June 12 , the National Health and Care Commission recently issued "on the new situation to do a good job in the management of the clinical application of antimicrobial drugs notice ( draft for comments) public consultation announcement " ( hereinafter referred to as the " draft of opinions" ) , proposed to further strengthen the management of antimicrobial drugs , more notably, in the optimization of the antimicrobial supply catalog, the policy requires medical institutions should be combined with the basic drugs-led "1 plus X" drug model selection varieties.
Today's basic drug system has risen to the height of the country's basic medical security and poverty alleviation, the use of medical institutions at all levels has been constantly clarifiedIn addition, the expansion of the base drug catalog is expected to be strong, medical institutions at all levels are gradually accelerating the use of basic drugs policy landing, fully equipped and priority use of base medicine.
In fact, in the past practice, the price of basic drugs is generally low, marketing and sales there are some objective challenges, but with the three medical linkage and medical insurance reform deepening, to ensure the use of the premise, into the base medicine catalog means to save medical institutions into hospital and the upper amount of the cost, which will bring enterprises a new opportunity and test.
Variety selection should be "evidence full" Since 2009, the "National Basic Medicines Catalog" management system officially implemented, after which the basic drug system has been continuously improved, the catalog has been gradually adjusted and enrichedThe total variety of essential drugs in the National Basic Medicines Directory increased from 520 to 685 in 2018, and in 2019 the National Health Insurance Administration issued a letter abolishing local supplements for essential drugs, marking the unified use of the national essential drug catalogue.
In January last year, the State Health and Health Commission and the State Administration of Traditional Chinese Medicine jointly issued the Notice on Further Strengthening the Administration of the Use of Essential Medicines in Public Medical Institutions, which makes it clear that when public medical institutions formulate prescription sets and catalogues of drugs, they should prefer the National Base Drug, and public medical institutions shall scientifically set the indicators for the use of basic drugs in clinical departments, and the proportion of the amount of basic drugs used and the proportion of prescriptions should be increased year by year.
Then, in October, the General Office of the State Council issued the Opinions on FurtherIng the Work of Securing and Stabilizing prices for Shortage Drugs (State Office issued No47 of 2019) stipulates that the number of varieties of basic drugs is accounted for, and that the requirements of primary, secondary and tertiary medical institutions are not less than 90%, 80% and 60%, respectively. "Base drug 986" medical institutionterminal equipped with the framework of the formal setting, marking the basic drug policy landing into a new stage of accelerationIn February this year, the National Health and Health Commission, together with the Ministry of Education, the Ministry of Finance, the Ministry of Human And Social Affairs, the State Administration of Health Insurance and the State Drug Administration, formulated the Opinions on Strengthening the Administration of PharmaceuticalS in Medical Institutions to Promote Rational Drug Use, which clearly dynamically adjusts the National List of Essential Drugs, promotes medical institutions at all levels to form a "1 plus X" drug-led drug-led model, and improves the drug procurement system.
In this opinion draft, "1 plus X" once again received a focus on the requirement seeking medical institutions in the formulation of antimicrobial drug supply catalogue and prescription set, in addition to the prescribed guarantee of the number of species specifications, the selection of similar drugs should be selected safe, effective, economic and evidence-based evidence-based varieties.
Industry experts pointed out that the early base drug system tends to protect "basic drug use", mainly for the use of primary medical institutions, to commonly used general drug species, this kind of thinking has not been suitable for the grading of the general environment"It can be seen from the expansion of 685 types of base medicine, while meeting primary drug use, covering more diseases, to meet the tendency of all medical institutions to use drugs is very obviousMedical insurance catalog, base medicine catalog dynamic adjustment needs, consistency evaluation of the varieties, major disease innovation drugs, the efficacy of clear traditional Chinese medicine, may become the potential varieties of the base drug"Market at all levels to meet the "dynamic adjustment" of the base drug catalog dynamic adjustment expectations are not empty windAt present, the total number of drug varieties in the hospital is about 1200 on average, according to the past three-a-hospital base drug ratio (usually 30%), the number of varieties does not exceed 360 According to the current "986" policy, the tertiary hospital requires that the proportion of basic drugs should not be less than 60%, that is, the number of varieties is not less than 700 species, catalog dynamic adjustment space objective existence.
Since June 1 this year, the Law of the People's Republic of China on the Promotion of Basic Health care and Health has been officially implemented, which mentions in the drug supply guarantee that the state implements the basic drug system and dynamically adjusts the list of essential drugs in accordance with the clinical practice of drugs, changes in drug standards and new drug listings.
With the gradual deepening of the reform of graded diagnosis and treatment and medical insurance payment system, it is undoubtedly a number of key tasks of medical institutions in the new era to promote the implementation of the national basic drug system, to coordinate the supply and stability of the shortage of drugs, to carry out comprehensive clinical evaluation of drugs, to promote the clinical equipment and use of drugs purchased by the state, and to monitor the use of drugs.
The industry generally believes that, in accordance with the spirit of the policy documents that have been published so far, in the future, medical institutions in the optimization of the catalog selection process, will be in the catalog adjustment will be some of the drugs that have not proved clinical efficacy out of the basic medical directory.
As a policy main line of the basic drug policy, strengthen the management of the use of base drug equipment, clinical port elimination of non-base drug species, market shuffling has begun: In April, Jiangmen City, Guangdong Province, the New Club District People's Hospital issued a notice that because the first quarter of 2020 base drug equipped with varieties accounted for 43.14 percent, the use of the amount of 35.7 percent, are not up to standard by the new health care bureau interview.
In May, Shandong Provincial Health and Health Commission issued a notice, starting from May 2020, divided into four stages of the formulation of programs, start implementation, effectiveness assessment, summary and promotion of the implementation of the national basic drug system comprehensive pilot, requiring medical institutions at all levels to fully equip and priority use of basic drugs, the formation of a base drug-led "1 plus x" drug use model.
In June, Shenzhen Central Hospital announced the "2020 phase-out of non-national basic drug varieties catalog", a total of 148 varieties, including amoxicillin kraviate (7:1) dispersal tablets, human haemoglobin, Changchun sitin injection, injection of erythropoietin, injection with brain protein hydrolysis and many other well-known varieties.
All along, because of the long-standing problems of the medical industry, medical institutions and departments bear the pressure of income generation, medical personnel lack the incentive to actively use low-cost essential drugs However, with the drug ratio, medical insurance control fees, tape procurement and other regulatory policies to wave "combination fist", the traditional pharmaceutical industry chain will be reshaped.