The next key point of high value consumables: "two ticket system" and national centralized purchase

On December 5, the State Health Insurance Bureau replied to the No 1209 proposal of the second session of the 13th National People's Congress The state health insurance bureau said in the "proposal on two vote system": In December 2016, the medical reform office of the State Council issued the implementation opinions on implementing the "two vote system" in the drug procurement of public medical institutions (Trial), promoting the implementation of the "two vote system" in the drug procurement of public medical institutions Since its implementation, it has played a role in regulating the circulation market, accelerating the integration and large-scale development of the circulation field However, considering the huge difference between high-value consumables and drugs and the complexity of their clinical use and after-sales service, the "two ticket system" of high-value consumables needs further study This means that the National Health Insurance Bureau has made it clear that due to the complexity of high consumption of clinical use and after-sales service, the two vote system for high value consumables will still be under research at the national level and will not be implemented in a unified way in a short period of time The state health insurance bureau did not give a detailed response to the specific problems of the two vote system for high value consumables The reasons for the suspension of the two ticket system for high value consumables are as follows: 1 Improve the management system of high-value medical consumables and build the national medical consumables code There are many, small and scattered medical devices in the production and operation of the country, so it is necessary to make a national coding system and improve the coding of consumables Unified coding of medical insurance consumables nationwide, unified identity certification of consumables, and elimination of future bidding price difference For this reason, the State Food and drug administration also issued the rules for the unique identification system of medical devices in August this year 2 Different from the pharmaceutical industry, a small number of doctors in the instrument industry have a lot of resources For example, endoscopy in urology may be practiced by 1300 doctors in China In this case, different from the drugs with multiple departments and indications, the market scale of devices will inevitably be unequal Therefore, if the two vote system is forced, some products may die, which is not conducive to the use of clinical devices Although the implementation of "two ticket system" for high-value consumables has been suspended nationwide, and the state has given many enterprises two years to adjust and adapt, the prototype is emerging, the situation of consumables market has been determined, and the "two ticket system" for high-value consumables will be realized sooner or later In July this year, the State Council issued the reform plan for the treatment of high-value medical consumables, which clearly stated that "encourage all regions to reduce the circulation of high-value medical consumables by means of" two ticket system "in combination with the actual situation" Note that the key point here is: all regions should combine with reality It can also be said that not affecting the use of patients and clinical treatment is the premise of the implementation of high consumption "two vote system", and the implementation can indeed reduce the circulation cost and procurement cost In fact, the two vote system of high-value consumables at the provincial level has come to the front of the national policy According to relevant statistics, 25 provinces have started or fully implemented the two vote system for consumables, and only 6 provinces and cities have not issued relevant policies ◆ in 2016, the former national health and Family Planning Commission and other nine departments printed and distributed the key points of special governance work for correcting unhealthy tendencies in medical purchase and sale and medical services in 2016, which pointed out that the two vote system should be implemented in the purchase of drugs and consumables in the pilot provinces of comprehensive medical reform and the pilot areas of comprehensive reform of urban public hospitals ◆ on March 20, 2018, the former national health and Family Planning Commission issued the notice on consolidating and breaking the achievements of medical supplement by drugs and continuously deepening the comprehensive reform of public hospitals, saying that the "two ticket system" for the purchase and sale of high-value medical consumables should be gradually implemented ◆ on July 31, 2019, the reform plan for the treatment of high-value medical consumables issued by the State Council also clearly stated that all regions are encouraged to reduce the circulation of high-value medical consumables through "two vote system" and other ways in combination with the actual situation, so as to promote the openness and transparency of purchase and sale Another key point of the response to recommendation 1209 is the proposal on centralized procurement of key high-value consumables in countries In this regard, the state health insurance bureau believes that the complexity of medical consumables is higher than that of drugs, specifically in three aspects: First, there is no common name for medical consumables; Second, the variety and specification of medical consumables are various and the market is scattered; Third, most medical consumables can only be used in medical institutions, and the level of users directly affects the medical effect Therefore, according to the requirements of the State Council's reform plan on the treatment of high-value medical consumables, the next step of the National Health Insurance Bureau will select key varieties to carry out the pilot work of "purchasing with quantity" and reduce the price of high-value medical consumables.