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    Home > Active Ingredient News > Drugs Articles > Drug centralized bidding is not a panacea

    Drug centralized bidding is not a panacea

    • Last Update: 2015-07-31
    • Source: Internet
    • Author: User
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    Source: on July 31, 2015, the pharmaceutical Observer newspaper held the 5th session of the 7th chairman's meeting of China Pharmaceutical Business Association in Shanghai recently Ye Hua, associate professor of pharmaceutical management, School of pharmacy, Fudan University, gave a "Reflection on the centralized bidding and purchasing system of drugs in public hospitals in China" The keynote speech pointed out that the drug procurement of medical institutions still needs to rely on bidding, but this method is not a panacea and cannot solve all problems According to Wang Zeyan / Ye Hua, who sells medicine and controls fees, two major changes have taken place in the field of medicine and health in China with the progress of the implementation of the reform and opening up policy One is that the single channel of drug supply in hospitals no longer exists; the other is that hospitals have changed from full appropriation units to "partial" appropriation units These two "changes" have completely changed the development trend of China's medical and health undertakings, and brought subversive consequences to the industry, which directly led to the introduction of drug bidding policies by relevant departments, and made drug procurement a battlefield for stakeholders to play games For a long time, patients' demand for drugs has been passive and asymmetric, which is vividly described by Ye Hua as "patients' demand is all in the pen that doctors write prescriptions" It is precisely because of the important position of medical institutions and their doctors that pharmaceutical companies are aiming at hospitals and trying to maintain a stable sales relationship with hospitals In order to open the market for pharmaceutical companies, the relevant personnel of hospitals have become the hot spots in the eyes of pharmaceutical representatives, which seriously interferes with the normal progress of hospital related work At the same time, in order to survive and develop, the hospital has to grab the maximum benefit through the legal zero difference and illegal kickback As a result, "big prescription" and "high price medicine" appear frequently, and "low price medicine" will no longer be popular To this end, the relevant departments and presidents are actually tacit In this way, the rise of drug prices and medical costs has become inevitable How to solve the abnormal growth in the rising medical costs has become an urgent problem How to simplify the supply channels of drugs and how to control the cost of medical institutions have been put in front of the relevant departments In such a context, the implementation of drug bidding and procurement system is a natural process As a matter of fact, the relevant government departments have designed a series of systems to seek solutions to the two major problems of drug supply and marketing channels and "cost control" for medical institutions As early as 1992, the total amount control and structural adjustment were carried out; the policy of "separation of pharmaceutical industry / division of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry / separation of pharmaceutical industry In 2002-2009, the drug was priced by the government, which led to the continuous price reduction of the drug In 2006, the "one product and two regulations" (one product and two regulations) appeared Then in 2009, the basic drug system and the basic drug catalog, as well as the measures of "zero difference rate" and prescription limit were introduced From here we can see, "why do we conduct drug bidding?" Its root lies in the government's efforts to solve the new problems in the field of medicine due to reform and opening up Drug bidding is to "establish market access mechanism" and "control fees" Ye Hua said that the original purpose of bidding is to establish a contract, including the subject matter, quantity, amount, delivery time, delivery place, quality standard, obligations of both parties, liability for breach of contract and other contracts In fact, drug bidding is for drug purchase, and the function of drug bidding is to try to solve the problem of market access The bidding and purchase of drugs focuses on solving the problems of "difficult and expensive to see a doctor", rational use of drugs and ensuring the quality of drugs; for medical institutions, it focuses on solving the problems of returning to public welfare, doctors' big prescriptions and "red envelopes"; for drug production and management enterprises, it focuses on promoting the development of drug production and management enterprises, and overcoming the problems of "small, scattered and poor efficiency" To solve the problems of drug production and circulation order and commercial bribery But is the problem really solved? Ye Hua pointed out that there is still a long way to go in the process of being solved In fact, this is a worldwide problem The introduction of drug bidding system, to some extent, standardizes the market order, governs the unhealthy trend in the purchase and sale of drugs from the source, standardizes the purchase and sale of drugs in medical institutions, and reduces the burden of social medical expenses In this regard, Ye Hua can be divided into the following categories: it is conducive to regulating drug purchase behavior, purifying the pharmaceutical market, preventing unfair competition, improving transparency, and blocking "secret operation" It is beneficial to reduce the intermediate link of drug purchase and drug price; to control the quality of drugs; to reduce the proportion of hospital drug revenue; to facilitate hospital drug management, speed up turnover, reduce inventory and improve the utilization rate of health funds; to strengthen market competition mechanism, enable enterprises to organize drug production in a planned way, promote the adjustment of pharmaceutical industry structure and Healthy development of pharmaceutical enterprises However, in the specific implementation of drug bidding and procurement process, due to the different bidding subjects and Bidding Schemes in different provinces, the bidding activities are not standardized (price is more important than quality), there is no clear procurement quantity, the standards are not scientific, local protectionism and other situations continue to occur And the rise in drug prices, the "low-cost drugs" to recruit the situation is caused by high social concern In particular, drug bidding and purchasing causes the decline of production profits, the overload of enterprises, the avoidance of bidding, the virtual high or "virtual low" of drug price, and the hindrance of research and development and promotion of new drugs for pharmaceutical enterprises Its impact on medical institutions lies in the influence of hospital medication, avoidance of bidding, hospital neglect, mere formality, non-compliance with the contract, etc Since the implementation of drug bidding policy, it has not been really beneficial to patients, and the government's weak supervision of it also makes the problem more and more prominent Looking at the changes of policies in recent years, we can see the general trend of drug bidding in the future In 2014, eight ministries and commissions issued opinions on ensuring the supply of commonly used low-cost drugs Subsequently, the notice of the health and Family Planning Commission on the management of the purchase of commonly used low-cost drugs (Guo Wei ban Yao Zheng Fa [2014] No 36) requires that: to do a good job in the supply of commonly used low-cost drugs is an important part of deepening medical reform, establishing and improving the drug supply guarantee system, which is conducive to improving the centralized drug purchase policy We should adhere to the principle of "quality first, reasonable price", give full play to the advantages of centralized batch purchase, enhance the participation of medical institutions in drug purchase, guide and mobilize the enthusiasm of enterprises in producing and supplying commonly used low-cost drugs, and further reduce the burden of medical expenses on the masses In 2015, the general office of the State Council issued guidance on improving centralized drug procurement in public hospitals (GBF [2015] 7) It is pointed out in (No.) that centralized purchase of drugs should be conducive to breaking down the mechanism of supplementing medicine with drugs, speeding up the reform of public hospitals, especially county-level public hospitals; reducing the false high price of drugs, reducing the burden of drug use on the people; preventing and curbing the corrupt behavior in the field of drug purchase and sale, offsetting commercial bribery; promoting the integration, reorganization, fair competition and promotion of drug production and distribution enterprises Healthy development of pharmaceutical industry In the guiding opinions on improving the centralized drug procurement in public hospitals, it can be seen that in the future, China's drug bidding and procurement will implement the policy of classified drug procurement, further improve the way of drug payment settlement, strengthen the management of drug distribution, standardize the construction of procurement platform and strengthen the comprehensive supervision and management Ye Hua believes that medical institutions still need to rely on bidding for drug procurement, but this approach is not a panacea and cannot solve all problems However, before the hospital has found a better way to purchase drugs, drug bidding and purchase can not be abandoned, only to continue to improve Now, Anhui, Zhejiang and Fujian provinces have introduced relevant programs, in which the economic and technical standards of drugs that meet the relevant regulations are directly linked to the Internet after being shortlisted, and medical institutions purchase by themselves Therefore, we can easily infer that in the future, there are two "connections" in drug bidding and purchase, the connection between basic drug purchase and non basic drug purchase, and the connection between drug use in basic medical institutions and comprehensive medical institutions Ye Hua further predicted that in terms of drug bidding in the future, the boundaries between "basic drugs" and "non basic drugs" would become blurred The bidding method of "basic drugs" (such as "double envelope") will become the mainstream, the bidding management department is changing, and the drug bidding scheme of each province will be more complex Although the opportunities of enterprises are increased, and the "cake" is cut smaller and smaller, the freedom of purchase of hospitals may be expanded.
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