[Medicine heaven and earth] "17 + 13 + X" anticancer drug price reduction tide started, 3 places announced "4 + 7" plan, the national medicine anti-corruption war started!

Before the implementation of "17 + 13 + X" anti-cancer drug collection in Anhui and Zhejiang, Anhui and Zhejiang medical insurance bureaus and health care Commission issued the notice on "17 + 13 + X" anti-cancer drug landing for the benefit of the people " Among them, "17" in the mechanism of "17 + 13 + X" anticancer drugs benefiting the people "refers to 17 anticancer drugs included in the medical insurance through negotiation by the National Health Insurance Bureau," 13 "refers to 13 anticancer drugs successfully negotiated and negotiated on December 24 in Anhui Province, and" x "refers to that x anticancer drugs will be selected at the right time and then purchased in tissue volume to expand the types of anticancer drugs benefiting the insured patients In terms of procurement, the province requires public medical institutions at all levels to conduct online centralized procurement and zero margin sales according to the price determined by the national negotiation of "17 + 13 + X" anticancer drugs and the provincial-level procurement with volume, and no secondary negotiation and price negotiation will be organized And the procurement process should be simplified as follows: Step 1: medical institutions enter the "drug price management" → "provincial anti-cancer drug negotiation drug" interface of the trading system to maintain the actual transaction price Step 2: the production enterprise logs in to the trading system to set up the distribution enterprise Step 3: the distribution enterprise logs in to the transaction system to confirm the distribution Step 4: medical institutions confirm distribution; send purchase order, daily purchase In terms of cost accounting, "17 + 13 + X" anticancer drug costs are not included in the total control scope, not included in the assessment scope of "drug proportion" and "three fees for each time", and the reasonable use costs are separately accounted and guaranteed Relevant departments should take reasonable factors into consideration as a whole and adjust the total fund control quota in a timely manner At the same time, we should adjust the medication catalogue and disease settlement quota of chronic disease medical insurance, and bring the "17 + 13 + X" negotiation anticancer drugs into the overall payment scope of outpatient service In terms of payment collection, from the date of delivery, acceptance and warehousing, the medical institutions at the basic level, county level, provincial and municipal level shall not exceed 30 days, 60 days and 90 days respectively to collect payment from the "17 + 13 + X" anti-cancer drug supply enterprises Following Shanghai and Dalian, on January 18, Tianjin public solicitation for 4 + 7 implementation plan issued by Tianjin Pharmaceutical purchasing center "the announcement of the opinions of Tianjin Medical Security Bureau on public solicitation for the implementation plan of Tianjin implementing the pilot work of centralized purchase and use of drugs organized by the state" which focuses on the following: key points of the implementation plan (1) Within 5 working days after receiving the medical insurance advance payment, the medical institution shall allocate the corresponding drug payment to the selected drug manufacturer, and within 3 working days after receiving the payment, the selected drug manufacturer shall allocate the drug payment to the selected drug manufacturer (2) According to the purchase amount of the contract, the medical insurance agency shall prepay the medical insurance fund to the designated medical institutions twice (the first prepayment proportion is 50%, which shall be completed after the signing of the purchase and sale contract, and the second prepayment proportion is 50%, which shall be completed within six months after the signing of the purchase and sale contract) (3) The specific measures to improve the medical service pay of public medical institutions are to allow medical and health institutions to break through the current wage control level of public institutions; to allow medical service income to deduct costs and withdraw funds according to regulations, which are mainly used for personnel rewards (4) After the completion of the task amount, public medical institutions can still purchase other varieties with appropriate price in the municipal comprehensive application management platform for pharmaceutical procurement In principle, the quantity converted according to the proportion relationship shall not exceed the usage amount of the selected varieties Tianjin can be said to be the third city in the "4 + 7" urban volume procurement that has issued relevant centralized procurement detailed rules and documents A simple comparison shows that the implementation rules issued by Dalian and Tianjin are similar to the supplementary documents issued by Shanghai There are two points to pay attention to: (1) in terms of payment, Dalian put forward to actively explore the new operation mode of medical insurance fund directly prepaying drug funds to enterprises in order to solve the problem of difficult settlement and payment collection of drug funds in the previously published work plan of implementing centralized purchase and use of drugs organized by the state in Dalian (Draft for comments) (2) In terms of the procurement of the failed product specifications, Shanghai's attitude is to continue to purchase, but it is required to voluntarily reduce the price to no higher than the bid price of the volume procurement, and the procurement shall not exceed the bid product specifications, which not only ensures that the market share of the bid product specifications in the hospital is more than 50%, but also retains a certain market share of other varieties, and reserves certain prescription options for doctors and patients Doctors and drug agents need to be cautious Recently, a picture of "forbidding medical representatives to flow in hospitals" was quickly spread on major media websites By "stream string" two words of wantonly exaggeration, this is undoubtedly let the industry that medicine represents this brilliance is no longer From the point of view of the anti-corruption actions carried out by the state and various provinces, it is pointed out that the representatives of medicine are "targeted by the public" From February 9, 2017, the general office of the State Council issued several opinions on further reform and improvement of drug production, circulation and use policies, which mentioned that the food and drug regulatory authorities should strengthen the management of pharmaceutical representatives, establish a registration and filing system for pharmaceutical representatives, and make the filing information timely and public Medical representatives can only engage in academic promotion, technical consultation and other activities, and shall not undertake the task of drug sales Their dishonesty shall be recorded in personal credit records On December 22, 2017, the former CFDA and the national health and Family Planning Commission drafted the measures for the administration of registration and filing of medical representatives (Trial) (Draft for comments), which aims to regulate the practice of medical representatives and promote the healthy and orderly development of the pharmaceutical industry In August of the next year, nine ministries and commissions, including the national health and Health Commission, the National Health Insurance Bureau, the Ministry of industry and information technology, the Ministry of public security, the Ministry of Finance and so on, jointly issued the key points of special governance work for correcting unhealthy tendencies in the field of medicine purchase and sale and medical services in 2018 The paper clearly proposed to promote the filing management of pharmaceutical representatives, build a kickback governance system, joint disciplinary action by multiple departments of illegal pharmaceutical enterprises, one dishonesty can 't do anything! When the state strikes hard, local action can be described as "fast, ruthless and stable" On January 2, 2019, nine departments including Guangdong Provincial Health Commission and Guangdong Provincial Department of industry and information technology jointly issued the key points of special governance work for correcting unhealthy tendencies in the field of pharmaceutical purchase and sale and medical services in 2018 (YWH [2018] No 1801) The document emphasizes "improving the management system of medical representatives and standardizing the work behaviors in the hospital" For the behaviors that are not related to the work, such as using the identity of medical representatives to participate in the product sales, drug unifying, dealing with bills, commercial bribery, providing donations, misleading drugs, distorting curative effect, concealing bad information, etc., they should be listed in the "blacklist" and reported to the relevant management departments According to the regulations of Hebei food and drug administration, all pharmaceutical production enterprises and management enterprises must first enter the Hebei food and drug integrity network platform led by the food and Drug Administration for filing, review and publicity if they want to conduct pharmaceutical sales business with enterprises registered in Hebei The platform can verify the medical sales personnel of both sides and share the drug purchase and sale inspection report From May 10, 2008, the registration and inquiry system for drug marketing personnel in Shandong Province was officially launched All pharmaceutical production and marketing enterprises and medical institutions in the province, when engaging in drug purchase and sale business with pharmaceutical marketing personnel, shall check and verify the legal qualifications of marketing personnel through the system, and strictly prevent the purchase of fake and inferior drugs According to the notice on the record management of drug salesmen issued earlier by Anhui Province and the guidance on the management of salesmen of Anhui drug wholesale enterprises issued by the Provincial Bureau, the food and drug supervision and administration departments of all regions, counties and cities also publicize the record situation of drug salesmen on the website according to the actual situation On May 13, 2016, Hubei Province issued the notice on the implementation of the registration and reporting system for personnel in key positions of drug wholesale enterprises, which requires that the personnel who need to be registered include the purchasing personnel and sales personnel of the enterprise In addition, it is reported that "brush face into hospital" in Zhejiang Province will be implemented in 2019 The first is to standardize the behavior of doctors and patients, and the second is to monitor the access of drug agents to hospitals Last year, about 30 hospitals in Beijing installed face recognition systems For the "familiar face" traffickers, they will cooperate with the public security department to timely dissuade and deal with them; Shanghai No.10 people's Hospital, Huashan Hospital and other medical representatives who failed to meet the requirements of opening the face recognition system monitoring All the bustle of the world is for profit, all the bustle of the world is for profit Behind every case of bribery of medical representatives, there are a group of hospital doctors, presidents, directors of pharmacy department and other personnel involved Therefore, "anti-corruption of medicine" should not only focus on drug generation, but also on the monitoring of doctors' behavior Just a few days ago (January 16), the Shanghai Municipal Commission of health and Health issued the measures of Shanghai Municipality on the management of scores of doctors' bad practice (for Trial Implementation) This time, Shanghai will "deduct scores" for doctors' practicing behaviors Once the scores exceed the specified standards, different penalties will be imposed Among them, the document points out that "the unified party for commercial purposes" is directly recorded with a maximum score of 18 points; "taking advantage of his position, accepting commercial bribes, or asking for or accepting the property of patients and their relatives or friends or seeking other improper interests" is also scored with 18 points If the score is deducted above, the staff shall leave the post for training for 3 months, and shall be given unqualified treatment in the regular assessment of doctors The document issued by Guangxi health and Health Commission at the beginning of 2019 states that "medical personnel are strictly prohibited from participating in the promotion activities of medical products, devices, health products and other commodities, and from participating in the entertainment activities (including tour, investigation, etc.) arranged, organized or paid by them" It is obvious that doctors' behaviors in and out of hospital are under strict management Information sources: yaozhi.com, yaozhi.com, sepilan, bureau of health and knowledge, e-medicine manager, Anhui Provincial People's government, China Medical Science and technology network, etc Statement: this opinion only represents the author, not the position of yaozhi.com, welcome to exchange and supplement in the message area; 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