Promote the normalization of drug procurement

Release time:

2020-09-16

Promote the normalization of drug procurement
Promote the normalization of drug procurement
Clopidogrel bisulfate, trade name Plavix, was originally purchased at 108.29 yuan per box in Jiangxi. After the state organized centralized purchase of drug tape, it dropped to 17.81 yuan per box, a decrease of 83.55. Acarbose, the trade name Beitang Ping, was originally purchased at 56.6 yuan per box in Jiangxi. After the state organized centralized purchase of drug tape, it dropped to 5.42 yuan per box, a decrease of 90.42. The centralized procurement and use of drugs organized by the state has made these imported original research drugs, which have occupied a huge market share for many years and have remained high in price, finally "diving from the high platform", benefiting more patients.
In order to explore and improve the centralized drug procurement mechanism and the market-led drug price formation mechanism, reduce the burden of drug expenses on the masses, standardize the order of drug circulation, and improve the safety of drug use by the masses, the state launched a pilot project of centralized drug procurement at the end of 2018. Public medical institutions in four municipalities directly under the Central Government, including Beijing, and seven cities, including Shenyang and Guangzhou, as the main body of centralized procurement, formed a procurement alliance to carry out centralized drug procurement, clearly with volume procurement and price linkage, which is called the "4-7" pilot. In April 2019, 11 cities began to implement the results of the "4 7" selection, and the average price of 25 selected drugs fell by 52%, with the largest drop of 96%; in September 2019, the pilot was expanded to the whole country, and the 25 drugs were expanded. The average price dropped by another 25% compared with the "4 7" pilot; in January 2020, the second batch of countries organized centralized procurement and use of drugs, the average price reduction of 32 drugs was 53%, with a maximum reduction of 93%; in August 2020, the third batch of countries organized the centralized procurement and use of drugs, and 55 drugs were selected from 191 product specifications, with an average price reduction of 53%.
The centralized procurement of drugs organized by the state has led to a sharp reduction in the prices of high-priced imported drugs such as Plavix and Batang Ping, and the "patent cliff" of expired patented drugs has appeared for the first time in China. "Patent cliff" refers to the phenomenon that after the patent period of innovative drugs, the sales revenue drops sharply because of the emergence of generic drugs with the same or similar efficacy. In China, a large number of original research drugs remain at high prices for many years after the patent period, one of the important reasons is the inability to distinguish between quality levels, so it is difficult to ensure quality in the case of quality with the advantage of volume procurement to achieve price reduction. In the centralized procurement and use of drugs organized by the state, only the original research drugs and generic drugs that have passed the consistency evaluation are eligible to participate, and the quality standards are clarified. Agreed on the purchase volume of each drug, smooth the purchase of drug price formation mechanism, so each batch of drugs in the price reduction of more than half. At the same time, the direct settlement between the medical insurance fund and pharmaceutical enterprises will be promoted, the time for drug payment will be shortened to within one month, and the marketing and production costs of enterprises will be greatly reduced. Procurement, payment, use, incentives and other supporting policies are linked up, the price of drugs can be reduced, the supply of drugs can be up, bid farewell to the "only low price is to take" "winning the bid, see the light" and other phenomena. For the pharmaceutical industry, the state has come forward to organize "super group buying", so that pharmaceutical companies can no longer "lead gold to race horses", improve the ecological environment of the pharmaceutical industry, and help the pharmaceutical industry to transform from marketing-driven to innovation-driven.
Let the "4 7" small incision with volume procurement play a major role in promoting the reform of the "three medical linkage" of medical care, medical insurance and medicine. We should also constantly complete the policy, deal with several aspects of the relationship, and actively promote the normalization of centralized procurement.
Handle the relationship between price reduction and quality assurance. On the one hand, scientifically evaluate the production cost of drugs, and on the basis of ensuring safety and effectiveness, purchase the most cost-effective drugs to ensure that the "low-price winning bid" does not move towards the "low-price theory"; on the other hand, strengthen regulatory services to ensure that the bid-winning products After market expansion and capacity expansion, price reduction will not be degraded, and the consistency evaluation of generic drugs must not be turned into a "one-time evaluation" prepared by enterprises to pass evaluation ".
Deal with the relationship between market competition and industry promotion. We should not only improve the selection rules, increase the number of selected enterprises, force domestic pharmaceutical enterprises to transform, upgrade and innovate by guiding fair and orderly competition among enterprises, encourage the promotion of consistency evaluation of generic drugs, and force the realization of the "patent cliff" of expired patented drugs, but also scientifically agree on the market purchase volume of bid-winning drugs, reserve "air outlets" in the market, and avoid "instant suffocation" of non-bid-winning enterprises caused by 100% purchase volume ". At the same time, for drugs that are not included in the scope of national centralized procurement, further improve the provincial platform with volume procurement direction, orderly guide and release enterprise market expectations.
Handle the relationship between "cage" and "bird change. Centralized procurement with quantity has made the "cage" vacated, and the "birds" have to sing happily to realize "vacating cages for birds". For the saved medical insurance fund, it is recommended to award a certain proportion of the hospital to mobilize the enthusiasm of medical staff. At present, the National Medical Insurance Administration and the Ministry of Finance have issued the "Guiding Opinions on the Retention of Medical Insurance Surplus Funds in the Centralized Procurement of Drugs Organized by the State", clarifying the incentive policy for the retention of balances, and hope to implement it as soon as possible.
Handle the relationship between conforming to the expectations of the masses and scientific and rational drug use. At present, there are 112 kinds of drugs purchased by the state in three batches, accounting for only 4.24 of the 2643 kinds of drugs in the national medical insurance catalogue. On the one hand, we should comply with the people's expectation of using good drugs, step up efforts to promote the consistency evaluation of generic drugs, and promote the expansion of the scope of national centralized procurement from over-evaluated drugs to non-over-evaluated drugs, from western drugs to proprietary Chinese medicines, and from drugs to medical consumables. On the other hand, we should strengthen publicity and guidance to let the masses understand what is the consistency evaluation of generic drugs and dispel their worries that generic drugs are inferior to the original research drugs, and create a social atmosphere conducive to reform.
Drug procurement, the relationship between the interests of thousands of households. It is expected that the national drug centralized procurement and use policy will be continuously improved, normalized development will be realized, and the people's sense of gain, happiness and security will be enhanced.
(The author is a member of the Standing Committee of the National Committee of the Chinese People's Political Consultative Conference and vice chairman of the Jiangxi Provincial Committee of the Chinese People's Political Consultative Conference)

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