Bidding for national basic drugs or great changes

Source: medical economic news July 18, 2014 may change the current bidding method according to the level and level of medical institutions By the end of June, the national development and Reform Commission announced the cancellation of the maximum retail price of 533 low-cost drugs Since then, the low-cost drug policy has entered the stage of implementation Due to the high coincidence between the list of low-cost drugs and the list of essential drugs, the bidding for essential drugs that is about to start all over the country is in embarrassment From the perspective of the low-cost drug policy, it seems that the price of chemical drugs and traditional Chinese medicine has been set at 3 yuan and 5 yuan, and then the "two envelope" bidding seems to be out of time Previously, the relevant people of the health and Family Planning Commission emphasized again at an internal meeting that the basic drug system would not be shaken, and stressed that low-cost drugs are only a policy exploration and attempt But recently, according to the insiders, the national health and Family Planning Commission is preparing reform measures, and the bidding method for essential drugs is expected to usher in great changes Recently, the national health and Family Planning Commission listened to the "Research Report on free basic drug supply of Zhejiang provincial health and Family Planning Commission", and entrusted Shanghai Research Center of health development to carry out the research project "feasibility plan for free basic drug supply of China" It seems that the free supply of essential drugs has been put on the agenda of relevant departments Bidding for low price drugs subversive base drugs? According to the relevant documents of who, availability, quality and rational use are the general objectives of national drug policy, and who's interpretation of availability is fair access and affordability of basic drugs However, five years after the implementation of the current system of essential drugs, 53% of the supply of essential drugs is still not guaranteed, and even some drugs are extinct in the market Therefore, some scholars believe that this also shows that the current system fails to guarantee the accessibility of essential drugs Wang Hongzhi, pharmaceutical partner of Beijing vertical and horizontal management consulting group, analyzed that the common ground of low-cost drugs and essential drugs is "supply guarantee", and "shortage" is the common background of these documents Through in-depth analysis, it can be found that 533 kinds of low-cost drugs are highly overlapped with 520 kinds of national essential drugs, and 276 kinds of drugs belong to two catalogues or lists In other words, the supply of essential drugs is not guaranteed in 53% of countries, and the role of market mechanism is needed to ensure the supply Therefore, Wang Hongzhi believes that 53% of essential drugs may no longer implement the policies of zero plus and two envelope procurement as the mark of essential drug system In addition, the low-cost drug policy has only set a general direction at present, and many supporting details are not clear According to the reporter, there are different ways to purchase low-cost drugs For example, in Beijing, the drugs that enter the low-cost drug catalog are directly linked to the Internet, and the price level is no longer used as the basis for winning the bid; as long as Guangdong Province passes the economic and technical bid, the production enterprises that meet the requirements of entering the market can win the bid; most other places still adopt the way of centralized bidding procurement However, the internal view of the health and Family Planning Commission is not the same as that of the external From the perspective of the trend of the reform of the centralized bidding and purchase system of drugs in public hospitals, there are institutional arrangements for low-cost drugs, and the relevant draft also requires that drugs with small consumption and short supply in the market should be produced, priced and distributed uniformly by the state or provincial (District, city) bidding Prior to the free supply of essential drugs, Shanghai Health Development Research Center was entrusted by the state health and Family Planning Commission to carry out the research project of "feasibility plan for free supply of essential drugs at the grassroots level" It can be seen that, in order to ensure the sustainability of the basic drug system, at the beginning of the introduction of the basic drug policy, many experts' wishful thinking of free basic drugs is likely to be implemented Yu Mingde, President of China Pharmaceutical Enterprise Management Association, said many times: "the list of essential drugs doesn't need to be too large The best way is to produce them at designated points, purchase and distribute them uniformly, and then supply them to patients free of charge." However, not everyone agrees that all essential drugs are free "Internationally, drug policies in some developed countries are often financed through medical insurance, and drugs are reimbursed by medical insurance in proportion Patients have to pay a certain proportion of their own drug costs, but for special groups, patients may be exempted from paying part of their own to get drugs free of charge," Wang said According to Wang Hongzhi, it is not necessary to free all or part of basic drugs On the one hand, the financing level of NCMS has been improved several times in recent years The existing financing level of NCMS can ensure that there is no problem in using drugs for minor diseases With the supervision of insurance institutions, the possibility of waste will be reduced; On the other hand, the current medical insurance system is becoming more and more perfect, and "Three Guarantees in one" will eventually be realized In this context, if an independent free drug supply system is established, the administrative cost is not cost-effective For China's situation, Wang Hongzhi suggested: "we can consider establishing a long-term full reimbursement system for drug use for low-income groups, the disabled, the elderly, etc in combination with serious illness medical insurance When the annual amount of drug use reaches a certain amount, the patients will be exempted from paying for it Long term medication reimbursement can ensure timely treatment of serious diseases and reduce the incidence of poverty caused by diseases " With regard to the problem of highly overlapped catalogues and the impact of low-cost drugs on essential drugs, the insiders of the health and Family Planning Commission said: "low-cost drugs and essential drugs are not a concept, and essential drugs still cover the drugs listed in Category A of medical insurance Because of the different levels of medical security in China and the poor payment ability of patients at the grass-roots level, the essential drugs catalogue is mainly to solve the problem that they can get paid drugs Product " However, at present, the financing level is limited, the actual reimbursement proportion of basic drugs for rural residents is not high, and because a large number of rural people live and work in different places, the new rural cooperative medical system is still unable to achieve settlement in different places, and the "welfare" of basic drugs is greatly reduced In order to solve the problems of accessibility and fairness of basic drugs, the national health and Family Planning Commission is very firm about the "going up" attitude of basic drugs In the future, the drug bidding policy may change the existing bidding method according to the level and level of medical institutions As provinces need to establish a "public hospital procurement catalogue", all essential drugs included in the procurement catalogue can enter all medical institutions only after one bidding By strengthening the requirements for medical institutions at all levels to increase the proportion of essential drugs, a broader market for essential drugs will be established Such measures are expected to alleviate the embarrassment of the shortage of low-cost essential drugs.