Observation: "Renewal" of the expiration of the first, fourth and fifth batches of national drug collections

It started with a question: What are the advantages of the "renewal" of the expiration of the local centralized procurement pilot and the "renewal" of the national-level centralized procurement?

According to the author's understanding, the implementation period of the first batch of "4+7" collections is subject to "renewal"
.

The author believes that on the one hand, local "renewal" will have various practices, and it may also imitate the "4+7" "renewal" practices

Regarding the "renewal" of the expiration of the normalized centralized procurement, the author inquired about the "Opinions on Promoting the Normalized and Institutionalized Development of Centralized and Volume Procurement of Drugs" by the General Office of the State Council (Guobanfa [2021] No.
2), and found only one sentence "After the expiration of the purchase agreement, we should focus on stabilizing market expectations, stabilizing price levels, and stabilizing clinical use, comprehensively considering factors such as reliable quality, stable supply, good credit, and clinical demand, adhere to the integration of recruitment and procurement, linking volume and price, and follow Determine the supply company, agreed purchase volume, and purchase agreement period in accordance with the regulations; if there are major changes in the supply-demand relationship and market structure, the selected company, the selected price, the agreed purchase volume and the purchase agreement can be generated through bidding, bargaining, negotiation, inquiry, etc.
Period"
.

Two feelings: First, there is no mention of "renewal" and no agreement.

Focusing on the "renewal" of the expiration date, and looking back at the fourth and fifth batches of national drug procurement documents, the author has some findings:

The fourth batch of National Drug Centralized Procurement Documents ("National Drug Centralized Procurement Document (GY-YD2021-1)") mentions: "Applicants must ensure that they meet the agreed procurement volume requirements of selected drugs in supply regions during the procurement cycle"; the fifth batch The National Drug Centralized Procurement Document ("National Drug Centralized Procurement Document (GY-YD2021-2)") mentions: "Applicants must ensure that the procurement requirements of selected drugs in the supply region are met during the procurement cycle, including agreed procurement quantities and exceeding agreed procurement Part of the volume"
.

The author feels: The requirements of the fifth batch of national drug procurement documents are too stable, too accurate, and too ruthless
.

From the perspective of pharmaceutical companies, it doesn't make sense

The fourth and fifth batches of national drug collection documents also mention these four aspects at the same time:

"If the actual number of selected companies in the country is 1 or 2, the current round of procurement cycle is 1 year in principle; if the actual number of companies selected in the country is 3, the current round of procurement cycle is in principle 2 years; the actual number of selected companies in the country is For 4 or more companies, this round of procurement cycle is in principle 3 years"

The author feels: This kind of agreement, now it seems, is more reasonable
.

According to ordinary logic, shouldn’t the agreement period be extended for products with fewer companies actually selected? Save trouble

"The purchase agreement is signed once a year during the purchase cycle.
When the purchase agreement is
renewed, the agreed purchase amount shall in principle be no less than the agreed purchase amount of the selected drug in each region in the previous year"

The author feels: "Renewal" here is not "renewal", it is called "renewal"
.

No matter who they then set under an agreement period, the Central Purchasing Agreement will adhere to the "volume and price linked to" the full amount as a basic task, open a small hole, called "in principle"

"If the agreed purchase amount for the year is completed in advance during the purchase cycle, the selected companies will still supply the selected companies at the selected price until the expiration of the purchase cycle.

"

The author's feeling: If you follow this approach, many companies and product regulations are selected in the centralized procurement, and many of them are "airborne
.

" From the perspective of territorial marketing, if a company only sells selected products, it will sell at low prices all the way to the end

We then continued the analysis "if we follow this", suggesting that the selected companies should not take their time off, and learn from Nongfu Spring that "we do not produce water, we are porters of nature", practice "products + services", and sell ourselves.
The products also serve the industry in compliance and serve the majority of patients and users
.

The current centralized procurement and distribution rules make full use of China's vast territory, one company in one place, and a good order from monopolistic competition

"On the basis of giving priority to the use of the drugs selected in this centralized drug procurement, medical institutions can purchase other drugs of the same variety at appropriate prices in accordance with the relevant regulations of the local centralized drug procurement management for the remaining amount.
"

The author feels that the phenomenon-level management of the clinical purchase and use of centralized procurement of drugs must exert a linkage effect
.

First, it is agreed that the supply of the selected enterprises in excess of the agreed purchase volume shall be based on the original price; the second is to gradually block various channels and situations that violate the previous agreement; the third is to focus on monitoring the appropriateness and reasonableness of the prices of other related drugs
.
If this work is not done well, centralized procurement will have fire spots and hot spots in the backyard
.

The fifth batch of national drug procurement documents mentions: "The selected company fails to supply the selected product in time and in sufficient quantities or cancels the qualification of the selection, etc.
, so that the agreement cannot be continued, the province can start the supply process
of the alternative company.
The candidate company can start the supply process of the alternative company.
It is determined among other selected companies for this product that the product will be supplied at the price selected by the alternative company.
Within the agreed purchase volume, the additional expenditures incurred due to the guarantee of supply shall be borne by the company that cannot perform the agreement.
"

The author feels: This is a gap in the interpretation of the policy to allow "renewal"
.
To clarify, it is not the "renewal" of the selected company, but the "renewal" of the candidate company to change the price and quantity
.
Therefore, this gap should be managed in a refined manner.
The first is to specify and deal with the two situations of "chain drop" during the agreement period and when the agreement expires; the second is to adopt no bidding or "combination of recruitment and procurement" for the ranking of alternative enterprises.
Method, taking into account timeliness and economy
.

Focusing on the expiry "renewal", looking back at the "4+7" first batch of "renewal" for purchases with volume,

The author feels: At present, the "renewal" rules in various regions are beneficial to the original selected companies.
For example, the original selected companies are allocated a large amount of purchases, and some regions even directly "renew" with the original selected companies.
This is conducive to maintaining the stability of clinical drugs and convenient procurement.
The start of the work, but it is not fair to the newly-over-assessed enterprises and the original un-selected enterprises
.

In that year, in a "Notice on Renewal of Procurement Agreements for Drugs Procured in Volumes", the Shanghai Pharmaceutical Affairs Office announced the renewal of 13 drugs that were purchased in volume
.
The document "Notice of Renewal Agreement" mentioned that the winning drug has been reviewed with the consent of the superior authority, and the winning drug company agreed to continue to supply the drug at the winning price; the winning drug has not been reviewed, and other manufacturers with the same generic name and specification have not been reviewed and The bid-winning drug company agrees to continue supplying at the bid-winning price; the bid-winning drug has not been reviewed, and there are less than 3 original research and over-reviewed drug companies with the same generic name and specification, and the original research and over-reviewed drug companies with the same product specification and over-reviewed drugs at the winning bid price have not responded.
The bid-winning enterprises and their drugs that meet these three conditions will renew their purchase agreements for one year
.

Let's take a closer look at the three cases of "renewal" that year: the bid-winning drug was over-evaluated, and the bid-winning drug company agreed to continue to supply at the bid-winning price
.
This is not only inconsistent with the regulations on bidding and procurement, but also inconsistent with pharmacoeconomics and reforms
.
The bid-winning drug has not been evaluated, and other manufacturers with the same generic name and specification have not been evaluated and the bid-winning drug company agrees to continue supplying at the bid-winning price
.
This is even more unreasonable.
There are more companies that have not been reviewed.
This is even worse than online purchases
.
The bid-winning drug has not been reviewed, and there are less than 3 original research and over-reviewed drug companies with the same generic name and the same specification, and the original research and over-reviewed drug companies with the same product specification at the winning bid price have not responded
.
how? Has the comment openly not made the first condition?

Looking back today, the "renewal" was an expedient measure that had a certain historical inevitability, necessity and significance
.
Looking forward today, the current "renewal" is governed by the law, and it is necessary to avoid providing "lazy nests" for enterprises as much as possible, otherwise, it will pay for it if it gets cheaper, and it will scream through the market
.