The State Health Insurance Administration issued a document on the national rectification of supplies rebates.

On September 16th, the State Health Insurance Administration issued the Guidance of the State Administration of Medical Security on the Establishment of a Credit Evaluation System for Pharmaceutical Prices and Recruitment (hereinafter referred to as the Guidance), referred to as the "Guidance"), until the existence of commercial bribery in medicine, and other acts of arms enterprises will be included in the scope of pharmaceutical prices and credit evaluation.
The Guidance shows that the State Health Insurance Administration has established a list of medical prices and the list of matters of breach of trust, implemented dynamic adjustments, and included in the list of non-trust matters, including pharmaceutical commercial bribery, tax-related violations, the implementation of monopoly acts, improper price behavior, disturbing the centralized procurement order, malicious breach of contract agreements and other acts contrary to good faith.
From the date of issuance of the Guidance, pharmaceutical enterprises (including pharmaceutical production license holders, pharmaceutical and medical supplies production enterprises, distribution enterprises with a principal-agent relationship with production enterprises, and distribution enterprises, the same below) shall be included in the scope of pharmaceutical prices and credit evaluation in the course of pricing, bidding, performance, marketing, etc., through the misinreinment listed in the catalogue.
According to the official website of the State Health Insurance Administration, the relevant person in charge of the price recruitment department of the State Health Insurance Administration said that the long-standing problems such as rebates and monopoly price increases in the pharmaceutical sector are important reasons for the inflated prices, resulting in excessive growth in medical expenses, a large loss of medical insurance funds, overburdening the masses, inducing excessive medical treatment, harming the health rights and interests of the masses, distorting the business environment and industry ecology, and weakening the innovation drive of the industry.
Taking the issue of drug rebates as an example, according to publicly available court decision documents, more than half of the country's 100 compulsory drug companies were found to have given or indirectly given kickbacks between 2016 and 2019, with the most frequently involving more than 20 cases in three years and more than 20 million yuan in a single case.
average sales expense rate of listed companies in China is more than 30%.
The purpose of establishing the credit evaluation system is to give full play to the guiding and normative role of the centralized procurement market for pharmaceutical products, to take appropriate measures to give rebates, monopoly price increases and other outstanding problems, to promote pharmaceutical enterprises to set prices in accordance with the principle of "fairness, reasonableness and good faith, quality and price conformity", to promote the reasonable return of pharmaceutical products prices, and to safeguard the vital interests of the people.
a number of armed enterprises face out of the "guidance" shows that the establishment of pharmaceutical enterprises to take the initiative to commit to the mechanism.
Pharmaceutical enterprises participate in or entrust themselves to participate in centralized procurement of medicines and medical supplies, platform networking, etc., and submit written commitments to provincial centralized procurement agencies, including to put an end to the act of disreponment, assume responsibility for failure of trust, accept disposal measures, etc.
establish a reporting mechanism for information that is not trusted.
to adopt the combination of enterprise reporting and platform records, pharmaceutical enterprises should take the initiative to report the information of loss of trust to the provincial centralized purchasing agencies where the loss of trust occurred.
provincial centralized procurement agencies regularly comb the summary, collect verification of pharmaceutical enterprises lost trust information.
follow-up National Health Insurance Administration will actively promote the establishment of a case source information sharing and exchange mechanism with relevant departments, and continuously improve the timeliness, accuracy and completeness of information acquisition.
, on September 17th the State Health Insurance Administration announced that the Supreme People's Court and the State Health Insurance Administration had recently signed a Memorandum of Cooperation on the Exchange and Sharing of Information on Commercial Bribery Cases in the Pharmaceutical Sector. The main contents of the
Memorandum are to establish a regular notification system of commercial bribery cases in the field of medicine, actively expand the application of judicial results of commercial bribery cases in the field of medicine in the field of pharmaceutical prices and recruitment, jointly promote information exchange and sharing at all levels of the system, and continuously deepen cooperation in the management of commercial bribery in the field of medicine.
According to the above-mentioned "guidance", this time will also carry out the credit rating of pharmaceutical enterprises, according to the nature of the act of disreponestment, circumstances, limitations, impact and other factors, pharmaceutical enterprises in the local tender procurement market of the situation of the loss of trust is assessed as general, medium, serious, particularly serious four levels, dynamic updates on a quarterly basis.
August 19, the State Administration of Health Insurance issued the Code of Practice for the Evaluation of Pharmaceutical Prices and Credits (Draft for Comments) and the Discretionary Benchmark for Pharmaceutical Prices and Credit Ratings (Draft for Comments).
The above-mentioned draft for comments shows that for pharmaceutical enterprises rated as "particularly serious", in addition to warning, warning risks, should be suspended all drugs and medical supplies of the enterprise hanging network, bidding or distribution qualifications, the suspension period of the pharmaceutical enterprises to repair credit, rating results changes.
In a single case, if the amount of bribes paid by the enterprises involved is more than 1 million yuan, or if all kinds of medical institutions and their staffs at all levels have been involved in commercial bribery of medicine within the scope of the province, the amount of bribes accumulated in more than 5 million yuan shall be assessed as particularly serious.
Giving Rebates≠ The Market Economy Guidance also published the List of Pharmaceutical Prices and Mis-TrustEd Matters (2020 Edition), as shown in the figure below: Specific matters currently included in the scope of evaluation include pharmaceutical commercial bribery, tax-related violations, monopoly practices, improper price behavior, disturbing centralized procurement order, malicious breach of contract agreements and other 7 categories of acts.
The State Health Insurance Administration price recruitment department responsible person said that the above-mentioned acts directly caused the price of drugs and medical supplies falsely high, the cost of too fast growth, the unreasonable burden of the masses increased;
At the same time, whether this is an administrative means to force the management of pharmaceutical prices inflated, the above-mentioned person in charge said, some pharmaceutical enterprises worry about credit evaluation, loss of trust constraints, is not the field of drugs and supplies no longer adhere to the market mechanism to play a leading role in the reform direction, is not to use administrative means to limit the power of independent management, independent pricing.
are all misreadings of the credit evaluation system.
first of all, as long as any subject in the pharmaceutical production and operation chain to carry out commercial bribery and other acts are found to be true, exposing the existence of high prices of pharmaceutical products, it exposed the pharmaceutical enterprises pricing behavior illegal and un trusted nature.
, the credit evaluation system is based on the relationship between the sale and purchase contract, based on the re-equalization of rights and responsibilities, based on the freedom of pharmaceutical enterprises to enter and exit the centralized procurement market.
to "eliminate the false high space of price" as an example, this is a way for credit-losing enterprises to repair credit, you can choose, or you can not choose, rather than the medical security department to the non-trust enterprises to take administrative enforcement measures.
, giving kickbacks and other illegal violations and market economy can not be equal.
market mechanism does not mean that there are no supervision constraints, but there is a red line, there is a bottom line.
just as there are traffic rules to better protect the freedom of driving, to create a fair and standardized, clean circulation order and trading environment, there will be a market mechanism to play a role in the space.
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