High-value consumables collection rules vary from place to place How will national collection rules be formulated?

On September 14, 2020, the State Health Insurance Administration, together with the relevant departments, organized a national organization of high-value medical supplies centralized procurement launch meeting in Tianjin, which identified the crown brace as the first batch of procurement products, and is expected to announce the final results of the collection in November.
a new storm is about to sweep through the high-value medical supplies sector.
the centralized procurement of high-value consumables in the absence of consistent evaluation? The New Kangjie combed through the collection policy and past cases at the national and regional levels, and made an in-depth analysis of the above problems.
01 Medical reform aims at high-value medical supplies, the collection of high-value consumables collected into the general trend is not a moment's efforts, but a long-term build-up, the country from 2019 on the continuous introduction of relevant management policies.
May 2019, the eighth meeting of the Central Committee for Comprehensive And Deepening Reform adopted the Reform Plan on the Management of High-Value Medical Supplies, which sent a strong signal on the reduction of prices of high-value medical supplies.
november of this year, the leading group of the State Council on deepening medical reform made it clear that the pilot provinces of comprehensive medical reform should take the lead in the exploration of centralized procurement of high-value consumables.
2020, the relevant agencies have issued a series of documents for high-value medical supplies for the national collection of escort.
these documents provide a grasping hand for the management of medical supplies, solve the problem of unclear standards and uniform coding of medical supplies in the past, and provide a basis for deepening the reform of high-value medical supplies.
In July 2020, the State Health Insurance Administration issued a document entitled "On the commission of the national organization of the crown stent centralized belt procurement program (draft for comments) ", and in this article mentioned from the crown stent to explore the development of national high-value medical supplies centralized belt procurement, promote the establishment of standardized, normal high-value medical supplies centralized belt procurement system, and in September formally identified the crown vein stent for the first batch of high-value medical supplies national collection products.
Figure 1: National policy for the collection of consumables escort data sources: open data collation, China Kang Industrial Capital Research Center 02 collection intensive start, high-value medical supplies price reduction obviously after the state issued a signal of high-value medical supplies reform, the local positive response to the province or provincial alliance as a unit, to carry out collection trial, in order to explore high-value medical supplies collection methods.
In terms of regional and time distribution, the collection of high-value medical supplies began in 2019 in Jiangsu and Anhui provinces and will be gradually launched nationwide in 2020, with intensive start-up in July and August.
2019, a total of 15 collections have been conducted in provinces or alliances.
, Jiangsu Province has the highest frequency, completing a total of 3 rounds of collection, involving 8 kinds of products.
In terms of price reduction, joints and stents for the collection of higher frequency, price reduction is also larger products, there is a decline of more than 50%, the larger price reduction space may also be the crown stent to become the first batch of high-value medical supplies national collection products one of the reasons.
noteworthy, ophthalmology artificial crystals have experienced a total of 5 harvests, prices continue to decline.
the first two harvests in Anhui and Jiangsu, prices were reduced by less than 30%, while in 2020, the prices of the 3-N alliance and the inter-provincial alliance were 44% lower than before the harvest.
And the latest round of Shanghai's collection, the price again waist cut, Johnson and Johnson eye strength JIAN ZA9003 for example, after winning the bid in the 3-N alliance, the price per piece has been reduced from 2700 yuan to 1300 yuan, and in Shanghai after another winning bid, the price per piece fell to 650 yuan.
Chart 2: Regions respond positively, high-value medical supplies collection intensive start-up data sources: government official website, Zhongkang Industrial Capital Research Center 03 high-value consumables rules are complex, regions groping for optimal collection methods due to the lack of generic drugs Consistency evaluation process, high-value pharmaceutical supplies product quality is difficult to control, the same type of products are also a wide variety, while doctors have a certain personal preference for product selection, change clinical products will exist a certain risk, resulting in more complex evaluation rules.
, how to choose the best collection method, in order to ensure the quality of the selected products on the basis of the largest reduction in prices, has become the top priority of national collection.
the trial process, the bidding methods selected by each province and region are very different, and there is no uniform optimal collection standard.
the collection of artificial crystals as an example, the five collection bidding rules in provinces or provincial alliances are not the same.
the selection rules in the horizontal comparison, in the two provinces of Anhui and Jiangsu, where the collection was initially conducted, bargaining was adopted because of the small number of enterprises involved.
province chose two rounds of bargaining, while Jiangsu Province determined the selected varieties according to the magnitude of the price reduction.
After the increase in the number of participating enterprises, the Beijing-Tianjin-Hebei 3-N Alliance adopted the grouping method, the group of fewer varieties adopted the way of bargaining, and the group of more varieties adopted the way of bidding, this way of combining bidding, can be in the number of participating enterprises increased, to ensure that the price is fully reduced.
On the basis of the bidding rules of the Beijing-Tianjin-Hebei Alliance, the inter-provincial alliance introduced the expert group score to ensure the quality of the final selected product, and the bargaining group was selected according to the expert group's vote, while the bidding group first selected according to the experts after the elimination of some products, and then in the remaining products according to the price decision.
Shanghai's collection rules abandoned the bargaining group, but added a market share factor, aimed at reducing prices without changing clinical use habits.
Chart 3: The rules for the collection of artificial crystals in various regions have their own data sources: the official website of the government, the crown vein bracket of the China-Kang Industrial Capital Research Center has been identified as the first batch of products collected for the country, how to formulate the bidding rules? It can be expected that the number of enterprises involved in the provincial collection further increased, in the case of uneven quality, the introduction of expert group review as a quality control is very necessary.
On the basis of ensuring quality, we can choose to reduce the price of consumables by means of a combination of bidding and bargaining, in addition, market share can also be used as a condition for screening shortlisted enterprises to maintain clinical use habits.
, however, the screening of market share, although it can ensure that the use of habits are not changed, but not conducive to the entry of emerging products into the market, may ensure clinical habits at the same time, screen out some of the high-quality innovative products.
, in addition to quality and price reduction, how to balance clinical use habits and encourage innovation is also critical.
In short, high-value medical supplies products more complex rules, although all over the region have started regional collection and high-value supplies to successfully reduce prices, but the national collection has a long way to go.
believe that the collection of crown bracket, the country will combine the experience of various regions, choose the most suitable selection rules at this stage, price reduction and quality, benefit the people.
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