This year, two key points of medical reform have been made clear, and the second batch of volume procurement is expected to start by the end of September

On June 4, the general office of the State Council printed and distributed the key tasks of deepening the reform of the medical and health system in 2019 The formulation and requirements of the policy of belt quantity procurement and the specification of the use of medical consumables have become the two highlights of the task According to the task, by the end of September, we will complete the formulation of policy documents to further deepen the medical reform with centralized purchase and use of drugs as the breakthrough Industry analysts believe that the second batch of volume procurement is expected to start before the end of September After the policy is made, the volume procurement may be fully spread In 2019, 15 documents "tasks" were formulated to clarify the two key work contents First, it explicitly requires the research and development of 15 documents, and has formulated a schedule and designated the corresponding responsible departments Documents to be completed by the end of June: formulate opinions on the implementation of Health China action, health China action (2019-2030), organization, implementation and assessment plan of Health China action; formulate policy documents to promote the sustainable development of health and standardization of social medical services; and issue drug catalogue to encourage imitation Documents to be completed before the end of August: formulate policy documents to further standardize the use of medical consumables Documents to be completed before the end of September: formulate policy documents to further deepen medical reform with centralized purchase and use of drugs as the breakthrough; formulate Drug Administration Measures for medical institutions; formulate policy documents for Internet diagnosis and treatment charges and medical insurance payments; formulate guidance for deepening the reform of professional title system for health professionals; formulate guidance for establishing and improving the elderly health service system Documents to be completed by the end of November: formulate performance appraisal methods for public medical institutions at or below the second level; formulate methods for strengthening the management of doctors; and formulate management methods for medical consortia The documents to be completed before the end of December: formulate guidance documents for the reform of salary system in public hospitals; formulate policy documents for improving individual accounts of employee medical insurance; formulate regulations on the use of medical insurance funds The second is to promote the implementation of the key work, mainly around solving the problem of difficult and expensive medical treatment, and strengthening hospital management, etc., put forward 21 specific work To solve the difficulties in medical treatment, we should promote the construction of national medical center and regional medical center, orderly develop medical conjoined body, promote grading diagnosis and treatment, deepen reform of "letting go of clothing", support social work, promote the development of "Internet plus medical health", and promote the comprehensive medical reform of county, Shi Jiankang's China action, and strengthening cancer prevention To solve the problem of high cost of medical treatment, we proposed to promote the pilot project of centralized drug purchase and use organized by the state, promote the reform of high-value medical consumables, consolidate and improve the national basic drug system, promote the reform of medical insurance payment mode, improve the compensation mechanism of public hospitals, deepen the comprehensive reform of public hospitals, and deepen the implementation of health poverty alleviation In terms of strengthening hospital management, the paper proposes to carry out performance appraisal of public hospitals and further improve medical services Shi lichen, general manager of Beijing Dingchen Management Consulting Co., Ltd., said that the 15 documents identified in the task clearly defined the responsible unit and department, which is conducive to the landing of documents Many of these documents, such as the release of the drug catalogue encouraging imitation, will be conducive to drug research and development and supply, and solve the payment pressure of patients and medical insurance The second batch of volume purchasing is expected to start the formulation and requirements of volume purchasing policies by the end of September, and become a highlight of the task "Task" requires to complete the formulation of policy documents to further deepen the medical reform by the end of September, taking the centralized purchase and use of drugs as the breakthrough In terms of the key work to promote the implementation, the task specifically proposes that the state organize the centralized purchase and use of drugs, strengthen the monitoring of the quality of bid winning drugs, the priority use of public medical institutions in the pilot areas, the settlement of drug funds, the production of bid winning drugs and APIs, and do a good job in ensuring the use, quality, stable supply and timely payment collection Carry out pilot evaluation, conscientiously summarize pilot experience and push forward in a timely and comprehensive manner According to Shi lichen, the distribution of the task shows that the state has made clear the important work of centralized procurement, and has taken the procurement and use of drugs as the direction of medicine It is expected that the promotion speed of centralized procurement of drugs will be accelerated in the future In addition, it is very important to emphasize the use of drugs as well as the purchase of drugs The first batch of "4 + 7" procurement policies launched at the end of last year have achieved remarkable results since the pilot cities implemented them one after another at the end of March this year At a recent regular briefing, the state health insurance bureau said that the first batch of purchasing policies with capacity had been fully implemented The total amount of 25 selected varieties in 11 pilot cities reached 438 million pieces or pieces, 27.31% of the total amount of contracted purchasing According to the analysis of Ping An Securities, from the perspective of the policy details of the current pilot cities' volume procurement, such issues as medical insurance prepayment, hospital procurement volume limitation and payment collection have been basically implemented, and the procurement volume of the drugs that have won the bid obviously exceeds the market expectation When will the second batch of volume purchasing be launched? The market is highly concerned In Mr Shi's view, the purpose of deepening the policy-making of medical reform is to solve the existing problems through the centralized purchase and use of drugs The second batch of volume purchase is expected to start before the policy-making (at the end of September) After the policy is formulated, the volume procurement may be fully spread Societe Generale Securities believes that the timely launch of the second batch of volume purchase is necessary, and the current conditions are mature; the policy tends to be moderate and rational, and in the long run, it is unlikely to provide exclusive supply nationwide, "4 + 7" plays the role of "pioneer", and "test" the "moisture" of drug price When the price of generic drugs falls back to a reasonable level, the policy will be more flexible; the incremental logic is the core, but it does not mean that small enterprises are the reverse substitution for large enterprises Industrial Securities proposes to focus on two main lines of "high cost performance" and "medium and long term logic" The concentration of high value consumables industry will improve the use of medical consumables, and become another highlight of the task In order to promote the implementation of this key work, the task puts forward specific requirements, that is, to formulate rules for the unique identification system of medical devices Specifically, we should gradually unify the classification and coding of high-value medical consumables for national medical insurance, focus on the treatment of high-value medical consumables with relatively high unit price and resource consumption, and reform and improve the procurement policy of medical consumables The State Health Commission, the State Medical Insurance Bureau and the State Drug Administration are respectively responsible for the above work We should cancel the medical consumables bonus of public medical institutions, improve the compensation policy for public medical institutions, and properly solve the problem of reasonable income compensation for public medical institutions to cancel the medical consumables bonus This part of work is in the charge of the state health insurance bureau, the State Health Commission and the Ministry of finance Another analyst from the pharmaceutical industry of securities companies said that the requirements of the document basically coincided with the requirements for the use of high-value medical consumables at the eighth meeting of recent deep restructuring The management of high value consumables has been the focus of deepening medical reform for a long time After the early drug 4 + 7 centralized purchase policy, the market's expectation for the management of high value consumables industry has been relatively sufficient On May 29, the eighth meeting of the Deep Reform Commission of the Central Committee deliberated and adopted the reform plan on the management of high value medical consumables At the meeting, it was proposed that the management of high-value medical consumables could reduce the medical burden of the people We should adhere to the problem orientation, rationalize the price system of high-value medical consumables, improve the supervision and management of the whole process, purify the market environment and medical service practice environment, promote the formation of a governance pattern with reliable quality, fast circulation, reasonable price and standardized use of high-value medical consumables, and promote the healthy and orderly development of the industry Dongxing Securities believes that high value consumables have become a big burden for patients and medical insurance In recent years, with the reduction of drug prices and the control of the proportion of drugs, the proportion of drugs in medical expenses has decreased year by year, but the medical consumables, especially high-value consumables, have increased rapidly, partially offset the effectiveness of drug price reduction, and the total medical expenses are still increasing For a long time, the circulation and use of medical consumables lack of unified standardized management, which leads to commercial bribery, repeated abuse and other problems In response to the disorder of medical consumables, in 2017, the national health and Family Planning Commission, in conjunction with nine ministries and commissions, issued the special remediation program for medical consumables, which lasted for half a year However, there are still many problems with medical consumables, and the government has paid close attention to them CITIC Securities believes that under the guidance of policies, the high-value consumables industry is expected to further reduce the terminal price and channel water, which is conducive to import substitution and industry concentration in the medium and long term Specifically, the competition pattern of domestic orthopaedic industry is scattered, and the import substitution rate is still insufficient In the future, it is expected to usher in the industry integration dividend At present, the market position of leading enterprises in cardiovascular intervention industry is obvious, and in the future, it will be more necessary to compete the strength of innovative products and R & D pipeline to ensure the leading position.