The Medical Insurance Bureau's statement: squeeze circulation costs to rectify distributors

On January 17, the state health insurance bureau issued the second batch of national organization drug centralized purchase and use work answers to journalists' questions (hereinafter referred to as "answers to journalists' questions"), which clearly stated that to further squeeze the circulation costs would affect a large number of dealers The National Health Insurance Bureau said in the "answer the reporter's questions" that from the absolute price level, a considerable part of the product price has a high water content for a long time The price level of some products is more than 2 times higher than the international price, and the circulation cost accounts for the main part of the price, which is the main space for centralized purchasing with volume and price reduction The State Health Insurance Bureau stressed that in the traditional mode of "separation of bidding and procurement", only bidding price without quantity, quantity price decoupling, and the lack of sales volume expectation After the price reduction of some products, there is no commitment to purchase quantity, but there is no so-called space for selling expenses, which leads to "price reduction dead", so it is difficult to achieve effective price return to a reasonable level The core of centralized procurement and use of national organizations is to truly realize the integration of procurement with volume and bidding and purchase, to give the production enterprises clear expectations, which is conducive to their independent quotation declaration according to the procurement volume, to truly realize the volume price linkage, and to squeeze out the virtual high space It is understood that the second round of national drug volume negotiation has been completed recently, involving 33 major varieties, with an average price reduction of 53% and a maximum reduction of 93% In the answer to the reporter's questions, the state health insurance bureau also said that under the decentralized procurement mode, some enterprises do not pay attention to product innovation, quality and cost control, and excessively rely on sales channels In this marketing mode, the sales and medical staff are faced with the risk of violating laws and regulations With the volume procurement, enterprises return to cost and quality competition The public relations behavior of enterprises will be greatly reduced The competition among enterprises will turn into open and transparent product quality and cost competition The State Food and drug administration has made it clear that it is necessary to turn the gray operation under the water into fair competition under the sun, which fundamentally improves the ecological environment of the pharmaceutical industry and is conducive to the transformation of the pharmaceutical industry from marketing driven to innovation driven In addition, it is an indisputable trend to normalize with volume procurement According to the answer to reporters' questions, the next step is for the state health insurance bureau to establish a normalized and standardized centralized procurement system based on the improvement of the "4 + 7" pilot and expansion as well as the second batch of national centralized procurement and use experience, so as to include more products in the centralized procurement In addition, Han, member of the Standing Committee of the Political Bureau of the CPC Central Committee and vice premier of the State Council, is holding a symposium at the National Medical Security Bureau on January 9, according to CCTV news Han Zheng stressed that we should vigorously promote the national centralized procurement, promote the normalization of centralized procurement with volume, expand the scope of procurement varieties, and drive the reform of "three medical linkage" It is worth noting that the national health insurance bureau also published such a set of data in the answer to the reporter's questions: according to the audit survey of more than 100 common products by relevant departments, their average selling price is about 17-18 times of the production cost, and the production cost only accounts for a very low proportion of the price The price of the products selected in this centralized procurement has dropped significantly What has been squeezed out is the unreasonable moisture existing in the circulation field for a long time, rather than the production cost, which will not affect the product quality level In fact, the price is extremely opaque, which has long been a puzzle for the equipment industry For example, recently, Nanjing Medical Insurance Bureau issued the announcement on canceling the purchase of relevant blood dialyzer products with volume, which showed that the enterprises to be selected for blood dialyzer products could not supply according to the actual supply price after the interview because the negotiation price was higher than the actual supply price In the end, a winning machinery enterprise in Shanghai and two standby bidding machinery enterprises all gave up the qualification of winning It can be seen that there is still a gap between the lowest price held by relevant departments and the lowest price that enterprises can actually reduce The State Health Insurance Bureau stressed that we should "revive" the low price and return to the market According to the answer to the reporter's questions, from the perspective of historical purchasing data, some products with low production cost and full competition have low original price level However, due to the circulation mode, low-cost products are difficult to open up the market and are "eliminated" by high-cost products, so it is difficult for patients to buy products at low prices For example, for a certain antipyretic and analgesic product, the historical data shows that some enterprises sell it at a price of 0.02 yuan, but the low-cost product has not become the mainstream The price to be selected is 0.03-0.07 yuan, which promotes the stable supply of low-cost products After the centralized purchase and use of drugs organized by the state, enterprises no longer need to carry out sales public relations by purchasing and ensuring the use of drugs with quantity, which not only has the effect of reducing the false high drug price, but also has the function of "Reviving" a batch of low-cost products and returning them to the patients, which is also an international practice In addition, 90% of the bid winning enterprises with volume purchase enjoy one month settlement According to the state health insurance bureau, on the one hand, the centralized procurement of national organizations requires medical institutions to settle the payment in time; on the other hand, medical insurance funds should be paid in advance or directly settled with enterprises to ensure the payment in time.