Interpret | Normalization and institutionalization are the basis and guarantee for the strategic purchase of medical insurance drugs

As a programmatic planning document for the construction and development of the national medical insurance system in the next ten years, the Opinions of the State Council of the CPC Central Committee on Deepening the Reform of the Medical Security System clearly state that "the strategic purchasing role of the medical insurance fund should be played to promote the coordinated development of high-quality medical security and medical services".
It can be said that this has laid the institutional foundation and clear strategic objectives for the introduction of the policy of "promoting the normalization and institutionalization of drug centralized procurement" (hereinafter referred to as "opinion"), while normalization and institutionalization are the basis and guarantee for the realization of the strategic purchase of medical insurance drugs.
1, drug centralized volume procurement is an important strategic content and core link of the construction of the medical insurance system Strategy is to achieve specific goals and use the ability of science and strategy.
the strategic purchase of medical insurance drugs is to achieve their own strategic objectives and value, which is reflected in how to more effectively provide to meet the needs of the vast number of insured people for health care reasonable and effective services.
In china's medical insurance policy practice, the proportion of medical insurance funds to pay for drugs is about 35-40%, according to the total amount actually paid by the medical insurance fund, the medical insurance fund for drug payment nearly trillion, for the effective treatment of medical insurance and the development of the medical insurance system, the procurement of medical insurance drugs is bound to be an important strategic issue affecting the development of the system and policy performance, to solve the purchase of medical insurance drugs is an important and core link of sustainable and healthy development of payment.
2. The normal institutionalization of drug centralized belt procurement has four distinct characteristics From the point of view of strategy formulation and implementation, the opinion on promoting the normal institutionalization of drug centralized belt procurement work (State Office issued (2021) No. 2) has four distinct characteristics: First, the "opinion" is issued in the name of the State Council Office, rather than the work document of the State Health Insurance Administration, which illustrates the hierarchy and strategic significance of its strategy; Second, the "opinion" is an operational policy framework and a comprehensive and detailed process specification document, its purpose, significance, tasks, and practices are very detailed and specific, it has a clear target task, in the scope, quantity, quality, manner, as well as enterprises and pharmaceutical service agencies have a clear definition of responsibility and interconnecation;
In order to ensure the quality of the procurement of drugs, strict quality control, put forward the "four most stringent" requirements, that is, "the most stringent standards, the most stringent supervision, the most severe punishment, the most serious accountability" requirements, strengthen the production, circulation, use of the whole chain of quality supervision;
such as good supply and distribution, the implementation of "local management", improve the settlement method, the selected price and medical insurance payment standards, as well as procurement platform construction and improve the alliance procurement mechanism and so on.
3. Drug centralized band procurement will play a positive and unique role in drug price formation mechanism The normalization and institutionalization of drug centralized band procurement is an effective way to explore and continuously improve the optimization and summary of medical insurance drugs "belt procurement" represented by the "4-plus-7" regional alliance procurement in the early stage.
the "opinion" issued this time, is a clear policy objectives, and how to achieve the objectives of the complete policy implementation plan.
this scheme is not only combined with reality, but also has its own characteristics.
, especially to promote the formation of reasonable prices of drugs, reduce inflated drug prices, regulate the drug market, remodel circulation and behavior, etc. have a positive role in promoting.
From the strategic point of view of the development and perfect strategy of the medical insurance system, the program better embodies the strategic characteristics of global, innovative, feasible, certain long-term and stable, is the result of the active exploration of China's drug price mechanism for a long time, it better reflects the guiding role of the strategic purchase of medical insurance fund on the formation of reasonable price of drugs, and its "government organization, alliance procurement, platform operation" collection requirements, not only take advantage of the positive role of the market mechanism in price formation, but also take into account the public pricing requirements of drug price control, and have a clear guiding effect on the supply side.
the same time, the introduction of the "opinion" will also be the existing drug production guarantee and supply methods and mechanisms, the pharmaceutical industry and related pharmaceutical production enterprises strategy to bring direct and indirect impact.
4. The normalization of the centralized belt procurement of medical insurance drugs and the normalization of the centralized belt procurement of medical insurance drugs is the normalization and standardization of the work of "belt procurement" of medical insurance drugs, which is embodied in the periodic determination of the centralized strip procurement of medical insurance drugs, the correlation with the catalogue, the stability of the procurement rules and operating mechanism, and the trigger mechanism of the collection and collection work.
medical insurance drug centralized belt procurement work gradually tend to normal and stable state, tend to be more scientific and reasonable.
is that the centralized procurement of medical insurance drugs has rules to follow, and the rights and responsibilities are clearly divided.
reflected in the centralized procurement of drugs with precise policy objectives, clear work rights and responsibilities, scientific and stable processes, continuous improvement and improvement mechanism, the formation of a complete, authoritative and stable system of institutional policies to achieve the strategic purchase objectives of medical insurance drugs.
5, on the future development and prospects of medical insurance drug belt procurement work belongs to the category of strategic purchase, is a kind of strategic management of medical insurance services, it is different from the conventional procurement methods, and the general sense of procurement is different from: strategic purchase focus on the elements of the "lowest total cost", procurement is "a single minimum procurement price."
addition, strategic buying is a systematic strategic behavior with higher-level objectives.
it is a data analysis-based procurement method.
Simply put, strategic buying is the process of establishing a service supply channel at the lowest total cost, while general procurement is a transaction that obtains the current resources at the lowest purchase price and is only a market mechanism transaction.
It is not difficult to see that the analysis and comparison of the introduction of this "opinion", which basically has these characteristics, that is, it has clear objectives, clear thinking and concrete feasible programs, focusing on the improvement of the health insurance system and the effective operation of policies, which is to improve and improve the Chinese characteristics of the health insurance system system and operating mechanism has a positive role in promoting.
relative to the total demand for medical insurance drug use, the quantity and quality of medical insurance drugs are difficult to match the "overall strategy" objectives and tasks of health insurance.
But from the perspective of future development, with the continuous improvement and improvement of the centralized procurement of medical insurance drugs, especially the "opinion" put forward the goal of "accelerating the formation of a unified and open national centralized drug procurement market", as well as the implementation of medical insurance drugs "should be exhausted" to achieve the strategic purchase of medical insurance drugs The strategic objective of promoting people's livelihood and well-being, promoting the reform of the linkage and integration of the "three medicines", promoting the healthy development of the pharmaceutical industry, and meeting the needs of the insured for a better life will have a very positive role in promoting the procurement of medical insurance drugs in a centralized capacity, which is certainly an important part and core link of perfecting and reforming the medical insurance system and policy system.