugs purchased, and the number of foreign-invested companies selected is also the highest ever for the country’s centralized procurement of drugs.

  Wu Ming, assistant to the director of Peking University Medical Department, said that from the current situation, the centralized procurement of medicines is a breakthrough in the reform of the compensation mechanism of public hospitals and the promotion of the "three-medicine linkage".

With the expansion of centralized procurement coverage, the continuous improvement of rules, and the coordinated efforts of supporting policies, the effect of volume procurement will become more and more prominent, and the four effects at the beginning of policy design will be gradually realized, namely, drug price reduction and quality assurance, and the transformation and upgrading of the pharmaceutical industry. , Deepen the reform of public hospitals, reduce the burden of medical security and increase efficiency.

  Price reduction of high-value medical consumables by more than 90%

  At 1:37 am on January 1, 2021, 76-year-old Ms. Xiang entered the catheterization laboratory of the Chest Pain Center of the First People's Hospital of Xiangtan City, Hunan Province due to chest pain for 4 hours, and performed emergency coronary angiography, intracoronary thrombolysis and stent implantation. In the operation, the heart stent collected by the state at a price of 798 yuan was used, becoming the first patient in Xiangtan City to enjoy the reduced price of heart stent collection.

  Coronary stents, commonly known as heart stents, are high-value medical consumables used in the interventional treatment of acute coronary heart disease.

As coronary heart disease has become a common disease in my country, acute myocardial infarction is more and more frequent. Although the price of heart stents is higher, the number of clinical use is increasing year by year.

On November 5, 2020, the state organized the first batch of centralized procurement of high-value medical consumables, and the heart stent became the first centralized procurement product.

After centralized procurement, 10 products were selected, and the average price dropped from 13,000 yuan to about 700 yuan, a drop of more than 90%.

One of the drug-coated stent systems (rapamycin), which has just been on the market for 3 years, reported the lowest price of 469 yuan, a decrease of 96%.

  This central procurement of heart stents is expected to save 11.7 billion yuan.

After the collection of heart stents, the collection of coronary dilatation balloons has been successively carried out in various places. The overall cost of heart stent implantation surgery has been further reduced, and the medical insurance reimbursement will further reduce the cost of patients.

  In the future, more high-value medical consumables will be included in the collection, benefiting more patients.

In June of this year, 8 departments including the National Medical Insurance Administration issued the "Guiding Opinions on Carrying out the National Organization of Centralized Procurement and Use of High-Value Medical Consumables" clearly pointed out that the national organization of centralized procurement of high-value medical consumables should be carried out to explore and improve the centralized procurement policy. , And gradually expand the coverage.

Recently, the National Organization for High-Value Medical Consumables Joint Procurement Office issued the "National Organization for Centralized Procurement of Artificial Joints (No. 1)" to conduct centralized procurement for the initial replacement of artificial total hip joints and initial replacement of artificial total knee joints.

  The centralized procurement of medicines and high-value medical consumables has greatly reduced the burden of patients' medical expenses.

And the benefits brought by centralized procurement are more than that.

The state organizes the coordination of medical insurance, health, drug supervision and other departments to work together to ensure that the prices selected in centralized procurement are implemented, so that the people can really use high-quality products at a better price.

  Negotiate access to lower the prices of innovative and patented drugs

  "Is it okay to drop another 4 cents?" In 2019, a video on the scene of national health insurance negotiations went viral. The negotiation drug mentioned in the video was dapagliflozin (Andatang) for the treatment of type 2 diabetes. The price of 5.62 yuan for this offer fell to 4.36 yuan.

  This situation abounds in the national medical insurance negotiation scene. A large number of big-name new drugs and expensive drugs have been negotiated to the lowest price in the world, such as the 100mg/10ml Sintilimab injection (Daboshu ), after medical insurance negotiations, the price dropped from 7838 yuan to 2843 yuan, a drop of more than 60%; the price of imported hepatitis C drugs fell by more than 80%, the lowest in the world.

  Since the establishment of the National Medical Insurance Administration in 2018, my country has carried out 3 consultations on access to the medical insurance catalogue.

In 2018, special negotiations on anti-cancer drugs were launched, and 17 drugs were successfully negotiated, with an average decrease of 56.7%, covering more than 10 cancer treatment drugs for the treatment of non-small cell lung cancer, chronic myelogenous leukemia, childhood acute lymphoblastic leukemia, and melanoma; In 2019, a total of 97 drugs were successfully negotiated. Among them, the price of 70 newly negotiated drugs decreased by an average of 60.7%, and the price of 27 renewed negotiated drugs decreased by an average of 26.4%.

Relevant drugs involve more than 10 clinical treatment areas such as cancer, rare diseases, hepatitis, diabetes, and cardiovascular and cerebrovascular diseases. In 2020, 119 drugs have been successfully negotiated, with an average price reduction of 50.6%. The drug payment standards have been determined simultaneously, and patient expenditures have been reduced by nearly 70%.

  The drugs negotiated for medical insurance are exclusive drugs, often innovative drugs and patented drugs, with high prices. Medical insurance takes advantage of strategic purchases. With the world's largest market of 1.36 billion insured persons, reasonable prices can be negotiated to greatly reduce the burden on patients.

According to statistics, compared with before the negotiation, through the dual effect of negotiation and medical insurance reimbursement, the cumulative reduction of patient expenditures in 2020 will exceed 80 billion yuan.

  In order to ensure that patients can buy, use and reimburse the negotiated drugs at the first time, in May this year, the National Medical Insurance Bureau and the Health Commission issued a "dual channel" policy in a timely manner, and negotiated drugs pass through designated retail pharmacies and designated medical institutions "dual channel" Carry out supply guarantee.

At present, two batches of lists of negotiated drug allocation institutions have been announced, and 19 and 97 negotiated drugs in the two batches of lists are allocated by 5,572 and 84,000 designated medical institutions respectively.

The National Medical Insurance Bureau has opened a public inquiry channel on the National Medical Insurance Service Platform (APP), and the list of institutions equipped with negotiated drugs will be dynamically updated.

  Recently, the "2021 National Medical Insurance Drug Catalog Adjustment Work Plan" was announced, marking the official launch of a new round of national medical insurance drug catalog adjustment work.

The negotiating access phase will take place from September to October. At that time, another batch of new drugs will be included in the catalog through price reduction negotiations. The benefits of patients will continue to expand and the burden on patients will be further reduced.

Our reporter Li Hongmei