Excessive purchase of high-priced drugs well-known big three A was informed

Too much procurement of high-priced drugs, well-known big three A by the health insurance bureau named notice.
1, preferring high-priced drugs, well-known big three A was informed on the 4th, according to the Medical Economic News, a well-known three-a hospital in Hebei Province by the Hebei Provincial Health Insurance Bureau named and informed.
According to the documents released, the Hebei Provincial Health Insurance Bureau recently compared the data from January 1, 2019 to March 31, 2020 of the Hebei Province Drug Procurement Platform, as well as the provincial-level medical insurance settlement data for 2019 and the drug medical insurance settlement data for the province's medical institutions in 2019, and found that the above-mentioned hospitals were more typical in purchasing high-priced drugs.
specifically, the three hospitals to purchase the highest price of drugs on the procurement platform more varieties, and the purchase of high-priced drugs significantly more than the purchase of low-cost drugs.
documents show that in the procurement of cephalosporine injection (specification 1g), the hospital selected the price of 42.6 yuan / branch, and in Hebei Province, the same name, the same specifications, different manufacturers of the price is 2.4 yuan, 1.99 yuan and 1.35 yuan, product price difference of 58 times.
In addition, the hospital not only tends to purchase high-priced drugs, but also low-cost drugs procurement volume is significantly less - Hebei Medical Insurance Bureau in the notification, for example, in the specifications of 40mg, dosage form for the injection of freeze-dried powder needle sodium omeprazole procurement, Hebei Province drug platform prices from 0.98 yuan to 68.6 yuan, about 50 pharmaceutical companies to provide the product.
hospital chose to purchase a unit price of 68.6 yuan of products, the receipt volume of 33839 units.
the same standard drugs with a unit price of 31.8 yuan, the receipt volume of the above-mentioned hospitals is only 200.
2, the State Health Insurance Administration issued a positive "medical expenses abnormal growth warning system" in fact, this is not the first time Hebei because of the procurement data abnormal and named to inform the sanjia hospital.
, according to media reports, Hebei Provincial Health Insurance Bureau issued an inquiry letter to a provincial hospital, asking it to 108 high-priced drug procurement related to the situation.
the above actions are related to the warning system of abnormal growth of medical expense index of fixed-point medical institutions explored in Hebei Province, according to SaiBaiLan.
23, Hebei Medical Insurance Bureau issued a "notice on the establishment of fixed-point medical institutions medical expenses indicators abnormal growth warning system."
In accordance with the provisions of the notice, Hebei Medical Insurance Bureau will mainly be reminded of the following situations: the same generic name drugs only purchase high prices, not low purchase prices; the
notification requires that pharmaceutical institutions, after receiving the warning of abnormal growth indicators push, should promptly analyze the reasons for the abnormal growth of the indicators of this institution, and submit an analysis report within 10 working days through the "Hebei Medical Insurance Bureau Interactive Platform", the analysis report should indicate the departments involved in the problem and the relevant responsible persons.
not submitted by the provincial medical security bureau in accordance with the assessment method in the annual assessment points.
for the medical institutions notified, the Medical Insurance Bureau will take measures such as initiating interviews, reminding them of interviews, timely rectification and listing inspection.
Pharmaceutical institutions, departments or individuals (physicians) who have not completed the rectification within the time limit, appropriately deduct the security deposit at the end of the year and give the suspension of medical insurance services for 3-6 months;
it is worth noting that on August 14th, the State Health Insurance Administration introduced Hebei's exploration of regulating drug procurement behavior in provincial medical institutions in the first batch of health insurance management efficiency cases.
3, the spread of Hebei experience, it is worth paying attention to the Cypress Blue special author Code Wanzhi to SaibaiLan comments that Hebei to the highest level of some hospitals in the province to make a breakthrough, but also shows that similar problems are likely to exist widely, reform resistance and difficulty is not small.
situation, without the scientific guidance and responsibility of the fine management of health insurance, it is impossible to establish long-term reform.
Beijing Sheng Shikang to Chinese medicine marketing planning company chairman Shen Yong also said that because in the provincial recruitment platform, the same generic name, the same specification of drugs, the price difference between different pharmaceutical companies is large, in the reality of hospital procurement will inevitably appear for various considerations and some drug procurement preferences.
yards Wanxuan believes that, in accordance with the spirit of the No. 5, "focus on solving the problem of unbalanced development of medical security is inadequate", the fine management of medical insurance is a health insurance system throughout the upper and lower, left and right work test, long examination.
it encourages local governments to explore fine management experiments in specific work, provide examples for sustained reform, and gradually resolve some of the problems of inadequate safeguards, inadequate work and uneven progress.
the NHS's initiative for system-wide health care fine-tuning, we always saw that the reform pioneers were motivated and the reform laggards were under pressure.
and in the future, we can expect that the reform successors are motivated and the reform pioneers are under pressure.
because the overall level of fine management of health insurance only rise this way, continue to lag behind, relatively backward there is no way out, pioneers also have a lot of pressure.
On the exploration of Hebei Province, Guo Taihong, former president of the Zhejiang Pharmaceutical Industry Association, also expressed his view that the medical insurance bureau manages the use of drugs in hospitals, one is to see whether it is in the scope of the health insurance directory, and the other is to see whether to comply with the collection price.
yes, pay for health care, no, refuse to pay.
, it may not be the health care authority's re-competence.
can be said that in the context of high pressure on health insurance funds, the state has been encouraging all areas to carry out effective exploration, protect the security of the fund, save the use of the fund.
Hebei through the analysis of procurement platform data, interviews with medical institutions and other means, targeted treatment of the hospital preferred to purchase the use of high-priced drugs, coupled with Hebei's exploration was also the first batch of the State Health Insurance Bureau recognized management efficiency cases, "Hebei experience" proliferation deserves follow-up attention.
original title: well-known big three were informed