The head of the medical reform office of the State Council answers the reporter's questions on improving the centralized purchase of drugs in public hospitals
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Last Update: 2015-02-28
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Source: Internet
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Author: User
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Source: on February 28, 2015, the state health and Family Planning Commission of the people's Republic of China issued guidance on improving centralized drug procurement in public hospitals (hereinafter referred to as guidance) In this regard, the reporter interviewed the head of the medical reform office of the State Council Q: what is the background of the guidance? What is the significance of further deepening medical reform? answer Done in one vigorous effort and perseverance, Xi Jinping, general secretary of the CPC, stressed that the reform has entered the deep water area At the end of the new historical period, we must strengthen our confidence and courage, dare to bite the bones, dare to go to dangerous beach, and dare to persist in the stubborn chronic malaria disease accumulated for many years We must resolutely fight the battle of deepening the reform in an all-round way Eighteen 。 To improve the centralized purchase of drugs is an important content and key link of deepening the reform of the medical and health system The centralized purchase of drugs in China started in the 1990s It has gone through decentralized purchase in hospitals, centralized purchase of drugs in cities and regions relying on profit-making third-party intermediaries, centralized purchase of drugs in provinces (districts and cities) based on government led non-profit provincial platform, and new medical reform Since then, we have gradually established a new mechanism for basic drug procurement at different stages of development The implementation of joint procurement of drugs is an international practice and common practice It is a form of joint procurement to insist on the centralized procurement of drugs with provinces (districts, cities) as the unit Two thousand and six Since, the implementation of centralized online drug purchase in China has played an active role in standardizing drug purchase behavior, ensuring drug quality and safety, reducing the false high price of drugs and curbing the unhealthy trend in the field of drug purchase and sale In particular, the implementation of the basic drug system and the construction of a new mechanism for drug purchase at the grass-roots level have made new breakthroughs The public has gained obvious benefits and accumulated rich experience from all over the country However, at present, the centralized purchase of drugs in grass-roots and public hospitals is a "one platform, two methods" The bidding and purchase of drugs in hospitals are divorced Some drug prices are unreasonably high The frequent occurrence of drug kickbacks and commercial bribery cases is still prominent All sectors of society reflect this strongly Therefore, it is imperative to reform and improve the centralized purchase of drugs in public hospitals In accordance with the overall plan of the central government to deepen medical reform, the national health and Family Planning Commission, together with relevant departments, comprehensively evaluated the centralized bidding and procurement practices of drugs in all provinces (regions and cities), conducted in-depth analysis of existing problems, systematically summarized the beneficial exploration of the pilot cities of comprehensive reform of public hospitals and the successful experience accumulated in basic drug procurement, and learned from the common practice of international drug procurement According to the law, the opinions of local governments, medical reform members and experts were repeatedly solicited, and targeted policies and measures were put forward, forming the first draft of the guiding opinions After deliberation in the plenary session of the medical reform office of the State Council, the opinions of relevant departments, various localities, pharmaceutical production and distribution enterprises, medical institutions, industry associations, etc were widely solicited again, rational suggestions were fully absorbed and adopted, further revised and improved, and the draft of the guiding opinions was formed, which was deliberated and approved in the plenary session of the leading group of medical reform of the State Council, February 9 Printed and distributed in the name of the general office of the State Council with the approval of the State Council To improve the centralized purchase of drugs in public hospitals is conducive to breaking the mechanism of supplementing medicine with drugs and speeding up the reform of public hospitals, especially county-level public hospitals It is conducive to reducing the false high price of drugs, reducing the burden of drug use of the people, preventing and curbing the corruption in the field of drug purchase and sale, resisting commercial bribery, promoting the integration and reorganization of drug production and distribution enterprises, fair competition, and promoting the healthy development of the pharmaceutical industry The introduction of the guiding opinions is of great significance to accelerate the reform of public hospitals, standardize the order of drug circulation, improve the national drug policy, and establish a sound drug supply and security system based on the basic drug system Q: what are the general considerations of the guidance? What are the innovative measures and highlights in improving drug procurement? answer The general idea of improving the centralized drug procurement in public hospitals is to fully implement the spirit of the 18th National Congress of the Communist Party of China and the 2nd, 3rd and 4th plenary sessions of the 18th Central Committee of the Communist Party of China, to fully absorb the experience of basic drug procurement, and to adhere to the principle of taking the province (District, city) as the main body, in accordance with the general requirements of the market playing a decisive role in resource allocation and better playing the role of the government, drawing on the common practices of international drug procurement The online drug centralized procurement direction of the unit is to implement a platform, up-down linkage, open and transparent, classified procurement, and take measures such as bidding production enterprises, bidding procurement integration, quantity price linkage, double envelope system, and whole process monitoring, so as to strengthen the comprehensive supervision of the whole process of drug procurement and effectively guarantee the quality and supply of drugs Encourage local governments to explore and innovate in combination with the actual situation, and further improve the participation of hospitals in drug procurement The guidance puts forward a series of targeted innovative measures focusing on the key links of "what to recruit, how to recruit, how to distribute, how to settle accounts, and how to supervise" The first is to implement classified procurement of drugs For different drugs, bidding procurement, negotiation procurement, hospital direct procurement, fixed-point production and other methods are adopted to ensure the supply of drugs and reduce the false high price Second, improve the way of drug payment settlement Encourage pharmaceutical manufacturers and hospitals to settle drug payment directly, and settle distribution expenses with distribution enterprises, so as to further reduce intermediate links Third, strengthen the management of drug distribution We will focus on ensuring the supply and distribution of drugs in remote and inaccessible areas, and encourage all localities to explore the integrated distribution of drugs in counties and villages Fourth, standardize the construction of procurement platform We will expand the functions of provincial drug centralized purchase platforms, unify drug purchase codes, disclose drug purchase information, and share and interconnect drug purchase data Fifth, strengthen comprehensive supervision and management We will seriously investigate and deal with violations of laws and regulations by hospitals and pharmaceutical production and marketing enterprises Q: what are the specific contents of classified drug procurement proposed in the guidance? Answer: classified purchase mainly adopts different ways for drug supply, such as bidding purchase, negotiation purchase, hospital direct purchase, designated production, special drug purchase, etc First, for the basic drugs and non patent drugs with large clinical dosage, high purchase amount and produced by many enterprises, the two envelope system is adopted for public bidding procurement At the same time, it is necessary to carry out a comprehensive evaluation to avoid vicious competition for drugs with obviously low bidding price and possible quality and supply risks Second, we should establish an open, transparent and multi-party price negotiation mechanism for some patented and exclusively produced drugs, and reasonably reduce drug prices The establishment of national negotiation mechanism is a new work, and the negotiation method is under study Third, non patent drugs, emergency (rescue) drugs, basic infusion drugs, drugs with small clinical dosage and commonly used low-cost drugs for women and children's specialty shall be centralized on the Internet and directly purchased by the hospital Fourth, for drugs that are clinically necessary, in small quantities and in short supply in the market, they shall be produced and purchased by the state through fixed-point bidding and price negotiation Fifthly, narcotic drugs, psychotropic drugs, free drugs for the prevention and control of infectious and parasitic diseases, vaccines for national immunization planning, family planning drugs and herbal pieces shall be purchased according to the current provisions of the state Q: how to ensure that drug procurement works in the sun? A: in terms of strengthening comprehensive supervision and management, the guidance has taken a number of targeted specific measures One is to establish a prescription review and doctor interview system, give full play to pharmacists' guiding role in medication, and regulate doctors' prescription behavior Focus on the follow-up and monitoring of auxiliary drugs and drugs that are used abnormally in hospitals We will establish and improve a comprehensive evaluation system for clinical use of essential drugs, and promote the standardization of drug dosage forms, specifications and packaging Second, the centralized purchase of drugs is taken as an important assessment content of the hospital and its responsible person, and included in the target management and hospital evaluation In case of illegal offline purchase and delayed payment, the hospital shall be criticized according to the seriousness of the case, rectified within a time limit, ordered to pay liquidated damages, and downgraded Those involved in corruption such as commercial bribery shall be investigated and dealt with seriously according to law Third, we should strengthen the supervision and inspection of the implementation of drug prices, strengthen the investigation of drug costs and the monitoring of market purchase and sale prices, standardize price behavior, and protect the legitimate rights and interests of patients In accordance with the law, we will seriously investigate and deal with price violations and monopolistic acts, as well as counterfeiting or falsely issuing invoices, affiliated operations, and "walk away" and other illegal acts We will strengthen quality tracking of key drugs and quality supervision throughout the process, and crack down on the manufacture and sale of counterfeit and substandard drugs Fourth, strictly implement the integrity record and market clearing system All localities shall establish good faith records of pharmaceutical production and marketing enterprises and publish them in a timely manner Fifthly, the provincial drug centralized procurement platform collects the drug procurement information, the delivery rate of drug production and operation enterprises, and the bad records in a timely manner, and regularly publishes them to the public The Guiding Opinions also put forward that we should adhere to the national unified market, maintain a fair competition environment, and oppose various forms of local protection At the same time, we should comprehensively promote information disclosure, establish a reward reporting system, consciously accept the supervision of the people's Congress, the CPPCC and all sectors of the society, and ensure that all aspects of drug procurement operate in the sun Q: what are the specific requirements of the guidance for the standardized construction of the centralized drug purchase platform? A: the standardized centralized drug purchase platform is the key link and important support to improve the centralized drug purchase Data of each province (District, city) is a very valuable resource Without platform and data, procurement is a passive water At present, there is still a lack of unified construction standards, unified functional specifications and unified procurement codes for drug centralized procurement platforms in various regions, and there is not all networking between the state, provinces and provinces Therefore, the guiding opinions put forward specific requirements for standardized procurement platform construction One is to realize interconnection In 2014, the state has launched the construction of comprehensive management information system for drug supply guarantee, standardized the construction standard of provincial drug centralized purchase platform, and promoted the standardization of drug purchase code At present, it has preliminarily realized up and down transmission with five provinces (districts and cities) including Tianjin This year, it is necessary to accelerate the progress to realize interconnection and resource sharing among all provinces Two is to expand the platform functions The provincial drug centralized procurement platform should provide high-quality services for hospitals at all levels and drug production and marketing enterprises, and improve the ability in drug bidding and procurement, distribution management, settlement, evaluation, statistical analysis, dynamic supervision, etc Third, promote information disclosure Regularly publicize the purchase price, quantity, payment collection time, distribution enterprise list of each hospital, distribution rate of drug production and operation enterprises, bad records, etc to the society, and accept social supervision Fourth, implement the division of responsibilities To maintain the public welfare nature of the government led, non-profit drug centralized procurement platform, the provincial people's government should provide necessary human, financial and material support, which can only be strengthened but not weakened Q: in what ways does the guidance encourage local exploration and innovation? A: China is a vast country with obvious regional differences Reform needs to be explored and accumulated in practice The guidance strongly calls "four benefits" to test the effectiveness of centralized drug procurement in public hospitals, and encourages local governments to explore innovation in combination with the actual situation everything
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