In depth analysis: the new trend of "taking over" drug bidding by Medical Security Bureau

Source: Sina pharmaceutical held the Fourth Plenary Session of the first session of the 13th National People's Congress in the Great Hall of the people on the morning of March 14, 2018 Entrusted by the State Council, State Councilor Wang Yong made an explanation to the first session of the 13th National People's Congress on the institutional reform plan of the State Council The "plan" puts forward the establishment of the National Medical Security Bureau as an institution directly under the State Council Its main responsibilities are to formulate and organize the implementation of policies, plans and standards for medical insurance, maternity insurance, medical assistance and other medical security systems, supervise and manage relevant medical security funds, improve the national remote medical management and expense settlement platform, and organize the formulation and adjustment of drug and medical service prices and charging standards, Formulate and supervise the bidding and purchasing policies of drugs and medical consumables, and supervise and manage the relevant service behaviors and medical expenses of medical institutions included in the scope of medical insurance At the same time, in order to improve the collection and management efficiency of medical insurance funds, the basic medical insurance premium and maternity insurance premium shall be handed over to the tax department for unified collection According to the latest adjustment of the State Council's institutional reform program, a national health and Health Commission will be established instead of the national health and Family Planning Commission The leading group office of the State Council for deepening the reform of the medical and health system will no longer be established It can be seen that the centralized purchase of drugs, which was operated by the former health and Family Planning Commission for many years, will be officially "changed" and managed by the newly established state medical security bureau Well, the "Fujian model" of the [enhanced version] has finally been recognized and has risen to the national level Centralized purchase of drugs has always been a focus and hot spot of all sectors of the society With the promotion of No.7 and No.70 documents in 2015, the centralized purchase of drugs has made obvious progress in ensuring drug supply, meeting the clinical needs of medical institutions and promoting the level of the pharmaceutical industry as a whole, but there are still many problems: the main body of drug bidding is not separated, and drugs are not separated The centralized procurement procedures are complicated (there are many requirements for paper-based online application materials, various CAS, unreasonable margin charges, etc.), the only low price is to intensify vicious competition, the frequency of municipal (county) drug bidding is frequent, the volume procurement can not be implemented, and the payment for goods is still in arrears The result of blindly reducing price did not realize the win-win situation, but led to various dissatisfied voices Therefore, the medical security bureau took over the bidding procurement of drugs, on the one hand, it reflected "who pays, who runs the plate" On the other hand, it also took into account different drug use levels and industrial conditions at the level of the actual medical insurance fund pool, adopted the way of closely binding the bid winning price of drugs and the payment standard of medical insurance, and reasonably compensated by levels to achieve the maximization of relevant interests It can be seen that with the continuous improvement of medical insurance policies and the accompanying tight medical insurance funds, medical insurance fee control has become a normalization Next, in the context of the medical insurance bureau taking over the drug bidding, I believe that whether it is the centralized purchase of drugs or the payment of medical insurance, it will continue to explore and try, especially the payment of medical insurance, in advance With the rapid development of the system, doctors' prescriptions and treatments will be restrained For pharmaceutical companies, research industry policies need to be studied from the horizontal to the side and from the vertical to the bottom We should not only look at the past, pay attention to the present, but also pay attention to the future Just like the centralized purchase of drugs, it has been effectively tied up with the payment of medical insurance The marketing environment and market operation mode of prescription drugs of pharmaceutical enterprises must be adjusted synchronously with different strategies in order to adapt to the changes of the situation and the needs of policies In any case, the tripartite confrontation of the original health and Family Planning Commission, the national development and Reform Commission and the Ministry of human resources and social security in drug prices has collapsed The "dual pricing" will be officially unified from now on The newly established medical security bureau will officially take over the decision-making power of the final price of drug market circulation and sales Drug purchase will officially enter a new era of medical insurance Appendix: development trend of drug purchase in medical insurance departments of some provinces in Hainan In the fourth quarter of 2017, a notice on the establishment of Hainan Provincial Medical Security Administration issued by Hainan provincial organization establishment committee was circulated in the industry According to the requirements of the notice, Hainan will merge the responsibilities of human resources and social security, health and family planning, civil affairs and price, and establish a new Hainan Medical Security Administration According to the notice, one of the main responsibilities of Hainan Medical Security Administration is to "guide and supervise the negotiation and adjustment of medical security payment standards, as well as the joint purchase, distribution and settlement management of drugs, medical devices and medical consumables, supervise the service behavior of designated medical institutions, check and audit medical expenses, and promote the development of medical security information system of Hainan Province Planning and construction work, etc " On July 26, 2016, the general office of the people's Government of Fujian Province issued the notice on the establishment of the provincial medical security management committee The provincial government decided to establish the provincial medical security management committee, which is responsible for the overall guidance and coordination of the provincial medical security work On October 25 of that year, Fujian Province held the conference on the establishment of medical insurance management system, and officially issued the opinions on the problems of medical insurance management system in cities with districts, which emphasized that Fujian Province would establish the medical insurance administration and the medical insurance fund management center, and integrate all functions related to medical insurance The most famous case of Fujian model is the joint limited price sunshine purchase of Fujian drugs in 2017 (referred to as Fujian standard 10 for short) In May 2017, Guangdong provincial government issued the 13th five year plan to deepen the reform of the medical and health system The provincial medical insurance fund management center will be established in Guangdong Province, affiliated with the Provincial Social Insurance Fund Management Bureau, mainly responsible for fund payment and management, drug procurement and cost settlement, medical insurance payment standard negotiation, agreement management and settlement of designated institutions, etc Jinzhou On October 12, 2016, Jinzhou City, Liaoning Province held a working conference on comprehensive reform and medical reform of urban public hospitals According to the pilot implementation plan of comprehensive reform of urban public hospitals in Jinzhou City, the city will prepare to build a "three medical linkage" and "three insurance in one" management system, establish Jinzhou Medical Security Administration, and be responsible for the daily work of the leading group of medical and health system reform in the city.