The "Soul Bargaining" video sparked heated discussions. Many representatives and committee members offered suggestions and suggestions
on how to explore a more scientific drug quotation mechanism.
In December last year, the video of "soul bargaining" between medical insurance negotiators and representatives of pharmaceutical companies once sparked heated discussions. I saw hope.
In February this year, the seventh batch of national centralized drug procurement was officially launched.
This year's government work report also pointed out that my country will continue to improve its medical and health service capabilities, promote centralized procurement of drugs and high-value medical consumables, and strengthen the protection of rare disease drugs.
A number of delegates were interviewed by reporters from Beijing Youth Daily, and offered suggestions on the issue of centralized drug procurement and orphan drug use.
Ge Minghua, deputy to the National People's Congress
It is recommended that the government further expand the scope of the collection of varieties
Ge Minghua, deputy to the National People's Congress and president of Zhejiang Provincial People's Hospital, believes that centralized drug procurement has brought tangible benefits to patients, and also allowed hospitals and doctors to devote more energy to improving medical technology and service levels.
He believes that centralized procurement can also force companies to focus more on improving product quality to cope with competition.
He suggested that the government further expand the scope of centralized collection, and at the same time actively support enterprise innovation, especially original research.
As the president of Zhejiang Provincial People's Hospital, Ge Minghua has direct contact with the centralized drug procurement work, which he very much agrees with.
Ge Minghua believes that a significant change in the hospital after the centralized drug collection is that it is easier for the hospital to manage medical behavior and medical quality, the problem of drug abuse will be further reduced, the compliance of doctors with treatment standards and guidelines will be stronger, and the treatment will be more standardized. This further reduces the burden on patients.
At present, many types of drugs included in centralized procurement are for basic medical needs.
Ge Minghua believes that any work needs to be done step by step. "Centralized procurement starts with common diseases, which can benefit more people and meet the basic needs of policies."
After a period of exploration in centralized procurement, "the centralized procurement of high-priced medicines has also begun, which will definitely benefit more and more ordinary people, and the radiation coverage will be wider."
Some people worry that after the price of medicines drops, will manufacturers cut corners and lead to the inability to guarantee the quality of medicines?
Ge Minghua believes that after the centralized procurement of drugs, the decline in drug prices will lead to a smaller profit margin for a single or single box of drugs, but centralized procurement can achieve profit based on quantity.
At the same time, centralized procurement not only pays attention to price, but also pays attention to quality. After centralized procurement, enterprises will focus more on improving quality in the face of more intense competition.
In order to ensure the orderly supply of medicines, he also suggested that the government and enterprises should establish more communication mechanisms and explore a more scientific quotation mechanism.
Ge Minghua especially suggested that the relevant government departments should further strengthen supervision, "Drugs are used to save lives, and the quality is very important, and it should not be sloppy."
What is the next step in the layout of centralized drug procurement?
Ge Minghua suggested that in the future, pharmaceutical companies need to strengthen the awareness of innovation and development, increase investment in scientific research, make full use of the advantages of disease sources, actively carry out domestic and even international multi-center clinical research, and accelerate the launch of new products.
Government departments and medical institutions need to further support the construction of national brands, strengthen positive interactions with enterprises, and make concerted efforts for more Chinese pharmaceutical companies and leading international pharmaceutical companies in China.
Ma Jin, member of the National Committee of the Chinese People's Political Consultative Conference
It is recommended to carry out random inspection of routine drug collection
Ma Jin, a member of the National Committee of the Chinese People's Political Consultative Conference and the full-time vice chairman of the Shanghai Municipal Committee of Zhigong Party, said in an interview with a reporter from Beiqing Daily that the centralized drug procurement system can squeeze out the price water and promote the three aspects of medical treatment, medicine and medical insurance to go in the right direction. .
Ma Jin said that for pharmaceutical companies, they should optimize the market through centralized procurement, keep good companies, and eliminate some companies with relatively poor production capacity and product quality.
From the perspective of medical insurance, after the price reduction of drugs, the purpose of strategic purchase of medical insurance has also been realized, and patients can buy cheaper and better quality drugs.
Therefore, centralized procurement has indeed promoted the reform of my country's medical system and realized the "three-industry linkage". Medical care, medicine, and medical insurance are all moving in the right direction, allowing patients to spend less money to obtain more and better medical services. .
Regarding the problems that may arise after centralized procurement, Ma Jin believes that, first, some companies may be out of stock because their production capacity cannot keep up. In order to increase production capacity, in order to ensure production after winning the bid, the pharmaceutical factory may acquire and merge other companies through acquisitions and mergers. To help it produce, it involves quality supervision, and there can be no different quality before and after bidding.
"My proposal this year also mentioned that random inspections should be conducted on routine centralized procurement to ensure the quality of drugs."
Second, doctors' diagnosis and treatment habits may change. There are both good changes and some disadvantages.
Avoiding excessive medical treatment is positive, but will doctors choose more expensive alternative treatments that are not included in centralized collection?
This requires further improvement of supervision, and it is not possible to "press the gourd and float the scoop".
Third, centralized procurement requires guaranteed usage. At present, it is required to estimate the total procurement amount based on 60% to 70% of the total annual drug consumption of public medical institutions.
Due to the complexity of the disease, some patients do need to use non-collective medicines. At this time, different hospitals should have different regulations to solve the contradiction between universality and specificity.
Finally, the purpose of centralized drug procurement is to reduce the burden of medication for patients, and at the same time to ensure that their health is also improved, and long-term follow-up studies are required.
After the collection, what is the impact of this drug on the patient's health?
This work should be done in order to further improve the policy.
In terms of drug use for rare diseases, Ma Jin believes that the problem of "orphan drugs" cannot be solved only by the government and medical insurance, and social forces need to be used to solve the problem of expensive drugs for rare patients through multi-channel financing. 'Fund to ease the financial burden on patients'.
Fang Laiying, member of the National Committee of the Chinese People's Political Consultative Conference
Coordinate commercial insurance and other forces to solve the high price of rare disease drugs
"The centralized drug procurement is definitely a good thing for the common people." When talking about the centralized drug procurement, Fang Laiying, member of the National Committee of the Chinese People's Political Consultative Conference and vice president of the Chinese Hospital Association, "liked" the system.
He believes that in addition to reducing drug prices, centralized drug procurement can also promote the professional development of drug companies, drive corporate innovation, and help improve the ability to pay for medical insurance.
From the perspective of the use of centralized drugs, Fang Laiying believes that this can also encourage doctors to use these products more.
"Many of the medicines collected are first-line clinical medicines, which help to promote the scientific use of medicines in hospitals."
From the perspective of medical insurance funds, the decline in drug prices has actually improved the ability to pay medical insurance.
Fang Laiying gave an example: "For example, 100 yuan can only pay for two boxes. After the drug price is adjusted, 100 yuan can pay for three or four boxes. At the same time, the saved funds can gradually cover more drugs."
How can the quality of medicines be effectively guaranteed after the price of medicines has dropped?
Regarding this issue, Fang Laiying said that the existence of drug regulatory authorities will play this role. If the drug does not meet the national standards, it cannot be marketed.
Of course, "the ten fingers are not the same size", even if the consistency evaluation is passed, there must be quality differences between different products, which is inevitable, "but we emphasize that when the quality of drugs meets the national quality standards, This is acceptable, and the quality is guaranteed by the drug regulatory authorities."
At present, the price of rare disease treatment drugs is generally high, and there are many voices calling for the inclusion of rare disease treatment drugs in medical insurance, which is also a new problem that may be faced by medical insurance and centralized drug procurement.
Fang Laiying said that despite the medical insurance for serious illnesses, with the progress of the industry, new medicines and treatments will continue to emerge in the next few years, and these medicines and treatments cannot be cheap as soon as they appear.
In general, the use of drugs for rare diseases is very low, and it may not be possible to form large-scale production and sales in a certain region.
How to solve the problem?
Fang Laiying suggested: "It may not be realistic to rely on national medical insurance alone. When thinking about how to allow patients to get these services earlier, we can mobilize the power of society and consider coordinating national medical insurance, commercial insurance, various charitable funds, and public welfare organizations. Design, supplement from different angles, so that the latest scientific research results can benefit ordinary patients as quickly as possible, which requires new policy design, and I hope that some departments can take the lead in research."
Lv Hongbing, member of the National Committee of the Chinese People's Political Consultative Conference
Longer tolerance period for new drugs independently developed by enterprises
"It is recommended to refine and optimize the national centralized procurement policy, and give enterprises special attention and treatment for independent research and development of new drugs, especially biopharmaceuticals." During the National Two Sessions, a reporter from Beiqing Daily interviewed Lv Hongbing, member of the National Committee of the Chinese People's Political Consultative Conference and vice president of the All-China Lawyers Association.
Lv Hongbing said that for a period of time, the stock prices of listed biopharmaceutical-related companies have continued to decline.
Due to the long process of research and development of independent innovative drugs and the high investment cost, it is said in the world that it takes "10 billion US dollars" to develop an innovative drug, and the investment in innovative drugs has the risk of "nine deaths".
"If an innovative drug is put on the market, it will face a situation of high returns that cannot be obtained from high investment and high risk, which will greatly dampen the enthusiasm of venture capital and technological innovation. If these problems are not solved at the institutional level, it will go on like this in the long run. , will restrict a country's progress and development in this field."
He suggested that more detailed policies and rules for centralized procurement should be formulated that are conducive to fully protecting and promoting my country's independent innovative drug research and development.
"For enterprises that meet cutting-edge innovative technologies to independently develop new drugs, especially biomedicine, a longer tolerance period will be given, and the enterprise will decide whether to enter the centralized procurement catalogue and the price discount space for entering the centralized procurement catalogue, so as to encourage more market players. Invest in the development of innovative drugs and encourage global scientific and technological talents to gather in Chinese innovative drug companies."
He also suggested, "In the aspect of innovative drugs, full consideration should be given to the initial investment of drugs with long R&D cycles and large R&D investment, and when purchasing and pricing, from the perspective of recovering investment within a certain period of time and obtaining certain benefits, encourage and support Innovative pharmaceutical companies.”
In addition, Lv Hongbing said, "In the future world competition pattern, the competition in the field of life and health is not only related to the life and health of the people's livelihood, but also to the country's economic development and social progress, among which the innovation and development of biomedicine and biotechnology are the key. "
Stem cells and gene technology are indispensable technological cores for the innovation and development of biomedicine.
"With the improvement of people's living standards, the aging society has brought about a high incidence of tumors and degenerative diseases, and the development speed and technical capabilities of the above-mentioned technologies are related to the cost of treatment of these diseases and the availability of medicines, and will greatly affect my country's international reputation. Competitiveness and competitive advantage in the field of biomedicine.”
Yu Xinwei, member of the National Committee of the Chinese People's Political Consultative Conference
It is recommended to start the national centralized procurement of dental implant consumables and include them in medical insurance
For a long time, the high cost of dental implants has caused many dental patients to say "meat pain".
Yu Xinwei, member of the National Committee of the Chinese People's Political Consultative Conference, vice chairman of the Guangzhou Municipal Committee of the Chinese People's Political Consultative Conference, and chairman of the Guangzhou Municipal Committee of the Chinese Revolutionary Committee, paid special attention to the price of dental implants, and suggested that the national centralized procurement of dental implant consumables should be started and included in medical insurance to promote the high-quality development of my country's oral industry chain.
At the beginning of this year, the executive meeting of the State Council decided to normalize and institutionalize the centralized procurement of medicines and high-value medical consumables, and especially proposed centralized procurement of dental implant consumables at the provincial level, but the current progress of inter-provincial joint centralized procurement is slow.
Yu Xinwei analyzed that the abnormally high price of dental implants is mainly caused by the procurement mode, that is, the bidding and circulation links are pushed up, the proportion of imported brands is high, and there are many circulation links. Twice, forming a distorted dental implant price system.
The purpose of centralized procurement is to remove middlemen and squeeze out price moisture by exchanging quantity for price.
At present, the inter-provincial alliance oral implant system centralized procurement work led by Sichuan Province has completed information declaration and hospital historical consumption reporting, requiring all public hospitals to fill in historical procurement data, but the actual progress cannot be carried out as originally planned.
In addition, in terms of industry development, Yu Xinwei found that dental implant consumables have become a "stuck neck" area that inhibits the development of my country's oral industry.
Due to the exemption from medical insurance and centralized procurement control, the dental implant consumer medical industry has developed rapidly, forming an industrial chain of equipment consumables - information services - medical terminals.
However, the high price has inhibited the development of the market, the competitiveness of domestic equipment and consumables manufacturers is weak, and it is difficult for the dental industry chain to develop on a large scale.
In response to the above problems, Yu Xinwei suggested that the national centralized procurement of dental implant consumables should be started and included in the national medical insurance plan.
At the same time, it can promote the national overall reform of medical insurance, give full play to the role of commercial oral medical insurance, and national centralized procurement can prevent the reform from being stranded.
"It is also very important to strengthen the combination of production, education and research, and to encourage the integrated development of oral science and emerging industries." Yu Xinwei said that it is necessary to speed up the capture of dental implants, orthodontic devices and dental imaging equipment and other fields, and to deploy new dental materials and new technologies nationwide. , new manufacturing and other scientific research work, to promote the research and development and quality improvement of domestic dental implant consumables.
In terms of fees, Yu Xinwei proposed to improve the standards of oral medical services, accelerate the standardization and branding of outpatient management of oral terminal services, encourage the development of high-end dental services, standardize the charging standards of medical institutions, and improve the corresponding laws and regulations in each link of the dental industry chain. .
Text/Reporter Zhang Yuemeng Jiang Ruojing Li Zewei Meng Yaxu