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    Home > Medical News > Medical World News > In the next two years, the national drug belt procurement is facing a difficult battle.

    In the next two years, the national drug belt procurement is facing a difficult battle.

    • Last Update: 2020-08-03
    • Source: Internet
    • Author: User
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    The wind light medicine industry is very impetuous recently, the center point is mainly a message of the State Health Insurance Administration: July 15-16, the State Medical Security Administration of the relevant departments held a symposium on biological products (including insulin) and traditional Chinese medicine centralized procurement work to listen to expert opinions and suggestions, research and improve procurement policies in related areas, and promote procurement reform.
    so, around this news, various investment-type conference call minutes, some interpretation and even excessive interpretation of the raw.
    the author has always believed that the National Health Insurance Bureau this news, can not be isolated on a point to look at a certain point, should be beaded string, from the overall, long-term perspective to look at the National Health Insurance Administration on the volume of procurement of some practices, the author from a personal point of view, briefly speculate on the next two years the direction of drug volume procurement, for the pharmaceutical industry colleagues reference.
    , touch the stone and the bad touch of the stone - guess the state about the current attitude of the recruitment organizers to the volume of procurement, the relevant speech of the national recruitment organizers training course outflow, which has a paragraph, the author pays special attention to, excerpts are as follows: - we are now carrying out procurement of less varieties, "a needle, really see blood", but whether the formation of systemic changes in the body mechanism? Still small eye, has not formed a systematic inevitable reaction and irreversible development trend.
    the current national organization of more than a hundred varieties, upstream by the "consistency evaluation" of the impact of the downstream by further promotion of the selection of varieties, including comprehensive supporting measures, there are some drug categories have not yet broken the problem, such as biologics, Chinese medicine, more large quantities of supplies, by its own development stage, such as non-standard, not competitive and so on some impact, supplies to further promote their own difficulties.
    the reform of the volume of procurement can not be further advanced, extended to the relevant areas, the formation of the relevant recruitment scale, volume, it is difficult to "gold sales" to form a fundamental change.
    can be seen that, compared with two years ago when the National Health Insurance Administration was just established when the stone crossed the river, the current health care bureau has not only touched the stone, even under the riverbed to touch the gold mine of price reform.
    According to the 2019 National Medical Security Development Statistics Bulletin just issued by the State Administration of Health Insurance, by the end of 2019, 31 provinces (regions and cities) in China have a preliminary preliminary estimate of 991.3 billion yuan for the total amount of orders collected through the provincial-level centralized drug procurement platform.
    , orders for Western medicine (chemicals and biological products) amounted to 811.5 billion yuan and orders for traditional Chinese medicine amounted to 179.8 billion yuan.
    the amount of medical insurance drug orders in the net procurement of drugs was 832.7 billion yuan, accounting for 84%.
    by the end of 2019, the average amount of the 25 selected drugs in the pilot areas of the "4 plus 7" drug centralized band procurement was 183 percent of the agreed purchase volume, and the procurement volume of selected drugs accounted for 78% of the purchase volume of generic drugs.
    the pilot national expansion, 25 generic varieties of all the expansion of the procurement success, the expansion price decreased by an average of 59%, in the "4 plus 7" pilot based on a 25% reduction.
    a word, now the better touch of the stone has basically been positioned clearly: to the oral preparation of chemical drugs mainly, over-evaluation and evaluation, as long as touch three and above switches, automatically into the national band procurement vision, in these areas, the selection of procurement amount is high, clinically targeted, social impact, can play a pioneering role in drug price reform model.
    , according to Jiangsu Huarecruitment.com (june 23), 947 products have passed the consistency evaluation (including the same), involving 292 varieties, 319 enterprises, of which 336 products are considered the same drug.
    according to the "main ingredients and large dosage form" statistics (large dosage form, i.e. oral often-release agent form, slow release control release agent type, etc.), 3 or more enterprises adopted the standard, about 95.18% has been included in the first three batch of the procurement of the first three batches (the third batch to the current Requires the catalogue of the amount of statistics), and there are 2 enterprises through, but also 53.57% of the country into the first three batches, it can be seen that the national belt procurement fully reflects the "should be harvested" thinking, the future evaluation of enterprises to reach 3 and above have great possibilities to be included in the national band procurement.
    and other scattered stone blocks and stones (unrated or largely hopeless generics) are organized by provincial organizations in volume procurement or regional alliances.
    a better touch of the stone, the positioning is more clear.
    so hard to touch? For example, biologics, traditional Chinese medicine, by their own stage of development, such as non-standard, not competitive and so on some influence.
    According to Jiangsu Nanjing Yilian recruitment network data query, the current listed therapeutic biological products mainly include some peptides (including insulin), antibodies, non-antibody proteins, blood products and other categories.
    domestic competition more adequate biological similar drugs such as Adamu monotorenosis, beval-bead monotonic, Inasip have been gathered in three.
    , there have been places have carried out related biological drugs with a volume of procurement, such as Wuhan Group procurement of insulin, Qinghai band procurement and reorganization of human blood semi-generative.
    and traditional Chinese medicine, from the perspective of modern medicine, meridian, five lines, Yin and Yang, such as a set of Traditional Chinese medicine theory can not be verified, under the limitation of scientific level, the interaction between Chinese herbal medicine can not be proved from the perspective of chemical molecules.
    the disease and prescription can correspond, the mechanism of action in the middle has been in a mysterious state.
    Although the new crown outbreak, traditional Chinese medicine played a huge advantage role, but talk of traditional Chinese medicine inevitably talk editing Chinese medicine injections, "a variety of impurities are not easy to remove, quality is not easy to control, adverse reactions, product stability is poor..." and other worries have not yet been lifted.
    touch the stone can basically touch, not easy to touch the stone how to do? The stone did not touch the matter small, million again and again touch a "mine" thing big.
    November 29, 2019, the Leading Group of the State Council on Deepening the Reform of the Medical and Health System officially issued the Notice on A Number of Policy Measures to Further Deepen the Reform of the Medical and Health System with the Centralized Procurement and Use of Drugs as a Breakthrough (No. 3 of the State Medical Reform Administration (2019), which mentions that the policy document on the reform and improvement of the drug procurement mechanism has been issued.
    on the basis of doing a good job in the centralized procurement of drugs, explore the gradual integration of high-value medical supplies into the scope of national organizations or local centralized procurement.
    but No. 3, in addition to calling for "comprehensive deepening of the reform of centralized procurement and use of medicines organized by state organizations", special emphasis is placed on "improving the quality level of medicines and ensuring a stable supply of medicines".
    from this point of view, centralized procurement to do a good job of subtraction.
    not long ago, the Central Committee of the Communist Party of China and the State Council recently issued the Opinions on Accelerating the Improvement of the Socialist Market Economy System in the New Era, which clearly proposed three "higher" goals for future economic restructuring, namely, higher starting point, higher level and higher goal.
    so-called "subtraction", mainly reflected in the three "minimization" set out in the document.
    is: "minimizing the direct allocation of government resources and direct interference in microeconomic activities" "minimizing government interference in price formation" and "minimizing unnecessary administrative law enforcement matters".
    on the one hand, we should speed up the three-way linkage through drug price reform, on the other hand, we should deepen the reform of the medical and health system, and promote the reform of the payment method of medical insurance.
    this is destined to drug procurement of the pinch balance to be oriented, precise, not moving already, a thousand movements.
    through the above analysis, it can basically be judged that the relevant parties on the next step of centralized procurement has a general direction, although there is a direction, but in view of some of the complex reasons for the wrong, resulting in the path is not very clear, if go too fast, too strong, will only backfire.
    this is why the macro-policy of centralized procurement has been introduced one after another, but the micro-guidance document (similar to the new No. 7 no. 7) has been delayed.
    , there is fast and slow use of strategic tactics - how to deal with the combination of the length of the strategic layout of the combination of the length of the combination of the amount of the band, there is a relatively slow promotion (Chinese traditional medicine, biologic drug top-level design), of course, there is a faster pace of promotion.
    the third batch of national volume procurement promotion speed, far faster than the vast number of production enterprises operating enterprises expected to be faster! This speed, on the one hand, depends on this year is the end of the national anti-poverty offensive, on the other hand, depends on the economic downward pressure after the outbreak is too great, the vast number of patients in the medical treatment of medicine still has a greater burden.
    the most important point, after three rounds of two rounds of national belt procurement, the national belt budget procurement has not only had a preliminary impression, through three years of multiple inspections of Sanming, for the drug price management and adjustment, the Health Insurance Bureau has gradually formed its own ideas and programs.
    on the basis of the more mature thinking that has been formed, the National Health Insurance Administration is now to do is "far" and "near" things.
    far, although the path has yet to be refined, but the direction or future intentions are basically in mind.
    another two or three years, such as the price is relatively stable, then the drug tape procurement behavior will be transferred to the normal market access form of drugs, that is, will form a unified open, progressive normal access to drug transactions public platform.
    in the near past, speed up the national belt budget procurement efforts, urge the provincial belt procurement to speed up the development.
    speed up the establishment of information platforms and strengthen the establishment of regulations in the field of medical integrity. the formation of the
    platform depends on whether the national volume procurement can be successfully completed on schedule, depends on the level of mutual promotion and integration of provincial and inter-provincial volume procurement, the true presentation of the price of medical insurance payment, and more depends on whether the comprehensive reform of public hospitals is finally in place.
    as to the attention of the Chinese medicine belt procurement, in fact, the author understands that the most important thing is in the base medicine catalog of the relevant dosage is larger, the purchase amount is higher, can form a full competition of the varieties.
    such varieties, do not rule out two possibilities, the state formed a relevant thinking, guide provinces and cities to carry out volume procurement.
    or the state will directly take down some of the varieties that have a demonstration effect and do it themselves.
    the way in which access negotiations are adjusted through the health insurance catalogue, directly locking in the reference price of health insurance payment.
    of course, it is also an option to adopt a national volume procurement, volume-for-price approach.
    has fast and slow, this fast and slow combination of the rhythm, not only reminded of the liberation war in our People's Liberation Army's strategic use: focus on the advantage of forces one by one to break (over-evaluation of generic drugs), through the siege of the rescue (local organizations with volume procurement), in the movement to achieve success (effective price linkage).
    of course, to win on the fight (the country picks three batches), do not win on the siege without fighting, the formation of the warplane continued to fight (Chinese medicine, biological medicine, like the battle of Liao Shen four battles four flat).
    three, should be harvested and mutual lying, local recruitment ideas to form a new pattern of the recent, part of the city's quotation work urgently called to stop, a northern city will soon start the drug quotation through the form of group announcement requirements suspended, it seems that the relevant parties still want to inter-provincial union-oriented, on the one hand, the platform resources are relatively mature, on the other hand, the area covered can be rapidly expanded.
    and the city of the city jointly or separately to carry out the volume procurement, and provincial belt procurement how to connect or how to maximize the use of resources are a question mark.
    the author speculated that the national band procurement is establishing a demonstration effect, the provincial level and the country to form a mutually promoted recruitment pattern, if part of the city and then innovative single-belt procurement, may have a certain impact on the overall drug and consumables volume procurement pattern.
    from the present point of view, go all out to do a good job in the third batch of national mining, and then refer to the national blue book and then continue to do a good job at the provincial and local level of the city's belt procurement, is still a trend. According to the
    , in the first quarter of this year, the income of medical workers decreased by 13.1% year-on-year, and the health insurance of residents fell by 4.3%.
    , the incidence of all kinds of chronic diseases in China remains high.
    the total number of patients with high blood pressure, high blood sugar and hyperlipidemia exceeds 400 million, more than 3.8 million new cancer cases occur each year, and the social burden on the cost of chronic diseases is high.
    new equipment, new technologies and new drugs are being applied to clinical medicine, which will greatly stimulate the growth of medical consumption.
    at present, the provinces and cities have taken chronic disease drugs as the focus of collection.
    the price of nitrobenzene flat tablets (10mg specifications) in the special procurement of two diseases in Hebei Province has been as low as 1.23 points;
    local organizations of the belt procurement, its common denominator is to choose a high purchase amount, the use of large varieties. Most of the
    to antimicrobials, PPI, two diseases (heart, cerebrovascular diseases) drug-based, and accompanied by other medical reform policies, such as two-disease drug into urban and rural residents of outpatient co-ordination, key monitoring and management policies, such as the implementation of policies;
    the scientific connotation of "concentrated procurement as a breakthrough" must be fully understood in a comprehensive and comprehensive thinking in an all-round and systematic manner, and under the new situation, from the national to provincial-level area of procurement, must be clear and clear! This national organization experts held a symposium to investigate, refracted is the drug belt procurement should be taken.
    should be taken, in fact, the author understands that there are two levels.
    the first level, to pilot-oriented, catch large and small, will be large fish net, play a demonstration role.
    the second level, is the right time, all the big fish and shrimp all netted, so that cross-dead-end multi-dimensional hit, so as to truly form a quality-first, cost-first pharmaceutical market new pattern.
    touched the stone across the river, how far is it from ashore?! Depends on the hardness of the stone, but also on the determination of the frontman to come ashore.
    this is more like a war without smoke, to overcome difficulties, only to succeed.
    .
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