The Fourth Batch Of National Drug Centralized Purchase Was Launched, And The National Standing Committee Deployed The Normalization And Institutionalization Of "Procurement With Quantity"

On the evening of January 15, according to CCTV, at the executive meeting of the State Council held on that day, the reform of centralized drug procurement with quantity became an important topic. The executive meeting of the State Council mentioned that it was necessary to further promote the reform of centralized drug procurement with quantity, and to reduce the burden of medical treatment for the masses by means of normalized and institutionalized measures. By the end of last year, the average price reduction of drugs covered by procurement was 54%, and more than 53 billion yuan was saved every year. At the same time, the meeting made it clear that the fourth batch of centralized procurement will be carried out in the near future, and the scope of centralized procurement of medical consumables will be expanded.

"According to the basic and clinical principles, generic drugs, original research drugs and reference preparations all participate in the procurement under the common name, and the selected enterprises, drugs and consumables are generated through fair competition in quality and price. In addition, centralized procurement with volume should reduce the burden for patients and take into account the reasonable profits of enterprises. " Meeting requirements.

In addition, on January 15, the joint procurement office of national organization for centralized drug procurement and use issued the announcement of "national centralized drug procurement document (gy-yd2021-1)", and the fourth batch of centralized drug procurement and use work of national organization was officially launched, involving 45 varieties, and the bid opening was held on February 3.

The fourth batch of procurement with volume has been officially started on December 25 last year, and it is expected that two batches of centralized purchase will become the normal in the future. In fact, at the national medical insurance work conference held on January 12, Hu Jinglin, director of the State Medical Insurance Bureau, said that centralized bidding and procurement of pharmaceutical consumables should be implemented in a systematic and normalized way, so as to continuously reduce the burden of medical treatment for the masses, and guide the pharmaceutical industry to form a new situation of clean air and clean air.

According to Geng Hongwu, general marketing consultant of Jiuzhoutong, since its establishment, the National Medical Insurance Bureau has taken centralized procurement with quantity as the breakthrough point, and has solved the problem of unreasonably high price which has not been solved in the past 20 years by the medical reform, and has promoted the direct settlement of medical insurance and compressed the circulation links. The level of policy guidance channel is reduced, and the structure is flattened, which becomes the transformation direction of medical channel. "The original sales model dominated by gold sales has been completely subverted, and channel marketing will become the main sales mode of generic drugs in the future."

The fourth batch of procurement with quantity started

The above announcement shows that the fourth batch of centralized procurement with volume involves 45 varieties.

At the same time, the above announcement also clearly stipulates the agreed purchase quantity of each variety in the first year: if the actual number of selected enterprises in the country is 1, 50% of the calculation base of the agreed purchase amount in the first year; if the actual number of selected enterprises in the country is 2, 60% of the calculation base of the agreed purchase amount in the first year; if the actual number of selected enterprises in the country is 3, 70% of the calculation base of the agreed purchase amount in the first year; and If the number of internationally selected enterprises is 4 or more, 80% of the calculation base of the agreed purchase volume in the first year.

Among them, voriconazole, norfloxacin, terbinafine, cefprozil, levofloxacin, sodium hyaluronate eye drops (containing 0.1% and 0.3% concentration) and bivalirudin for injection in the first year were determined according to the following rules: the actual number of enterprises selected in China was 1 40% of the calculation base of the agreed purchase volume in the first year; 50% of the calculation base of the agreed purchase volume in the first year if the actual number of selected enterprises in the country is 2; 60% of the calculation base of the agreed purchase volume in the first year if the actual number of selected enterprises in the country is 3; 70% of the calculation base of the agreed purchase volume in the first year if the actual number of selected enterprises in the country is 4 or more.

Shi lichen, head of Beijing Dingchen medical consulting and management center, pointed out to the 21st century economic reporter that ensuring the purchasing quantity is the basis of purchasing with quantity, and only enterprises have the motivation to participate.

Previously, the medical insurance expert who was called "soul bargaining" by netizens also clearly mentioned: "now it is our whole country to negotiate with you."

For a long time, the problems of separation of bidding and purchasing, decoupling of quantity and price, and insufficient competition exist in the field of centralized drug procurement in China, which leads to the virtual high price of drugs. National pilot drug centralized procurement with quantity, following the market-oriented drug price formation mechanism, through the signing of dosage contract to obtain the ideal price and promote drug price reduction.

Professor Hu Shanlian of School of public health of Fudan University believes that there is monopoly purchasing power in the drug market, and centralized bidding and purchasing of drugs means that the medical insurance bureau purchases drugs from the perspective of consumers on behalf of the majority of patients, forming a monopoly market for consumers' purchase; this purchase is a strategic purchase, an active purchase based on health results and performance-based payment, including a signing mechanism And payment methods.

According to the progress of procurement with quantity released by the National Health Insurance Bureau, in April 2020, the actual purchase volume of 25 selected drugs reached 2.4 times of the agreed purchase amount after the expiration of the "4 + 7" pilot project in April 2020. The new procurement cycle has been successfully carried out and has been integrated into the national pilot expansion. The nationwide expansion of the pilot project has been implemented for more than 7 months, and the procurement progress has reached 1.6 times of the agreed procurement volume.

Before the start of the second batch of centralized mining, new crown pneumonia was encountered. Except for Hubei, other provinces implemented the selection results on time. In the past four months, the procurement implementation progress has reached 59%. Recently, the third batch of centralized drug procurement organized by the state has been launched.

Purchase with quantity into a normalized system

Centralized drug procurement cuts off the interest chain of drug circulation, standardizes the behavior of drug procurement and distribution, helps to reduce the burden of drug costs and ensure the safety of drug use.

The executive meeting of the State Council pointed out that by the end of last year, the average price reduction of the drugs covered by the procurement was 54%, and more than 53 billion yuan was saved every year. In addition, according to the calculation of the State Medical Insurance Bureau, the annual drug cost of 112 varieties collected in three batches decreased from 65.9 billion yuan to 12 billion yuan according to the agreed purchase quantity; according to the reimbursement proportion of 60%, it can save 21.6 billion yuan for patients and 32.3 billion yuan for medical insurance fund.

According to a survey conducted by Jin Chunlin, director of Shanghai Health and health development research center, the most intuitive impact of volume purchase is that the drug price drops significantly, with an average decrease of 51.75%, and the highest drop of 96%, which makes the drug return to the function of treatment. The society gives positive feedback on the purchase with quantity, 72.10% of the interviewed doctors approve of the pilot policy, and the medical institutions with lower level approve the pilot policy 79.21% of the doctors interviewed said that the proportion of the drugs used in the bid was greatly increased, and the bidding amount was 1.83 times.

The meeting of the State Council pointed out that it is necessary to further promote the reform of centralized drug procurement with quantity, and to reduce the burden of medical treatment for the masses with normalized and institutionalized measures. First, according to the basic and clinical principles, we will focus on bringing the drugs with large consumption and high purchase amount in the list of basic medical insurance drugs into the scope of procurement, and gradually cover all kinds of drugs and medical consumables that are clinically necessary and reliable in quality. Second, generic drugs, original research drugs and reference preparations all participate in the procurement with common names, and the selected enterprises, drugs and consumables are generated through fair competition in quality and price. Medical institutions should ensure priority in the use of selected drugs. Third, centralized procurement with volume should reduce the burden of patients and take into account the reasonable profits of enterprises. Medical institutions should be given incentive for saving medical insurance expenses according to regulations, so as to make patients, pharmaceutical enterprises and medical institutions benefit from this reform.

As early as September last year, the State Council held a forum on centralized procurement of drugs and high-value medical consumables, and high-level officials demanded to consolidate and improve the institutional achievements, form a more standardized system, and promote the normalization and institutionalization of centralized drug procurement work organized by the state.

Ping An Securities Analysis believes that the fourth batch of procurement work with volume has been started, and two batches of centralized purchase every year has become the norm. According to the average decrease of 53% in the second and third batch of centralized purchase, it is speculated that the average price drop of the fourth batch of centralized purchasing drugs is still more than 50%. "The normalization of centralized purchasing will bring about the reconstruction of the pharmaceutical competition pattern, which is expected to accelerate the domestic substitution of the varieties dominated by imported pharmaceutical enterprises, and bring opportunities for domestic pharmaceutical enterprises."

Geng Hongwu pointed out that with the further development of volume procurement, the original "Gaogao Shang" generic drugs had to be put down and become "general" drugs with high quality and low price. Among the 112 varieties purchased in three batches and four rounds, the minimum unit price of 253 product specifications is less than 1.00 yuan; the minimum unit price of 88 product specifications is less than 0.10 yuan, and even some products have entered the era of "one cent". The original sales model dominated by gold sales has been completely subverted, and channel marketing will become the main sales mode of generic drugs in the future.