It's not just centralized procurement and expansion! Jinhua's second batch of drugs is being purchased

June 12, Jinhua City Medical Security Bureau issued the city's procurement alliance committee on the second batch of drug tape procurement announcementThe first batch of drug-belt procurement announcements will be issued on November 18, 2019, and are really only about half a year apartBetween Jinhua two batches of drug tape procurement announcement, "Jinhua City drug supplies tape procurement implementation program" has also been implemented on January 1 this year.
In this paper, we are concerned about three aspects of the situation: First, Jinhua second batch of drug belt procurement announcement compared with the first batch of announcement, what evolution;
1Evolution is not only from 22 drug regulations to 274 drug regulations "the first batch, according to the same common name (prescribed dosage form, specifications, quality level) procurement of the top list of drugs (excluding the national 4 plus 7 negotiated drugs, national monitoring catalog products, etc.), according to the 2018 procurement volume of 60% statistics.
In the second batch, according to the pharmacological role of drugs are divided into several categories, after discussion decided to fight infection and Chinese traditional medicine category according to the total amount of procurement of the same common name ranked drugs, comprehensive consideration of dosage form, specifications, primary or non-original research, over-consistency evaluation and other factors, the formation of anti-infection primary research drugs, anti-infection non-original research drugs and Chinese traditional drugs three bidding groupsAnti-infective drugs are counted at 60% of the previous year's use, Chinese traditional medicines are counted by no more than 100% of the previous year's use, and Chinese traditional medicines included in the monitoring catalogue shall be counted at no more than 80% of the previous year's useOn October 10, 2019, Zhejiang Health and Health Commission announced the first batch of key monitoring drug catalogues, a total of 32 varieties, including the first batch of state key monitoring of rational drug products (chemical drugs and biological products) listed on July 1 of that yearJinhua's second batch of drug collection in the Danhong injection is the provincial-level addition of traditional Chinese medicine key monitoring varietiesSimilar to this kind of drugs into Jinhua's second batch of drug collection catalog, we have two understandings: First, can not only let the focus of monitoring varieties completely free from the price reduction procurement tools, after all, there is a market failure phenomenon; But even so, it's still controversial, we'll go on later in this article.
Jinhua's second batch of drug collection scoring procedures continue the first batch of practice, that is, divided into two stages: the first stage of comprehensive consideration of the clinical use of drugs, price, reduction and other factors, the top three products into the next stage of expert review, the two stages of the highest score in the enterprise selectionIf the score is the same, the low price of the enterprise to choose.
The scoring criteria for the first phase of the two batches were adjusted: in the first instalment, the first stage of the score took into account whether the base drug (4 points), clinical use (6 points), price (25 points), and decrease (50 points)The top three products with a score above 50 can go to the next stage of expert reviewIn the second instalment, the first stage score took into account clinical use (20 points), price (25 points), and decrease (40 points) The top three products can move on to the next stage of expert review.
It can be seen that the second batch of drug collection on the price, the total reduction of the total score decreased, while the clinical use of the degree of use to improve the score, and eliminated the first stage score above 50 points to enter the next stage of the requirements In the second stage of the score, 15 experts had a total of 15 subjective votes Clinical use of superior products, if it is possible to get more favor of expert group members, will bring the same competition products to bring greater price reduction pressure and risk of failure, which is the characteristics of the comprehensive scoring method.
Second, Jinhua drug collection program has some details to learn from the "by the city procurement alliance initial selection recommended expert group recommendations, the city procurement alliance validation of the negotiation expert group validation, to determine the second batch of drug procurement varieties and procurement quantity." Revelation: Jinhua City has established a normal expert group mechanism from the initial election recommendation, validation to the score, which not only ensures the professionalism and flexible matching of the business, but also reduces the color of administrative intervention.
"Implementation scope: all the city's health insurance fixed-point hospitals and health insurance fixed-point pharmacies to participate in this drug belt procurement Medicare fixed-point pharmacies are sold at a price of no more than 15% at the winning price Revelation: Jinhua will be the city's procurement alliance member units organized, in two batches of drug collection clearly include selling health insurance fixed-point pharmacies, both allow pharmacies in the fare increase range of free competitive sales.
"After the result of the proposed transaction has been announced without objection, the municipal procurement alliance office shall be entrusted by the medical institutions and pharmacies to sign a supply contract with the selected pharmaceutical manufacturer Each medical and health institutions in Zhejiang Province, according to the actual transaction price of the drug procurement platform for online procurement Enlightenment: Jinhua City on the drug collection of the choice of drug contract form arrangements for pharmaceutical companies to save high efficiency, have direct protection Of course, it also reduces the risk of collusion between pharmaceutical companies and dispersed buyers.
"The medical insurance agencies shall prepay 30% of the agreed purchase amount to medical institutions within 1 month after the execution of the contract, as the working capital of medical institutions Municipal procurement alliance member units to increase the rate of return, in accordance with the provisions of the agreement in a timely manner with the enterprise settlement, from the receipt acceptance of the acceptance to the payment shall not exceed 45 days Revelation: In Jinhua's first batch of drug collection results landed, the city procurement alliance member units from the receipt acceptance of acceptance to payment provisions should not exceed 30 days, the current change to 45 days, to avoid advance funds.
"If the purchase price of the superior is lower than the purchase price of our city, the enterprise must carry out the outstanding purchase quantity according to the purchasing price of the superior." The selected enterprise in the higher purchasing enterprise is different from the selected enterprise in our city, such as the winning enterprise is not willing to reduce to the same price as the higher-level enterprise, no longer execute the outstanding purchase volume "Revelation: In the "4 plus 7" when there has been a similar embarrassment, with the local volume procurement pilot wind surge, Jinhua two batches of drug collection have this provision, advancing with the times, avoid controversy.
"Taking into account the actual situation of medical institutions, non-selected enterprise drugs higher than the price of the selected product regulations, the highest payment standard for medical insurance was deferred by one month Revelation: And adopt the city procurement alliance member units proposed to modify the settlement payment period, this new provision to the relevant stakeholders buffer processing time, to minimize passive losses.
Third, from Jinhua's second batch of collection and collection program to talk about some contradictions and limitations", "in Jinhua's second batch of drug collection, forced price reduction, 10% start, the negotiated price is the same group of the same varieties of medical insurance to pay the price Prior to Jinhua City's first batch of collection, 22 drugs directly reduce the burden of patients 54 million yuan, an average decline of 28%, the highest decline of a single drug up to 73.6% Discussion: Do the pharmaceutical companies concerned want their products to be included in the volume purchase? The mood should be contradictory Our observation is that, if the previous batch has been included in the band purchase and selected, this batch will not have to be cut again locally But if because the variety in the local band procurement selected, the same variety is more likely to be included in the superior or outside area volume procurement, and their own or other pharmaceutical companies dedicated more favorable prices, for the continued implementation of the supply, pharmaceutical companies in the local before the winning price is bound to be reduced Specifically look at Jinhua's first batch of drug belt procurement price reduction effect, the average reduction of 28%, compared to superiors and the field, in fact, can also bear In particular, the second batch of scoring standards have done some relaxation, the relevant pharmaceutical companies are willing to face up to Into you have to face the spiral price reduction track, do not enter by the same kind, different kinds of kick.
"Jinhua second batch of drug collection and collection of the implementation rules clearly: anti-infective drugs according to the original research drugs and non-original research drugs quoted, to the current Zhejiang Province medical insurance payment standards (low-cost drugs to the linkage (procurement) price), the price reduction shall not be less than (including) 10% "Discussion: collection of layers, quality rules will often be good thinking to make things worse In Jinhua's first batch of drug collection is divided into the quality level, in the second batch directly reflected in the original research drugs and non-original drug classification The contradiction of the current practice lies in: First, the original research drug and non-original research drug should have been the same competition (especially for the one-time consistency evaluation of drugs), artificially set the column is like the "patent cliff" next to the fence; There is no problem with the general embodiment of multiple rules in the collection catalogue But to adhere to the "reasonable difference ratio principle", otherwise the drug companies between easy to form a tacit understanding of the alliance and even the ring.
"Where there is a low-cost drug in the same generic name, the maximum price policy shall be adopted, and on the basis of the maximum price, the price shall not be reduced by less than 10% (including) 10%, wherein the single product regulation production enterprise is a low-cost drug, the price reduction shall not be less than (including) 20% on the basis of the maximum price." "Discussion: If there is a low-cost drug in the same generic name, the maximum price policy shall be adopted There are two contradictions: First, if the low-cost medicine is really hard scalp in doing, this is to put low-cost drugs to continue to the track of price reduction, fair? Fortunately, there is only one winning bid, low-cost drugs want to win the bid has a historical price advantage, but in order to win the bid to continue to reduce prices at least 10%, I am afraid it is unreasonable Second, if some exclusive "low-cost medicine" do not say to drop 20%, that is, 80% is willing to gamble to lose, then the collection of "belt volume" to it is a price and market protection We see that some drugs are not in the focus of monitoring scope, but secondary collection, secondary volume, many of them are also impossible to enter the list of basic drugs Let's think: collect "quantitative price hook" right, in case it is taken advantage of by the mind?