It's not just the volume expansion! Jinhua's second batch of drugs is in progress

On June 8, Jinhua Medical Security Bureau issued the announcement on the second batch of drug volume procurement issued by the municipal procurement Alliance CommitteeIt's only about half a year before the first batch of drug carrying purchase announcement was released on November 18, 2019Between the announcement of Jinhua's two batches of drug volume purchase, the implementation plan of Jinhua's drug consumption volume purchase has also been implemented since January 1 this year< br / > in this paper, we pay attention to three aspects: first, what is the evolution of Jinhua's second batch of drug volume purchase announcement compared with the announcement of the first batch; second, what are the specific plans and agreements of Jinhua's second batch of drug volume purchase, and what are the reference values in details; third, we make great efforts such as Jinhua medical reform and Jinhua's two batch of drug volume purchase pilot, However, what are the knotty problems? < br / > for the first batch, the drugs (excluding national 4 + 7 negotiation drugs, national monitoring catalog products, etc.) ranked first in the total purchase amount according to the same common name (prescribed dosage form, specification, quality level) are counted as 60% of the purchase amount in 2018< br / > in the second batch, the drugs are divided into several categories according to their pharmacological effectsAfter discussion, it is decided that the anti infective drugs and Chinese patent drugs rank first in the total purchase amount of the same generic nameConsidering the factors such as dosage form, specification, original research or non original research, over consistency evaluation, three bidding groups of anti infective original research drugs, anti infective non original research drugs and Chinese patent drugs are formedStatistics of anti infective drugs shall be based on 60% of the usage of the previous year; statistics of Chinese patent drugs shall not exceed 100% of the usage of the previous year, and statistics of Chinese patent drugs listed in the monitoring catalogue shall not exceed 80% of the usage of the previous year" < br / > on October 10, 2019, Zhejiang health and Health Commission announced the first batch of key monitoring drugs catalogue, with a total of 32 varieties, including 20 varieties listed in the first batch of national key monitoring and rational use drugs catalogue (chemical and biological products) on July 1 of that yearDanhong injection in Jinhua's second batch of drug collection is the key monitoring variety of Chinese patent medicine added at provincial levelDrugs like this are included in Jinhua's second batch of centralized drug purchase catalogueWe have two understandings: first, we can't just let the key monitoring varieties be completely separated from the price reduction procurement tools, after all, there is market failure; second, we should include the key monitoring varieties with conditions into the price reduction procurement tools, and also make another discount according to the last year's procurement volumeBut even so, it is still controversial, we will continue to say later in this article< br / > the scoring procedure of Jinhua's second batch of drugs for centralized purchase continues the practice of the first batch, which is divided into two stages: the first stage comprehensively considers the factors such as the degree of clinical use of drugs, price, reduction, etc., the top three products with scores enter the next stage of expert review, and the enterprises with the highest scores in the two stages are selectedIf the scores are the same, the enterprises with low quotation shall be selected< br / > the scoring standards of two batches of centralized purchase in the first stage have been adjusted: in the first stage, whether the base drug (4 points), clinical use (6 points), price (25 points) and decline (50 points) are considered comprehensivelyProducts ranking in the top three and above 50 can enter the next stage of expert reviewIn the second batch, the clinical use degree (20 points), price (25 points) and decline rate (40 points) were considered in the first stageThe top three products can enter the next stage of expert review< br / > it can be seen that the second batch of centralized purchase of drugs has decreased the total score of price and reduction, increased the score of clinical use, and cancelled the requirement that the score of the first stage is higher than 50 to enter the next stageIn the second stage, 15 experts got 15 subjective scoresIf the products with superior clinical use level are likely to be favored by more members of the expert group, it will bring greater pressure on price reduction and risk of bid dropping for the products in the same competition, which is the characteristic of the comprehensive scoring method< br / > 2There are some details of Jinhua drug centralized purchase scheme that can be used for reference < br / > enlightenment: Jinhua City has established a normalized expert group mechanism from primary recommendation, approval to scoring, which not only ensures the professional and flexible matching degree of business, but also reduces the color of administrative intervention< br / >Medical insurance designated drugstores shall be sold at a price not more than 15% higher than the selected price" < br / > enlightenment: Jinhua has organized the member units of this city's purchasing allianceThe centralized purchase of two batches of drugs clearly includes the designated pharmacies for medical insurance, and the pharmacies are allowed to conduct free competitive sales within the price increase range< br / >All medical and health institutions conduct online procurement at the actual transaction price on the purchasing platform of medical equipment in Zhejiang province" < br / > enlightenment: Jinhua City's arrangement of drug contract form in drug centralized purchase is convenient, efficient and directly guaranteed for drug enterprisesOf course, it also reduces the risk of collusion between drug companies and decentralized purchasers< br / > The member units of the municipal procurement union shall improve the collection rate, settle accounts with the enterprise in time according to the provisions of the agreement, and shall not exceed 45 days from the acceptance of goods to the payment " < br / > enlightenment: when the results of the first batch of drug centralized purchase in Jinhua are implemented, the member units of the municipal procurement alliance shall not exceed 30 days from the acceptance of the goods to the payment, which is now changed to 45 days to avoid advance payment < br / > If the selected enterprise of superior purchase is different from the selected enterprise of our city, for example, if the selected enterprise is unwilling to reduce to the same price as the selected enterprise of superior purchase, the unfinished purchase quantity will not be executed any more " < br / > enlightenment: similar embarrassment occurred in "4 + 7" With the rapid development of pilot volume purchase in various regions, Jinhua has such regulations for centralized purchase of two batches of drugs to keep pace with the times and avoid disputes < br / > < br / > enlightenment: as suggested by the member companies of the municipal purchasing alliance, the new provision provides the relevant stakeholders with buffer processing time to minimize the passive loss < br / > Third, some contradictions and limitations are discussed from the second batch of centralized purchase scheme of Jinhua < br / > in the second batch of centralized purchase of drugs in Jinhua, compulsory price reduction starts at 10%, and the negotiation price is the medical insurance payment price of the same group and the same variety Prior to the first batch of centralized purchase in Jinhua City, 22 drugs directly reduced the burden of patients by 54 million yuan, with an average decrease of 28%, and the maximum decrease of a single drug reached 73.6% " < br / > discussion: do relevant pharmaceutical companies want their products to be included in the volume purchase? Mood should be contradictory Our observation is that those that have been included in the volume purchase and selected previously do not need to be haggled locally However, if the product is selected in the local volume purchase, the same product is more likely to be included in the superior or non local volume purchase, and the company or other pharmaceutical companies offer more preferential prices In order to continue to implement the supply, the price selected by the pharmaceutical companies before the local market is bound to be lowered Specifically, the price reduction effect of Jinhua's first batch of drugs with volume purchase, with an average decrease of 28%, is actually affordable compared with the superior and other places In particular, the second batch relaxed the scoring standards, and the relevant pharmaceutical companies were willing to face it If you enter, you have to face the spiral price reduction track If you don't enter, you will be kicked out by the same kind and different kinds < br / > < br / > discussion: centralized procurement, level by level, and quality control are often good ideas to do things badly In Jinhua's first batch of drugs, the quality level is divided In the second batch, the drugs are directly classified according to the original drugs and non original drugs The contradictions of current practices are: first, the original research drugs and non original research drugs should have competed in the same field (especially for the drugs with consistency evaluation), artificially setting up a column is like building a fence next to the "patent cliff"; second, because the original research drugs are "opened to small stoves", more exclusive phenomena are brought in the volume purchase (there are also exclusive Chinese patent drugs), which makes the bidding into negotiation and administrative intervention more obvious There is no problem in itself with regard to the general reflection of multiple specifications in the catalogue of centralized purchase However, we should adhere to the principle of "reasonable price difference ratio", otherwise, it is easy to form a tacit alliance or even besiege between pharmaceutical enterprises < br / > < br / > discussion: if there are low-cost drugs in the same generic name, the maximum price limit policy shall be adopted There are two contradictions: first, if low-cost drugs are really being made, it is fair to continue to drive low-cost drugs on the track of price reduction? Fortunately, there is only one bid winner, and low-cost drugs have historical price advantages if they want to win the bid, but in order to win the bid, they must continue to reduce the price by at least 10%, which is not reasonable Second, if some exclusive "low-cost drugs" are reduced by 20%, that is to say, 80% is also willing to lose the bet, then the "volume" of centralized purchase is a kind of price and market protection We see that although some drugs are not included in the key monitoring scope, the next time of centralized purchase and the next time of large quantity, many of them are also impossible to be included in the base drug catalog Let's think about it: it's right to link the quantity and price of centralized mining What if it is used with ulterior motives? < br / > original title: it's not just the volume expansion of centralized purchase! In the process of purchasing Jinhua's second batch of drugs in volume, these details must be paid attention to