Sun Zhigang investigates drug purchase in Australia and transmits three policy signals

Source: Health circle / Hao Lanlan 2015-08-26 recently, Sun Zhigang, deputy leader of the leading group of medical reform of the State Council and deputy director of the national health and Family Planning Commission, led a team to Australia and New Zealand to conduct a special investigation on drug procurement, and saw the reference significance of the reform concept of Australia and New Zealand in promoting the reform of China's drug supply and security system The leading group of medical reform of the State Council believes that China should put the reform and improvement of the medical supply security system in a more prominent position; at the same time, it is suggested to integrate the drug management system into the 13th five year plan for medical reform as a whole For the controversial centralized drug purchase system, the leading group of medical reform under the State Council believes that the direction of centralized drug purchase should be unswervingly adhered to, doctors, pharmacists and other factors should be brought into play, and the reform of centralized drug purchase mode should be promoted It is reported that the application system for drugs for special diseases is a common practice in most countries in the world, and China has not yet established this system Through investigation, the leading group of medical reform of the State Council suggested that an application system for the use of special drugs for patients with special diseases should be established "Drug purchase": adhere to the direction of centralized drug purchase In the past 15 years, the call to abolish centralized drug purchase has never stopped At the two sessions of 2013-2015, the representatives of the pharmaceutical industry proposed to abolish the centralized bidding procurement of drugs for three consecutive years To this end, the leading group of medical reform of the State Council gave a clear response after its investigation in Australia It is necessary to adhere to the direction of centralized drug procurement, gradually improve the drug procurement methods, and establish a new drug procurement mechanism in line with China's national conditions Recently, the general office of the State Council issued the guiding opinions on improving the centralized procurement of drugs in public hospitals, which clearly defined the direction of classified procurement and volume procurement The health sector learned from the routine press conference recently held by the national health and family planning commission that a new round of centralized drug procurement program is being studied and formulated by all regions, and will be implemented in the middle and late November 2015 The leading group of medical reform stressed that it is necessary to promote the reform of centralized drug procurement and improve the purchasing management ability We should give full play to the roles of doctors, pharmacists, patient representatives, scientific research institutions, universities and enterprises, and work together to provide advice for the centralized procurement of drugs In order to reform the mode of centralized drug purchase, we should focus on the price negotiation of patented drugs and exclusively produced drugs, so as to reduce the false high drug price In this regard, New Zealand health officials believe that price negotiation and gaming with pharmaceutical enterprises is a long-term and arduous undertaking, and it is worth investing certain human and financial resources "Drug management": the biggest experience of the drug management system incorporated into the "13th five year" medical reform planning and medical reform leading group's new visit to Australia is that all links such as drug quality supervision, medical insurance catalog determination, bidding procurement, use management, etc should be integrated into one another, and exchange should be linked In Australia and New Zealand, the functions of drug quality supervision, price control, bidding and procurement are all concentrated in the Ministry of health, which effectively integrates all aspects of drug management resources into a "fist", establishes a linkage mechanism, and forms a strong restraining force for drug manufacturers, so that the health sector always takes the initiative in centralized procurement and price negotiation In China, drug bidding and procurement work is to implement the responsibilities of the health and Family Planning Commission, the development and Reform Commission, the Ministry of human resources and social security, the Ministry of finance, the Ministry of Commerce, the Ministry of industry and information technology, the State Food and drug administration, the CIRC and other relevant departments, and there is no linkage mechanism The leading group of medical reform suggested that we should organize forces to conduct in-depth research on China's drug management system and system, plan as a whole in the 13th five year plan for medical reform, promote the separation of medicine, eliminate the use of medicine to support medicine, and realize the efficient operation and sustainable development of medical system and drug system According to the evaluation report on the pilot reform of urban public hospitals recently issued by the leading group of medical reform of the State Council, the elimination of drug addition alone can not fundamentally eliminate the problem of supporting hospitals with drugs, and it is more difficult to solve the problem of profit seeking of public hospitals We should simultaneously push forward the reform of the mechanism of canceling drug markup, drug pricing, drug circulation, and bidding and purchasing "Drug use": the leading group of medical reform to study the establishment of drug use system for special diseases found that both Australia and New Zealand have established drug application system for rare diseases For example, in New Zealand, if the treatment of some special diseases is not included in the subsidy list (equivalent to China's basic medical insurance catalogue), the government will give subsidies as long as the treatment needs, but special applications are needed Specific methods include authorization, guarantee, evaluation, special use right expert group, etc In Australia, for some special diseases but there is no corresponding treatment drug in the drug subsidy list, the hospital can directly apply to the Ministry of health The leading group of medical reform suggested that China should establish an application system for the use of special drugs for patients with special diseases in accordance with the practice of Australia and New Zealand, meet the drug demand of patients with serious and rare diseases, and solve the medical burden of some patients with serious or special diseases.