In the first half of the year, there are five major trends in recruitment and mining! Drug price adds downward pressure

Source: pharmaceutical economic news August 9, 2017 according to Tianfeng Securities Research Report, as of the middle of July 2017, 11 provinces and cities, including Zhejiang, Anhui, Hunan, Fujian, Guangxi, Tianjin, Hebei, Inner Mongolia, Heilongjiang, Sichuan, Beijing, have taken the lead in completing a new round of provincial drug centralized bidding procurement Jiangxi, Ningxia, Gansu and other 11 provinces and cities are in the state of completion or partial completion, while Guizhou, Jiangsu and other 7 provinces and cities are still in the process of promotion From the perspective of current provincial plans, the bidding and mining mode is developing towards decentralization and integration Provincial centralized bidding and procurement platform is more like an access platform, and price negotiation and procurement on Provincial platform in the form of city or medical association has become a new direction of bidding and procurement On the other hand, medical insurance is gradually embedded in drug procurement, more cities propose to explore GPO procurement, and more and more provinces and cities join in cross regional alliance procurement With the continuous emergence of new models and the diversification of procurement subjects, the downward pressure on drug prices will continue to increase Trend 1: more cities explore GPO, Shanghai, Shenzhen and Guangzhou Who will be the promotion model? In the first half of this year, Guangzhou, Foshan and Hubei Province all proposed to explore GPO mode after Shanghai and Shenzhen successively implemented GPO mode Among them, the news that GPO will be implemented in Guangzhou has attracted wide attention According to the implementation plan for comprehensive reform of public hospitals in Guangzhou issued by Guangzhou on July 13, the functions of Guangzhou Municipal Bureau of human resources and social security in formulating the procurement and distribution policies of drugs (medical consumables) in Guangzhou and organizing and coordinating the centralized procurement of drugs (medical consumables) in public medical institutions were added, and the specific organization and handling management of drugs (medical consumables) in Guangzhou were added ）The function of centralized procurement Relying on the GPO platform established by Guangzhou public resources trading center, and in accordance with the requirements of centralized procurement with volume, we will promote the unified organization, centralized bidding procurement and unified distribution of drugs (medical consumables) in public hospitals in Guangzhou For the concept of GPO mode in Guangzhou and Foshan, the official website of Guangdong Drug Trade Center shows that Huang Fei, deputy director of Guangdong health and Family Planning Commission and director of Guangdong Medical Reform Office, and his delegation proposed to explore the "provincial and municipal co construction GPO mode" when they went to the provincial drug Trade Center for investigation, and they will take Guangzhou and Foshan as the pilot to explore the establishment of "GPO special area" or "urban sub center" on the platform of Guangdong Province to innovate the transaction form We will use the Internet plus to achieve cross provincial transactions and establish a third party drug electronic trading platform in southern China, and move towards the whole country to the world At present, the GPO models of Guangzhou, Shanghai and Shenzhen are different Shanghai GPO is in the charge of Shanghai Medical and health service center and coexists with Shanghai Sunshine pharmaceutical procurement Price reduction is mainly carried out in the way of supply chain allocation, with a decrease of about 20% GPO in Shenzhen is in charge of purchasing by "quanyao.com" and will directly reduce the total cost of drugs to more than 30% However, this year, the national development and Reform Commission put forward an investigation opinion on Shenzhen GPO In this regard, the whole drug network said that it has completed the corresponding rectification work, and the trend of Shenzhen GPO mode remains to be observed The specific mode of GPO in Guangzhou also depends on the detailed rules issued later Which of the above three GPO models will become a model for national promotion deserves the attention of the industry Trend 2: the medical insurance embedded bidding has gradually become the mainstream, showing the national promotion trend The practice of medical insurance embedded bidding has attracted attention since Sanming, Fujian Province In 2013, Sanming established the first medical insurance fund management center in China, taking the lead in realizing the "Three Guarantees in one" The medical management center added drug price limit purchase settlement, medical service price adjustment, audit and settlement of designated medical insurance institutions for urban and rural residents and urban employees, and supervision and audit management of medical behaviors of designated medical treatment institutions Sanming model is encouraged by the state level, and presents a trend of promotion to the whole country In 2016, Fujian began to promote the Sanming model in the whole province, officially established the provincial medical security management committee, which was responsible for the supervision and management of medical insurance fund, medical service price negotiation, joint purchase and settlement of drug consumables, supervision of medical service behavior, construction of medical insurance information system, etc In March 2017, under the guidance of the medical insurance office, Fujian Province launched a new round of joint limited price sunshine procurement of drugs Medical insurance embedded recruitment is also spreading in other regions At present, Zhejiang, Tianjin, Anhui, Chongqing, Gansu and other provinces and cities have said that they have organically combined medical insurance with drug procurement In Shaanxi Province, Foshan, Dongguan, Zhuhai, Zhongshan in Guangdong Province, Xiangxi in Hunan Province and Jinzhou in Liaoning Province, the municipal medical insurance fund management center will be established by reference to Sanming model According to Foshan plan, the newly established municipal medical insurance fund management center will integrate and undertake the responsibilities of medical insurance management, medical insurance fund payment and management, negotiation and adjustment of medical insurance payment standards, joint procurement, distribution and settlement management of drugs and medical consumables, agreement management and settlement of designated medical institutions, etc The medical insurance center will also implement the "six unifications" reform of unified catalogue, unified distribution, unified procurement, unified budget, unified settlement and unified profit sharing of drugs and medical consumables In the view of the industry, medical insurance deep embedded recruitment is becoming a mainstream way, which can not only effectively reduce the price through price leverage, but also fully mobilize the enthusiasm of medical institutions and avoid the formation of large prescriptions Trend 3: the role of provincial platform in provincial shortlist, municipal standard confirmation and provincial platform is fading, the role of provincial platform in drug bidding and purchasing is gradually fading, and the provincial platform is more equivalent to an access platform, and all regions will also negotiate and purchase on the provincial platform with the city as the unit On July 18, Guangdong Province issued the implementation plan for further reform and improvement of drug production, circulation and use policies, which clearly promoted the classified purchase of drugs by regions by public medical institutions Guangzhou and Shenzhen may implement group procurement (GPO) for units, while other cities may purchase drugs by themselves on the provincial third-party drug electronic trading platform for units In launching a new round of drug procurement, Hebei Province allows pilot cities Tangshan, Handan, Zhangjiakou, Xingtai, Cangzhou and Hengshui to purchase drugs on their own on the provincial drug procurement platform Throughout the country, the city as a unit to participate in procurement has been rising in various places Gansu said it would further reduce the price of drugs through volume procurement in cities Hubei made it clear that the provincial procurement platform would implement the "procurement access" system Before that, Zhejiang and Jiangsu had carried out price negotiation at the municipal level after being shortlisted in the provincial bidding, forming the model of "provincial shortlisted, municipal sure bid" According to the guiding opinions on improving the centralized drug purchase in public hospitals issued by the general office of the State Council, although the direction of centralized drug purchase in provincial units has been determined, it is also indicated that in the pilot city of public hospital reform, it is allowed to purchase on the provincial platform of centralized drug purchase in municipal units It is understood that the number of pilot cities for medical reform has reached 200, accounting for 57.5% of 348 prefecture level cities in China In addition, some non pilot cities have also expressed their encouragement to participate in the purchase negotiation at the municipal level The purchasing power based on the city is growing day by day At present, the municipal purchase price will be reduced by about 5% - 10% based on the provincial platform price limit According to the practice of some regions, when the bid winning price of the pilot city of medical reform is lower than the provincial bid winning price, the provincial bid winning price shall be adjusted according to the bid winning price of the pilot city For example, Liaoning and Gansu stipulate that if the transaction price of the pilot cities is lower than 5% of the provincial bid winning price, the provincial bid winning price will be kept low by the transaction price of the pilot cities Trend 4: the rise of medical consortia procurement and the improvement of medical institutions' participation in price negotiation Since 2013, the state explicitly proposed to encourage medical consortia for the first time, provinces and cities across the country have been exploring and experimenting with medical consortia models By the end of 2016, 205 cities above prefecture level had carried out relevant work, accounting for more than 60% of the total number of cities above prefecture level At present, the state has made it clear that it will comprehensively promote the construction of medical consortia In April this year, the general office of the State Council issued the guiding opinions on promoting the construction and development of medical consortia, which pointed out that in 2017, a variety of pilot medical consortia construction should be launched in an all-round way, all the three-level public hospitals should participate in and play a leading role, and at least one medical consortia with obvious results should be built in each province and city of the pilot comprehensive medical reform and in the pilot cities of hierarchical diagnosis and treatment By 2020, on the basis of summing up the pilot experience, we will comprehensively promote the construction of medical consortia and form a relatively complete policy system of medical consortia The procurement of medical consortia is spreading all over the country Guangdong, Liaoning, Shandong, Inner Mongolia, Gansu, Hubei and other places have proposed to explore the procurement of medical consortia in the latest medical reform or drug procurement program In the medical association model, the leading hospital will become the core, which determines the drug varieties in the Medical Association and is the key to the marketing of pharmaceutical enterprises In addition, the Medical Association will be able to achieve a relatively unified use of drugs in large and small hospitals In 2015, in promoting the construction of medical consortia, Beijing proposed to gradually unify the drug catalogue and regulations of core hospitals and communities within the scope of regional medical consortia And the grass-roots drug use is gradually opening up This year, Guangdong announced that it will no longer restrict the use of basic drugs at the grassroots level, and Zhejiang increased the use of non-basic drugs at the grassroots level from 30% to 50% last year It is worth noting that the medical consortium procurement further improves the participation of medical institutions in the centralized procurement of drugs, and the bargaining power of medical institutions as the main procurement and use body cannot be ignored And to encourage medical consortia to purchase with volume, that is, to further negotiate on the basis of centralized purchase Trend 5: encourage cross regional joint procurement Large volume of procurement can greatly increase bargaining chips Up to now, there have been a number of cross regional joint procurement alliances for pharmaceutical consumables in China The four provinces one city alliance, Sanming alliance, Western medical consumables procurement cooperation alliance and Beijing Tianjin Hebei consumables procurement alliance have been established one after another Each alliance is also constantly absorbing new members to join, covering a wider and wider range Western alliance from the original Shaanxi, Sichuan, Inner Mongolia, Ningxia four provinces and regions, and then added Gansu, Qinghai, Xinjiang, Hunan, Heilongjiang, Liaoning six provinces and regions Sanming alliance has 19 prefecture level cities and 31 counties In addition to recruiting new members, the alliance is also promoting the relevant procurement rules In January 2017, the Beijing Tianjin Hebei Medical Consumables joint procurement platform issued the joint procurement work plan In the first batch, six categories of medical consumables were selected, i.e stent, rhythm management, anti adhesion, hemostasis, artificial joint and stapler Different centralized procurement methods, such as bidding and bargaining, were adopted to carry out centralized procurement in batches Finally, the unified transaction price of products in Beijing, Tianjin and Hebei will be formed, and the purchase results will be jointly implemented in public hospitals above the second level in the three places At the end of 5, 2017, the joint meeting of "Shanghai, Jiangsu, Zhejiang, Anhui and Fujian" four provinces and one city comprehensive medical reform clarified the division of labor in the promotion of medical reform in four provinces and one city Among them, we will promote the experience of purchasing medical consumables with quantity in Ningbo, Zhejiang Province, select 1-2 types of medical consumables with large quantity and high price, and implement the joint procurement of four provinces and one city In terms of drug procurement, Fujian Province will take the lead in selecting several original and exclusive varieties with large consumption and high price, and carry out joint procurement and price negotiation among four provinces and one city Jiangsu Province mainly completed four provinces and one city