Exposure! National mining will carry out two batches each year, and what bottlenecks need to be broken?

Wen /Tong Tai Meng according to the "medical time" news, a recent talk about the national drug collection spread out.
include: normalization of centralized procurement of drugs.
as long as the number of drug varieties or their amount that meet the conditions for collection reaches a certain level, it will trigger the initiating of national harvesting.
is expected to be carried out in two batches per year.
this key talk includes: accelerating the promotion of centralized volume procurement as the dominant model.
At present, the drug regulatory department has accelerated the progress of consistent evaluation of injection generic drugs, more than two enterprises at the same time waiting for the evaluation of varieties has reached about 150, from next year, will gradually increase the proportion of injectable varieties in the national collection.
July 21, Shanghai Sunshine Pharmaceutical Procurement Network issued a "notice on the implementation of some drug-related basic information collection work", according to the procurement amount, covering the first 80% of the drugs about 500, by 2021 to cover 250, 2022 to be fully covered, the state did not carry out, by the provincial organizations.
in the category coverage, chemical drugs, biological agents, Chinese medicine should be included in the collection.
only 113 drugs are currently purchased in three batches, a distance from 500.
, the People's Daily issued a message, looking forward to the continuous improvement of the national drug centralized procurement and use policy, to achieve normal development, in order to enhance the people's sense of access, happiness and security.
from the current trend, the normal development of volume procurement has been nailed.
two months, is the implementation of the "4 plus 7" two years, in this period, the volume of procurement to rethink, far-reaching significance.
01 exactly do not do consistency evaluation a few years ago, the pharmaceutical industry spread a saying, "do not do consistency evaluation is waiting for death, do consistency evaluation is to find death."
this reflects the enterprise to do a consistent evaluation of the confusion, enterprises want to ask, do what can be done? Although in 2016 the State Council issued "on the development of generic drug quality and efficacy consistency evaluation of the opinion", clearly the same varieties of drugs through the consistent evaluation of the production enterprises reached more than 3, in the centralized procurement of drugs and other aspects no longer selected without consistent evaluation of the varieties, but in fact there is no corresponding supporting measures.
Until the end of 2018, the "4 plus 7" with the volume of procurement out of the world, with the consistency evaluation to form a perfect set of "combination fist", did not pass the consistent evaluation of the varieties can not be included in the belt procurement, which further promoted the enterprise to carry out generic consistent evaluation enthusiasm.
, with the volume of procurement into the deep water area, pharmaceutical companies in the face of consistency appeared a second confusion.
in the "4 plus 7" volume procurement, the exclusive winning model to ensure the sales of the winning companies, but this has caused other failed companies to complain.
At the time, the company's anger was that "we spent $5 million on consistency evaluations (the average cost of consistency evaluations was $5 million), but market share was given to the winning companies, and the cost of consistency evaluations could not be recosted."
" in a cry, with the volume of procurement rules quickly adjusted, the winning enterprise from one to three.
, the winning bid is not happy.
"Even if the winning bid, the market share of equal share can really guarantee the "quantity for price" logic?" "In fact, the consistent evaluation is really wrong, the key is the drug price of the fierce killing, moving 70% to 80% of the price reduction, can you exchange 70% to 80% of the sales increase?" Sky volume sales increase for barefoot enterprises are still easy to achieve, for shoes I am afraid to achieve more difficult.
, the best representatives of shoes are multinational pharmaceutical companies.
of course, at present these international students to China have also learned fine, to take the amount of procurement of the examination room to see the scenery, hand in a white roll, and then turn quickly into the hospital market.
02 does not participate in the volume of procurement as shoes, multinational giants on the volume of procurement has always been negative attitude.
"4 plus 7", Shi Guibao's Fusinplina exclusive bid, but then Hebei Province announced the follow-up "4 plus 7" with volume procurement, Shi Guibao gave up following the bid, on the grounds of insufficient production capacity.
, of course, the lack of productive capacity is only an excuse, as Marx said, if there is a hundred times the profit of capital, he will take risks.
low profits are a key factor for Mr. Shi.
in the third batch of volume procurement, foreign companies are more direct, simply give a "suicide" offer.
for hepatitis B drug Ramif tablets, Shijiazhuang Dikang Longze quoted 11.94 yuan / box, GSK quoted 904.2 yuan / box.
5mg of oral disintegration tablets, with a maximum effective price of 9.25 yuan and Lilly quoted 129 yuan.
can be said that in this volume of procurement, foreign enterprises kicked open the volume of procurement of this "price meat machine", foreign companies showdown, is not to play.
the future, how the movement of foreign enterprises, the state will introduce what kind of policies to respond to foreign enterprises do not cooperate, it is worth paying attention to.
whether 03 can better fall on the ground procurement has been a big problem. the design of
-band procurement is intended to be consistent with the evaluation of the landing, generic drugs and the quality and efficacy of the original drug to achieve consistency, along with the decline in drug prices, for the common people to save medical costs, that is, by reducing drug prices to break the "expensive to see a doctor" disease.
So, in the context of volume procurement, the planned landing path is: the drug through a consistent evaluation (presumed) - the drug into the collection - drug prices fall - patients buy drugs - patients enjoy benefits - patients further purchase collection varieties.
In theory, the chain is a virtuous circle, patients develop the habit of spontaneous purchase of varieties, promote the sales of winning products, stimulate the enthusiasm of pharmaceutical companies to carry out consistent evaluation, more high-quality, low-cost domestic generic drugs into the market.
, but in fact, the chain is very difficult to land.
, the consistency assessment is not deeply rooted in people's minds.
reporter reported that, because of the consistency evaluation publicity is not in place, many people do not understand the consistent evaluation, some medical staff have always been convinced that "generic drugs are not as good as the original research drugs."
, on the other hand, the appeal of falling drug prices is limited.
Although the price reduction is significant, for example, the average decline of 52% and the largest decrease of 96% for the 25 drugs of the "4 plus 7", and the average decrease of 53% for the third batch of 55 varieties purchased with the volume, the price itself is not high, even if the reduction of more than 50%, the impact on patients is not great.
To 20mg Atovastatin calcium tablets as an example, the winning bid of 4 plus 7 Beijing Jialin Ale price reduction of 83%, after the price reduction of 0.94 yuan per piece, compared with the price reduction of 5.52 yuan / piece before the price reduction of 4.58 yuan.
is calculated as a box of 7 pieces, each box price reduction of 32 yuan.
but for patients, the savings of tens of dollars don't actually have much impact (it doesn't take into account health care, and there are fewer savings after reimbursement).
and 20mg Lipto 3.53 yuan per tablet, although the price is close to four times that of Ale, but because the cost of drugs is not high, there are still a number of patients adhere to the original drug.
So, the amount of digestion that had been hoped for patients actually transferred to hospitals and doctors, and the path to eventual landing was: the drug through a consistent evaluation (presumed) - the drug into the collection - drug prices fell - the agreed amount allocated to the provincial health insurance bureaus - the provincial health insurance bureaus assigned to the heads of local hospitals - the local hospitals assigned to the doctor's head - the doctor's prescription "digested" the collection task.
"quantity" of the band purchase has actually changed into a doctor's task indicator, and if it is not completed according to the target, performance will be affected.
in the industry, doctors were reluctant to prescribe more expensive drugs until the end of the year for fear of exceeding the proportion.
the end of the year, doctors are reluctant to prescribe a cheaper batch of drugs because the target for volume purchases has finally been completed.
two years of implementation of the procurement of the pharmaceutical industry has brought about far-reaching changes.
from the point of view of the linkage between the three doctors, the purchase of volume is actually a deep game between medicine, medical care and medical insurance, the most direct beneficiary is medical insurance, the phenomenon of medical insurance fee control is obvious.
but medicine and medicine in which as a weak side, but like dumb eat yellow company in general.
As a pharmaceutical person, we understand that reform is accompanied by pain, but we sincerely hope that through the improvement of policies, as soon as possible to straighten out the imperfect mechanism in the procurement of volume, in medicine, medical care and medical insurance to find a balance, fully mobilize the enthusiasm of both supply and demand of drugs, and sustainable promotion of the normal development of volume procurement."
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