Release of the implementation plan of implementing two vote system in drug procurement of public medical institutions in Shandong Province

Health and health committees, development and reform committees, industry and Information Bureau, Commerce Bureau, market supervision and Administration Bureau, medical security bureau, big data Bureau, tax bureaus of Shandong Province under the State Administration of Taxation, and medical institutions under the jurisdiction of the provincial health and Health Commission: Since the implementation of "two ticket system" implementation plan for drug procurement of public medical institutions in Shandong Province (Trial) (LWF [2017] No 31), all localities and relevant units have worked closely with each other to promote the implementation of relevant policies and measures, and achieved positive results, initially achieving the goal of reducing circulation links, standardizing circulation order and promoting the healthy development of the pharmaceutical industry Objective In order to continuously promote the relevant work, we revised the implementation plan based on the summary and evaluation Now the revised implementation plan of "two vote system" for drug procurement in public medical institutions of Shandong Province is printed and distributed to you, please follow it Please report the situation and problems occurred in the implementation process to the relevant provincial departments in a timely manner Implementation plan of "two vote system" in drug purchase of public medical institutions in Shandong Province In order to implement the Circular of the general office of the CPC Central Committee and the general office of the State Council on transmitting the opinions of the leading group of the State Council on deepening the reform of the medical and health system on further promoting the experience of deepening the reform of the medical and health system (Ting Zi [2016] No 36) and the opinions of the general office of the State Council on further reforming and improving the policies on the production, circulation and use of drugs (Guo Ban Fa [2017 13) in accordance with the specific requirements put forward by eight departments including the medical reform office of the State Council (Trial Implementation) on the implementation of "two vote system" in drug procurement of public medical institutions (Guo Yi Gai Ban Fa [2016] No 4), and in combination with the actual situation of our Province, this implementation plan is formulated 1、 General requirements We will thoroughly implement the major decisions and arrangements made by the CPC Central Committee, the State Council, the provincial Party committee and the provincial government on deepening the reform of the medical and health system and the spirit of the national and provincial health and health conferences, continue to deepen the reform of the drug distribution system, and follow the basic principles of "standardizing the market, strengthening supervision, promoting at different levels, and ensuring supply" to implement the "two vote system" in drug purchase and sale In order to promote the healthy development of the pharmaceutical industry and better meet the people's demand for medical treatment, we should reduce the middle links, reduce the false high prices, crack down on illegal affiliation, money laundering through tickets, commercial bribery and other acts in accordance with the law, purify the circulation environment, promote the healthy development of the pharmaceutical industry 2、 The definition of "two ticket system" refers to that pharmaceutical manufacturers issue one invoice to circulation enterprises and circulation enterprises issue one invoice to medical institutions Encourage medical institutions and drug manufacturers to directly settle the payment for goods, and drug manufacturers and circulation enterprises to settle the distribution expenses （1） If the following conditions are met, it can be regarded as a manufacturing enterprise 1 A commercial company established by a pharmaceutical manufacturing enterprise or a group enterprise integrated with science, industry and trade that only sells its own (Group) drugs (for drugs sold in Shandong Province, only one company for each type is regarded as a manufacturing enterprise) 2 Domestic general agent or domestic sub packaging enterprise of overseas drugs (only one domestic general agent or sub packaging enterprise in China) 3 Pharmaceutical manufacturing enterprises or trading enterprises entrusted by pharmaceutical listing license holders to sell drugs on their behalf (only one manufacturing or trading enterprise in China) （2） Special treatment may be given to those meeting the following conditions: 1 The transfer of drugs from a group enterprise to a wholly-owned (holding) subsidiary or a wholly-owned (holding) subsidiary may not be regarded as one vote, but the invoice can be issued at most once 2 In response to special circumstances such as natural disasters, major epidemics, major emergencies and emergency (emergency) rescue of patients, medicines purchased urgently or medicines stored by the state and the province, as well as medicines in the list of medicines in short supply published by the state and the province, can be handled specially 3 The circulation and operation of narcotic drugs, psychotropic drugs, toxic drugs for medical use and radioactive drugs, Chinese herbal pieces, vaccines and other special drugs under special management of the State shall still be carried out in accordance with the current provisions of the state 3、 Scope of implementation (I) "two vote system" is fully implemented in drug procurement of public medical institutions at all levels in the province (including grass-roots medical and health institutions and village clinics) Encourage other medical institutions to actively implement the "two vote system" in drug procurement （2） The pilot implementation of "one vote system" in the pilot city, select some drugs with large consumption and simple market supply channels to try out the "one vote system" (medical institutions and drug manufacturers directly settle the payment for goods, drug manufacturers distribute by themselves or by Commission, and drug producers issue an invoice to the medical institutions) We will encourage regions where conditions permit to take the form of joint procurement and centralized payment with cities and counties as units, and explore the implementation of the "one vote system" for drug procurement （3） Strictly control the "third ticket" in order to ensure the supply of drugs at the grass-roots level, some remote and inconvenient township (town) medical institutions can increase one ticket according to the actual situation The list of specific medical institutions shall be strictly controlled by the municipal health and Health Committee, and shall be uniformly published after being reported to the provincial health and Health Committee for the record 4、 Work content (1) implement dynamic list management and publish the list of "first ticket" and "second ticket" billing enterprises on the provincial drug centralized purchase platform, allow to add the list of "third ticket" medical institutions, as well as the list of "one ticket" pilot hospitals, enterprises and drugs Pharmaceutical production and distribution enterprises shall make a written commitment to strictly implement the "two vote system" The production enterprise comprehensively considers the original distribution channels, selects (including change and cancellation) circulation enterprises independently in the list to ensure the comprehensive coverage of the supply area Medical institutions shall not designate circulation enterprises, but only select circulation enterprises selected by production enterprises in the list to establish distribution relations For enterprises that do not implement the "two ticket system" as required, they will be ordered to make rectification within a time limit If they still do not meet the requirements after rectification, they will be withdrawn from the list and disqualified from winning the bid, hanging the network or distribution of the product （2） In order to standardize the management of drug purchase and sale bills, drug production and distribution enterprises shall issue special value-added tax invoices or ordinary value-added tax invoices (hereinafter referred to as "invoices") in accordance with the relevant provisions of invoice management, and complete the items The sold drugs shall also be attached with the corresponding bill of lading in accordance with the requirements of the drug quality management specification (drug GSP), and the name, payment direction and amount of the buyer and seller of the invoice (and the list, the same below) shall be consistent with the same bill of lading When purchasing drugs, drug distribution enterprises shall take the initiative to ask for invoices from drug manufacturers The invoices must be issued by the drug manufacturers in the list When selling drugs to medical institutions, they must provide delivery invoices, copies of purchase invoices (stamped with the official seal or special seal for sales of the current enterprise) and accompanying documents, and ensure that the invoices, goods and accounts are consistent When issuing the delivery invoice, the drug distribution enterprise must associate all the purchase invoice codes and numbers corresponding to this batch of drugs, and input the codes and numbers of the delivery and purchase invoices into the bill information system of the provincial drug centralized purchase platform for future reference For pharmaceutical manufacturers and distribution enterprises outside Shandong Province, in addition to the codes and numbers of invoices for shipment and purchase, pharmaceutical distribution enterprises also need to enter the date and amount (excluding tax) of the special VAT invoice or the date and verification code (the last six digits) of the ordinary invoice into the bill information system of the provincial pharmaceutical centralized purchase platform for future reference For drugs with "one ticket system" on trial, the drug manufacturer shall input the invoice code and number into the bill information system of the provincial drug centralized purchase platform for future reference （3） Strictly implement the bill inspection work when medical institutions sign purchase contracts with pharmaceutical production and circulation enterprises, they must list the implementation of "two bill system" as contract terms At the time of drug acceptance and warehousing, it is necessary to ask the circulation enterprises that distribute drugs for the accompanying bills, ask for and verify invoices (the second ticket) before payment, and also require the circulation enterprises to provide copies (or electronic invoices, the same below) of purchase invoices (the first ticket) obtained from the production enterprises and stamped with the seal of the circulation enterprises, and check through the bill information system of the provincial drug centralized purchase platform Check the invoice information The goods can be put into storage and used only when the bills (tickets), goods and accounts of the same line are verified, and the name of drug distribution enterprise, drug batch number and other relevant contents of the two invoices are mutually verified before payment If the relevant contents of the two invoices cannot be verified by each other, the medical institution shall truthfully feed back the relevant information through the provincial drug centralized purchase platform Drug distribution enterprises shall be responsible for the authenticity, legality and interrelationship of all bills (including the first and second votes) provided by them, and shall make clear in the purchase contract (agreement) （4） To create favorable conditions to ensure the implementation of the "two ticket system", all localities and relevant departments should actively create favorable conditions for the implementation of the "two ticket system", and accelerate the cleaning up and abolishment of unreasonable policies and regulations that hinder the healthy development of the pharmaceutical circulation industry in the aspects of enterprise registration, pharmaceutical procurement, cross regional operation, selection of distributors, chain operation, etc Support large-scale circulation enterprises with complete network system, good quality and reputation, and modern logistics ability to carry out drug distribution Support the construction of national and regional drug logistics parks and distribution centers, promote the effective integration of warehouse resources and transportation resources of drug distribution enterprises, coordinate the distribution of multiple warehouses, allow drug distribution enterprises to build warehouses in different places, and use qualified drug warehouses of their own enterprises across regions in the province According to the principle of combination of near and far and linkage between urban and rural areas, encourage and support the integration of regional drug distribution between urban and rural areas, and ensure the effective supply of drugs at the grassroots level For medical institutions at or above the county level, it is not allowed to select circulation enterprises and designate or divide distribution areas through administrative means We should give full play to the supporting role of information technology, build a unified "two ticket system" information bill management system based on the provincial public health information platform, and effectively reduce the burden of bill review and management of circulation enterprises and medical institutions Gradually promote the interconnection and data sharing between provincial drug centralized procurement platform, VAT invoice management system, drug traceability system and integrity system construction platform and provincial public health information platform, so as to realize the interconnection of illegal clues, regulatory standards and mutual recognition of processing results For enterprises that meet the requirements and can input and associate the bill information (including the first ticket, the second ticket, the third ticket and the intermediate ticket) through the information-based bill management system as required, they do not need to provide the medical institutions with copies of paper invoices, nor need to scan and upload the invoice picture information on the provincial drug purchase platform Medical institutions log in the information-based bill management system to verify the authenticity of invoices and whether they meet the requirements of "two bill system" If they fail to pass the information-based verification, they shall ask for paper invoices from relevant enterprises for verification 5、 The relevant departments of supervision and management should closely cooperate and take the initiative, do a good job of supervision and connection according to the division of responsibilities, form a working force, gradually establish and improve the cross departmental and cross regional regulatory linkage response and cooperation mechanism, and effectively carry out the "two vote system" （1） The administrative department of health and health should strengthen the supervision and inspection of the implementation of the "two ticket system" in conjunction with relevant departments, take the implementation of the "two ticket system" in public medical institutions as an important part of the assessment of medical institutions, and treat the doctors who are not strict in asking for and checking tickets (certificates), "two ticket system" is not implemented in place, who are in arrears of payment for goods, and who have no orders