The country's first centralized procurement of proprietary Chinese medicines with volume opened for bids, which is expected to save more than 2.6 billion yuan in drug costs each year——
The centralized procurement of proprietary Chinese medicines is here, and the price of medicines is "slim down" and the people "reduce the burden"
Our reporter Wang Weiyan
"The cost of western medicine has dropped a lot, and proprietary Chinese medicines have become the bulk of the cost of medicine." Zhang Jie, a citizen of Xiangyang, Hubei, sighed when sorting out the bills of medicine for the previous year.
It is the aspiration of many people to reduce the inflated cost of proprietary Chinese medicines.
At present, my country has successfully carried out centralized procurement of 6 batches of drugs, but Chinese patent medicines have not been able to carry out centralized procurement due to the special characteristics of difficult to evaluate the quality and many exclusive products.
Recently, Hubei Province led a coalition of 19 provinces to carry out the nation's first centralized procurement of proprietary Chinese medicines, with a procurement scale of nearly 10 billion yuan.
This means that the "water" in the future drug fee will be further squeezed out.
In this centralized procurement, 97 companies and 111 products were selected. The average price of the selected products decreased by 42.27%, and the largest decrease was 82.63%.
According to the calculation of the annual demand of the 19-province alliance, it is expected to save more than 2.6 billion yuan in drug costs each year.
Why is it difficult to carry out centralized procurement of Chinese patent medicines?
"There is no way for proprietary Chinese medicine to do centralized procurement." This is a view circulated in the industry before.
Since the reform of centralized drug procurement in 2018, the country has successfully carried out 6 batches of centralized drug procurement, covering mainstream drugs for chronic and common diseases such as hypertension, diabetes, hyperlipidemia, chronic hepatitis B, etc., but no Chinese patent medicine has been included in a large-scale centralized delivery. purchase.
Why is it difficult to carry out centralized procurement of proprietary Chinese medicines?
The person in charge of the Department of Medicine Price Bidding and Purchasing of the National Medical Insurance Administration explained that the particularity of Chinese patent medicines increases the difficulty of centralized procurement.
First, the quality of proprietary Chinese medicines is difficult to evaluate.
The consistency evaluation of the quality and efficacy of chemical drugs ensures the efficacy and safety of generic drugs, but Chinese patent medicines are generally made according to the inherited classic prescriptions, and there is no such thing as "original drugs" and "generic drugs".
The lack of support for consistent evaluation means that there is no unified and convincing judgment standard for the quality and efficacy of proprietary Chinese medicines.
Secondly, there are many proprietary Chinese medicine products.
According to the previous centralized procurement rules for chemical drugs, consumables and biological preparations, the drugs entering the centralized procurement are all non-exclusive products, which can ensure that they are fully competitive and have room for price reduction.
However, due to the academic and cultural characteristics of "one source and multiple streams" of traditional Chinese medicine, the classification and naming of proprietary Chinese medicines are complicated, and the formula and process will become new varieties with slight changes, so there are many exclusive products.
At present, there are more than 1,000 exclusive varieties of Chinese patent medicines in my country, and the competition is not sufficient. A few "exclusive" are even "tailor-made" to avoid market competition. This is another real dilemma in the centralized procurement of Chinese patent medicines.
How to reduce the price of exclusive Chinese patent medicine
In view of the characteristics, difficulties and controversial points of Chinese patent medicines, more than 70 clinical experts from medical institutions, pharmacy experts, university and industry policy experts formed an expert group to formulate a highly innovative centralized procurement plan for Chinese patent medicines to ensure high quality and good prices.
Since proprietary Chinese medicines are not supported by consistent evaluation, and the quality system is complex, the direct use of price competition is likely to lead to the controversy of "bad money eliminates good money".
To this end, this centralized procurement creatively adopts a comprehensive scoring method, with the price competition score accounting for 60% and the technical evaluation score accounting for 40%. , product quality and safety, etc.
"This takes into account not only the price factor, but also the supply capacity, credit, quality and other factors of the enterprise, which solves the problem of no quality evaluation system." The relevant person in charge of the Hubei Provincial Medical Security Bureau said.
It is worth noting that this centralized acquisition introduced the medical institution recognition index into the comprehensive score, and all second-level and above medical institutions (more than 24,000 in total) in the 19 provinces of the alliance participated in the evaluation, which is equivalent to conducting a full sample evaluation. , to improve the credibility of the quality efficacy score.
Aiming at the difficulty of too many exclusive products of proprietary Chinese medicines, this centralized procurement solves the problem through "merging common name procurement".
According to the method of centralized procurement of chemical drugs, the same generic drugs that enter the centralized procurement need to have multiple companies to compete through consistency evaluation.
According to the national sales value ranking of Chinese patent medicines, and combined with the varieties actually used by medical institutions, some large-value varieties were selected, and the drugs with different names with similar functions and indications were combined and collected, and 76 kinds of Chinese patent medicines in 17 product groups were finally determined. Purchasing Directory.
In addition, since the product prices of different companies are already low before the centralized procurement, there is not much room for reduction. In order to avoid the situation of "low-priced drugs being eliminated", the centralized procurement regulations this time will not deduct the same group of items. The "product with the lowest average daily treatment cost" will be given the opportunity for supplementary selection, so as to ensure the people's sense of gain and the enterprise's sense of fairness.
Drug prices "slim down" and people "reduce the burden"
After sorting out the published results, we can see that the collection of Chinese patent medicines includes 17 large varieties of Chinese patent medicines, such as Shenmai, Xuesaitong, Xueshuantong, Ginkgo biloba, Salvia miltiorrhiza, and Shuanghuanglian, 76 kinds of medicines, and 111 products.
"Clinically commonly used varieties and commonly used brands are basically selected. The vast majority of clinically commonly used products, especially those with a large purchase volume, have achieved a considerable drop." Director of the Price Recruitment and Procurement Office of the National Medical Security Research Institute Jiang Changsong said that the results of the selected price in this centralized procurement with volume have reached expectations.
This also means that the prices of standing medicines and commonly used medicines in many people's homes will be more "close to the people".
The reporter found that a certain brand of ginkgo leaves for the treatment of stroke had the highest decline, with a drop of 82.63%, and the price of each box (30 pieces) of ginkgo leaves dropped from 24 yuan to 4.17 yuan.
Another brand of Ginkgo biloba leaves from the same product group costs as low as about 0.08 yuan per piece.
Shuanghuanglian oral liquid for treating colds dropped by up to 55%, and the price per box (12 pieces) dropped from RMB 25 to RMB 11.25; Xuesaitong dropping pills for treating cerebral arteriosclerosis dropped by up to 55.01%, and a box (90 The price of pills) dropped from 30.32 yuan to 13.64 yuan, which can save patients from 2.78 yuan to 5.56 yuan a day.
"It is necessary to let the people enjoy lower drug prices, but also to purify the industry environment, so that drugs can return to the essential attributes of curing diseases and saving people." The person in charge of the Department of Drug Price and Bidding and Purchasing of the National Medical Insurance Bureau said that the reform of centralized procurement has changed from the initial chemical drugs. Centralized procurement, advanced to the centralized procurement of high-value medical consumables and biological preparations, and then to the centralized procurement of proprietary Chinese medicines, to build a "puzzle" for promoting the reform of centralized pharmaceutical procurement in an all-round way, saving more than 260 billion yuan in medical insurance and patient expenditures.
The National Medical Insurance Administration said that in the next step, the national centralized procurement of drugs will be normalized and institutionalized, and the scope of centralized procurement of high-value medical consumables will continue to be expanded to benefit more patients.