The State Health Insurance Administration issues a list of medical prices and a catalogue of matters of breach of trust.

Medical Network July 27th, 2020 - On July 24, 2020, the official website of the State Administration of Medical Security quietly went online with a notice, "guidance on the establishment of pharmaceutical prices and recruitment credit evaluation system (draft for comments)" for public consultationIt was published by the National Health Service in the form of a formal consultation several months ago, after the draft was circulated informally in the industryE drug managers have also conducted an analysis of the circulating draft of the draftThis draft is not a hollow oneAs early as December 2019, the State Health Insurance Administration commissioned industry associations and industry experts to hold a seminar in Beijing on the integrity system and the construction of the corrections system in the drug procurement sector of public hospitalsAt the time, the meeting discussed how the health care sector could use prices and recruitment tools to combat commercial bribery such as gold salesJudging from the content of this draft, it largely continues the content revealed in the seminarCommercial bribery, market manipulation, etcof pharmaceutical companies will be rated and documented by the health insurance department, which will give different disciplinary measures in the procurement of tenders, depending on the severity of the conductCommercial bribery in medicines such as gold sales has always been the "persistent disease" of the pharmaceutical industry, and is also considered to be the main driver of high drug pricesOver the years, different departments have adopted various strategies for the sale of pharmaceutical companies, but either the punishment is difficult to enforce, or the punishment is less severe, most of the impact is limitedSince 2019, from the Ministry of Finance, the Health Insurance Bureau to 77 pharmaceutical companies to carry out fiscal and tax verification storm, access to pharmaceutical companies first-hand cost structure information; Increase anti-corruption high-pressure in October 2019, CCTV news also reported a unified program piece, the people involved in the case have been medical representatives, through the sale of hospital data profit of nearly one million yuanThis is just one of several cases of commercial bribery in the pharmaceutical field that CCTV news reports in the past two yearsIn the "Chinese adjudication instrument network" to "medicine" "kickback" as the keyword search, you can get thousands of recorded casesThe key words involved are surrender, kickbacks, job positions and so onPharmaceutical sales market competition is fierce, with gold sales has become an industry's unspoken "secret", and the field of purchase and sale of gold sales is the hardest hitGold sales methods are diverse, but also hidden complex is not easy to detect, the combination of the buckle, it is difficult to define the illegal boundary But with the medical reform into the deep water area, the field of pharmaceutical purchase and sale of anti-corruption has become the implementation of various policies of the "transportation hub." Since 2018, the National Health and Health Administration, the State Health Insurance Administration and other nine ministries jointly issued the "2018 to correct the field of pharmaceutical purchase and sale and medical services in the field of improper governance of the main points of work," provinces and cities have issued anti-corruption documents for the purchase and sale of medicines, anti-corruption and high-pressure continued Previously, the largest punishment in the field of pharmaceutical purchase and sale is the procurement "black list", once included in the provincial drug tender procurement blacklist, then two years banned from the market, more than twice in five years blacklisted, then the national public hospitals are not allowed to purchase their products within two years However, the industry believes that the "black list" system in the actual implementation process because the standard is not detailed enough, the punishment is light, it is difficult to implement Coupled with the fact that medicines are special commodities, especially those in short supply in some markets, it is not scientific to adopt a "no-go market" simply and crudely In fact, drug-related problems related to shortages also require a better solution As early as October 2019, the General Office of the State Council issued the Opinions on FurtherIng the Work of Supply and Stabilize Prices for Shortage Drugs, and put forward measures to stabilize prices, and put forward an early warning on strengthening the monitoring of drug price anomalies We will improve the mechanism of drug price cost investigation, establish a credit evaluation system for price and bidding and procurement, and restrict drugs with comprehensive cost investigation and suspension of the internet, such as price increases or frequency anomalies, large regional price differences, etc Whether it is the anti-corruption storm in the field of pharmaceutical purchase and sale, or the formation of a more scientific and perfect recruitment system, the market needs a more systematic, enforceable, covering the pharmaceutical industry throughout the process of supervision of the pharmaceutical industry behavior credit rating As a result, the Draft for Comments came into being If the draft is formally implemented, the actions of pharmaceutical companies will be subject to stricter regulation and accelerated market standardization It is worth noting that the draft also published a list of medical prices and breach of trust, which involved seven acts For pharmaceutical companies, multi-directional, multi-angle to examine their own marketing and price behavior is imminent, and after this, accelerate the transformation of marketing compliance is also placed in front of all pharmaceutical companies a big issue Guidance on the establishment of a credit evaluation system for pharmaceutical prices and recruitment (draft for comments) the provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps Medical Security Bureau: the pharmaceutical sector received rebates, monopoly control and sales and other acts resulting in inflated prices of medicines and medical supplies, medical expenses growth too fast, a large number of losses of medical insurance funds, seriously endangering the safety of medical insurance funds, infringing on the interests of the masses, and increasing the burden of medical expenses for the masses In order to implement the Opinions of the State Council of the CPC Central Committee on Deepening the Reform of the Medical Security System (Cpc (2020) No 5), improve the mechanism for the formation of market-led pharmaceutical prices, and establish a system of evaluation of pharmaceutical prices and recruitment of credits, the following comments are put forward 1 The guiding ideology is based on the civil rights and obligation relationship of centralized procurement of medicines and medical supplies, relying on the bidding and procurement platform for pharmaceuticaland medical supplies, system integration and trustworthiness commitment, credit rating, graded disposal, credit repair and other mechanisms, the establishment of equal rights and responsibilities, coordination of linked pharmaceutical prices and credit evaluation system, to promote the honesty and trustworthiness of all parties, and jointly create a fair and standardized, clean and stable circulation order and trading environment, and ensure the safety of the masses and health insurance funds 2 Establish a list of credit evaluation catalogues to establish a list of pharmaceutical prices and breach of trust, and the items of breach of trust listed in the list include, but not limited to, rebates or other improper benefits (hereinafter referred to as "pharmaceutical commercial bribery"), abuse of market dominance, tax-related violations, improper price behavior, malicious breach of contract agreement, and disruption of centralized procurement order Since the date of the issuance of this Opinion, pharmaceutical enterprises (including pharmaceutical production license holders, pharmaceutical and medical supplies production enterprises, distribution enterprises with entrusted agency relations with production enterprises, as well as distribution enterprises, the same below) in the pricing, bidding, performance, marketing and other processes, through the list of list of breach of trust to obtain improper benefits, into the scope of pharmaceutical prices and credit recruitment 3 The voluntary commitment of pharmaceutical enterprises to participate in or entrust pharmaceutical enterprises to participate in the centralized procurement of pharmaceutical and medical supplies, platform network, and medical insurance fixed-point medical institutions (hereinafter referred to as "medical institutions") for the record procurement, should be independent legal entities to the pharmaceutical and medical supplies centralized procurement agencies (hereinafter referred to as "central procurement agencies") to submit written commitments, commitments include the establishment of a compliance review system, not the inclusion of the list of breach of trust, The distribution enterprise that employs its personnel or has a principal agent relationship shall bear the corresponding responsibility for the breach of trust in its own medicine or medical supplies; Fourth, the establishment of the report ingnet reporting channels to take the combination of enterprise reports and platform records, timely, comprehensive, complete and standardized collection of medical enterprises' breach of trust information, the establishment of pharmaceutical enterprises price recruitment information base Pharmaceutical enterprises take the initiative to report the information of the breach of trust to the centralized purchasing organization where the breach of trust occurred in a timely manner Under the framework of cooperation established by the State Medical Security Administration and relevant departments, centralized procurement agencies regularly comb together the relevant departments' open adjudication instruments, administrative penalty decision instruments, etc., collect and verify the information of the pharmaceutical enterprises for breach of trust and record it In the daily operation of centralized purchasing institutions, through monitoring, correspondence, interviews, acceptance of reports and other means, to grasp the pharmaceutical enterprise pricing, bidding, performance and other aspects of the breach of trust information and record V To carry out the credit rating of pharmaceutical enterprises in accordance with the requirements of "reliable sources, clear conditions, strict procedures, strict operation", according to the nature of the breach of trust, circumstances, timeliness, and the scope of influence and other factors, the pharmaceutical enterprises in the local tender procurement market of the breach of trust assessment as general, medium, serious, particularly serious four levels, dynamic updates on a quarterly basis For acts of breach of trust involving illegal and illegal violations, the facts on which the credit rating is based shall be governed by the court's decision or the administrative punishment decision of the law enforcement department Encourage local areas to explore quantitative credit rating methods to improve the standardization of credit rating 6 The centralized procurement institution for the classification of breach of trust shall, in accordance with the credit rating of the pharmaceutical enterprise, adopt written reminders and warnings, prompt the purchaser with risk information by relying on the centralized procurement platform, suspend the bidding network of relevant drugs or medical supplies, suspend the supply and distribution of the winning drugs or medical supplies, and disclose the breach of trust information to the public, and implement the liability of the pharmaceutical enterprise for breach of trust If the supply structure of the drug or medical supplies involved is single and the supply and demand situation is tight, the measures of graded disposal shall be taken in the event of accessibility 7 Encourage pharmaceutical enterprises to repair credit to establish a mechanism for automatic credit repair and active repair of pharmaceutical enterprises If the breach of trust has been revoked for more than a certain period of time since it has been confirmed or if the relevant judicial judgment or administrative penalty decision is revoked according to law, the record shall be retained but shall no longer be included in the credit rating range Before the disposition measures come into effect, remind the pharmaceutical enterprises, and give certain complaints and rectification periods, as the case may be, allow enterprises to take practical measures to take practical measures to repair credit, including terminating related breach of trust, submitting compliance rectification reports and accepting compliance inspection, publicly issuing apology statements to eliminate adverse effects, removing false space in the price of drugs or medical supplies involved, returning or unconoric proceeds of public donations The correct use of pharmaceutical prices and credit evaluation to establish a credit evaluation system for pharmaceutical prices and recruitment is an important measure to purify the order of the pharmaceutical market, optimize the environment for pharmaceutical business, and promote the high-quality development of the pharmaceutical industry The centralized purchasing agencies in various places shall accept the guidance and supervision of the medical security department, adhere to the laws and regulations as the criterion, take the market mechanism as the guide, take civil rights and obligations as the fundamental, and guarantee the right of pharmaceutical enterprises to independent pricing and independent operation in accordance with the law; Nine, jointly promote the construction of credit evaluation system, centralized procurement institutions should establish and implement by the end of 2020 the provincial-based pharmaceutical price and credit evaluation system, adhere to the principle of joint construction and sharing of governance, promote the active participation of pharmaceutical enterprises, medical institutions, guide pharmaceutical enterprises to consciously fulfill the obligation to comply with price rules, operate in good faith, guide medical institutions under the same conditions to give priority to the choice of better credit rating pharmaceutical enterprises as supply or distribution units The centralized purchasing institutions should further promote standardized construction, improve bidding and procurement services, make full use of information-based means to provide convenient and efficient services and support for pharmaceutical enterprises to submit commitments, record information, repair credit, etc