The proposed bid winning result of volume procurement is released, with a big drop of 53%! Guan Xuan: Revive low-cost medicine with quantity

Late yesterday night, Shanghai Sunshine pharmaceutical purchasing network announced the results of the second batch of volume procurement to win the bid The average price reduction of this volume procurement reached 53%, with a maximum drop of 93% It is expected that patients nationwide will use the selected drugs in April 2020 At the same time, the press release said that the selected drugs will be used preferentially in hospitals, which is the key to the success of centralized drug procurement organized by the state The Department of health and health has issued special documents to require medical institutions to unblock the policy channels for priority use of selected drugs, improve the reasonable use level of selected drugs, establish and improve the incentive mechanism and performance appraisal system, strengthen the monitoring of clinical use of selected drugs, and ensure the use of selected drugs The medical insurance department provides strong guarantee for the use of selected drugs through such incentive measures as prepayment of medical insurance fund, encouragement of medical insurance fund to settle accounts directly with enterprises, and surplus retention of medical institutions According to the data released in the press release, up to the end of December, the average procurement progress of 25 selected drugs in "4 + 7" pilot areas has been 183%, with selected drugs accounting for 78% of the same generic drugs Obviously, 25 varieties have brought market rolling effect to competitive products However, for specific varieties, the effect may be different Interesting academic has also made analysis, and will not repeat here (if you are interested, please click the link: 25 products purchased with quantity, 162 competitive products are greatly reduced! 13 varieties of medicine price has been rolled) Qilu quotation return cautious in the purchase of the second wheel belt quantity, the manufacturers with more shortlisted varieties are (photo source: minenet): among them, Qilu is the manufacturer with the most shortlisted varieties At the time of the first round of belt procurement and national bid expansion, Qilu showed fierce performance Not only many products won the bid, but also the bid price was far lower than that of competitors, which showed that Qilu was determined to win In the new round of belt purchase, Qilu has 7 varieties shortlisted, and 4 varieties have successfully won the bidding, including trimetazidine hydrochloride sustained-release tablets, tegio, adefovir Dipivoxil and Sullivan succinate However, in terms of the bid winning price, there is not much difference compared with other prices to be selected, and most of them are the ones with high price and advantages For example, only two pharmaceutical companies won the bid for tegio, namely Hengrui and Qilu The winning price of Hengrui was 5.66 yuan / tablet and Qilu was 7.81 yuan / tablet According to the press release of the three principles of adjustment of bidding rules, there are four reasons for the successful price reduction of the current volume purchase, including the volume purchase, the integration of bidding and procurement, and the timely payment collection In addition, the press release believes that there are two reasons: improving the rules and reviving low-cost drugs Among them, in order to improve the rules and promote competition, the state health insurance bureau said that the drugs included in the second batch of centralized procurement scope are the more competitive varieties of three or more manufacturers On the basis of summarizing the experience of "4 + 7" pilot and pilot expansion, and on the premise of ensuring the prevention of monopoly and supply risks, we have further improved the procurement rules, which not only allows multiple companies to choose, but also maintains moderate competitiveness It is allowed that there are differences in the selected prices of different enterprises of the same drug At the same time, the reasonable control of the price gap between different selected enterprises of the same drug not only respects the appropriate price difference caused by market competition, but also prevents the treatment imbalance caused by too large price gap Three principles are embodied in the bid winning rules of this volume purchase: 1) to meet the ultra-low price, that is, to achieve 1 point / piece, to win the bid naturally; 2) to reduce enough That is to say, the maximum price will be reduced by 50%; 3) the principle of fairness will be followed, and the bid will not be accepted until the price is no more than 1.8 times of the minimum price Yesterday, we analyzed that Beijing Fuyuan had just passed the consistency evaluation and obtained the bidding qualification before the bid opening However, when quoting, we didn't expect that Bayer's quotation was only 18 cents per tablet, which led to a 48% reduction of Beijing Fuyuan compared with the ceiling price However, because the price was more than 40 cents and more than twice the lowest quotation, the bid was lost miserably The inspiration for the industry is: 1 The varieties that may be included in or will be started to be purchased with national capacity in the future should be the ones that are fully competitive among three or more manufacturers 2 In terms of competition rules, fairness is a principle that must be considered, and any loopholes that may lead to unfairness will be blocked This volume purchase blocked the fairness problem caused by the price gap In the procurement of the first wheel belt quantity, it is allowed to win the bid at different prices for the same variety, but because the price gap is not specified, leading to a large price gap for some varieties, which means that patients will face the following problems in the use and reimbursement of medical insurance: the difference between the purchase price and the payment price of the same drug in different regions is very large, which is a problem of unbalanced treatment Of course, the fairness issue can be further extended For example, the belt price is in the belt region, and the non belt price is in other regions For example, Bayer acarbose, the middle price is in the middle selection region What about in the non middle selection region? Will it be sold at the original price? There is also quantity assurance, how to actively guide patients to use? There has been a response from patients in Zhejiang Province, leading to the issuance of documents by the medical insurance bureau, and forbidding hospitals to cut off the supply of non selected products (for details, please refer to the joint issuance of documents by the provincial medical insurance bureau and the health and Health Commission, and forbid to stop the supply of non selected varieties with a volume of purchase!) In my opinion, these problems will force the introduction of medical insurance payment standards as soon as possible After several rounds of belt quantity purchase, the price based on market discovery will become the payment standard of medical insurance, and will not be reimbursed in the payment standard of medical insurance, so that in the non belt quantity market, the payment standard of medical insurance can guide enterprises to quote, and also give patients the right to choose drugs The press release also said that from the historical purchasing data, the original price level of some drugs with low production cost and full competition is very low However, due to the circulation mode, low-cost drugs are difficult to open up the market and are "eliminated" by high-cost drugs, so it is difficult for patients to buy drugs at low prices For example, acetaminophen, an antipyretic and analgesic drug, has been sold by enterprises at a price of 0.02 yuan / tablet according to historical data, but low-cost drugs have not become the mainstream The price to be selected is 0.03-0.07 yuan / tablet, which promotes the stable supply of low-cost drugs The same is true for metronidazole and amoxicillin 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 drugs and sending them back to patients, which is also a return to international practice Attachment: bid winning result of the second tire quantity procurement