The price of some drugs is getting higher and higher in Jiangsu Province!

Source: medical economic news 2017-04-18 Since the general office of the State Council issued guidance on improving centralized drug procurement in public hospitals (GBF [2015] No.7) in 2015 and the notice on implementing guidance on improving centralized drug procurement in public hospitals (ghyzf [2015] No.70) issued by the state health and Family Planning Commission, all provinces (cities and autonomous regions) have responded to the call, according to the document "reducing drug deficiency" In combination with the characteristics of the province (city, autonomous region), we will gradually carry out a new round of drug bidding work In the drug bidding of various provinces, drugs are generally divided into different quality levels, such as patented drugs, new drugs of a class, and drugs that have won important awards, etc., which will be classified into high-quality level Drugs that only pass the GMP certification in China are generally in the low-quality level Drugs of the same quality level will compete in the same field Based on the recognition and protection of high-quality drugs, the bid winning price of low-quality drugs shall not be higher than that of high-quality drugs, commonly known as "the price shall not be reversed" With the introduction of drug bidding and procurement programs and the in-depth development of bidding work, some strange phenomena in the price of drug bidding are emerging In the drug bidding in some provinces, there is a prominent unreasonable phenomenon in the bid price of drugs, which makes people feel that the higher the drug price is, the higher the bid price is On April 13, the unreasonable price increase of some varieties was announced by Jiangsu provincial drug centralized purchase center, and the results of evaluation of economic and technical bid for drug centralized purchase in Jiangsu Province in 2015 According to the notice on declassification of quotation of centralized drug purchase products in Jiangsu Province in 2015 (syzz [2017] No 18) issued on the same day, the author declassified the quotation of products on April 17 and found that in the direct online purchase project of small dosage drugs in Jiangsu Province, some of the shortlisted varieties had obvious unreasonable high prices and upside down phenomenon Taking cefazolin sodium for injection as an example, Shenzhen Lijian Pharmaceutical Co., Ltd (hereinafter referred to as "Shenzhen Lijian") which belongs to the fourth quality level (the lowest quality level) has a bid price of 23 yuan / piece (0.5g), 39.5 yuan / piece (1.0g), and Zhongshan Jincheng daobo pharmaceutical Co., Ltd (hereinafter referred to as "Zhongshan Jincheng") has a bid price of 33.22 yuan / piece (0.5g) The bidding price of cefazolin enterprises in the third quality level is between 0.85-4.8 yuan / piece (see Table 1) The price of low-quality Shenzhen Lijian and Zhongshan Jincheng is much higher than that of high-quality manufacturers In particular, such a price means hundreds of yuan a day of treatment costs, and now patients according to the last round of Jiangsu bidding price to buy drugs, a day just a few yuan Can the common people accept this contrast?! Table 1: the situation of the shortlisted enterprises of centralized purchase of cefazolin sodium for injection in Jiangsu Province to win the bid as the national class a medical insurance and national basic drug, cefazolin, a commonly used clinical antibiotic, was priced at 1.8 yuan and 3 yuan respectively in the national basic drug retail guidance price published by the national development and Reform Commission in the past After the drug price was released, the prices of various manufacturers remained stable at the highest retail prices According to preliminary statistics, there are only about 600 drugs with multiple quality levels for small products, but there are about 300 drugs with "upside down" bidding price at the upper and lower quality levels It can be seen that the occurrence of such unreasonable phenomena is closely related to the formulation and implementation of bidding rules in different regions The survey found that the price of some varieties increased significantly under the mode of multi land direct network For example, in Jiangsu Province's emergency (rescue) and women's and children's specialty non patent drug online procurement, 1311 shortlisted products were regulated, 1193 of which were online price rising The online drug successfully avoided the cruel price fight of the "double envelope" mode of bidding procurement, and drug companies generally increased the price online (see Table 2) Table 2: according to the bidding practice and actual results of each province, the prices of drugs in Jiangsu Province are generally increased by a large margin at present, which mainly occurs in three centralized procurement methods: low price drug hanging net, emergency rescue, women and children's non patent drug hanging net, and small dosage drug price limit hanging net Among them, there are still restrictions on the daily treatment costs of the national development and Reform Commission for low-cost drugs, while there are no restrictions on the prices of the other two categories With the cancellation of drug pricing by the national development and Reform Commission, some enterprises take advantage of the state's deregulation of drug prices, do not pay close attention to the policy dividend, improve the quality and guarantee the supply, but start on the spot The only restriction factor of these two kinds of drug prices is the government's formulation of classified purchase rules and upper limit price, and the perfection of classified purchase scheme design and the formulation level of upper limit price determine the final purchase price What needs to be paid attention to by the relevant departments of each province is that there are many such drugs on the Internet, which involve a wide range of areas, and improper handling is likely to cause negative social reactions Taking Jiangsu Province as an example, there are more than 1100 products on emergency rescue net, more than 7300 products on low-cost drug net, nearly 6000 products on small quantity list, and more than 6900 drugs with large quantity are finally shortlisted The proportion of drugs on net is very large Once the setting of rules or the setting of price limit is unreasonable, it is easy to have a large area of sharp price increase, and there will be extreme phenomena such as dozens of times of price increase of cefazolin Phenomenon From the perspective of the new round of centralized purchase of drugs in China, how to understand and implement the new centralized purchase policy of the country is a test for the centralized purchase departments of drugs in all provinces However, the centralized purchase of drugs in Jiangsu Province has a great influence in the whole country, which has been standardized and rigorous all the time Even so, it is not difficult to find that some enterprises will exploit the loopholes of drug bidding rules and greatly increase the drug price Therefore, the price of some drugs with the same general name, the same ingredients and the same pharmacological mechanism will be higher and higher, which will seriously disrupt the normal order of the drug market.