Why has centralized drug purchase become a breakthrough?

In another 10 days (January 17), in the cold winter, with the expectation of all people, the second round of national joint mining will officially start shooting! There are 4 + 7 successful water test, combined mining and expansion demonstration, followed by the tragedy of Hebei special procurement for two diseases and the ice breaking of Anhui regional procurement It can be expected that what kind of killing situation will appear in the coming new national combined mining To use one word to describe 2019 is undoubtedly "anxiety": under the background of economic downturn, all walks of life are not easy to do, especially in the pharmaceutical industry! Restricted by the policy, we eat in the weather The consistency evaluation is incessant, the volume purchase is in full swing, the catalog monitoring is near at hand, and the medical insurance transfer out is restless But it is the so-called don't forget the first heart, then can eat at ease After dinner, you may think about a very important topic: where will the centralized purchase of drugs go in 2020? 2018 is a very important year for the reform of medical and health system and top-level design The institutional reform was carried out in an all-round way, and there were obvious changes in the adjustment of departments In the optimization and adjustment of institutional functions in the fields of medical treatment, medical insurance, medicine and key links, the establishment of the state medical insurance bureau is the key measure to build the three medical linkage in the future from the perspective of "security" In 2019, the 4 + 7 and combined mining expansion officially launched, and gradually evolved from the original 4 + 7 single source of goods to the relevant provisions that "multiple enterprises are allowed to be selected, and each drug enterprise is generally no more than 3; the price of the selected products is lower than the price of the selected products in the" 4 + 7 "pilot, and the purchase agreement period is set as 1-3 years" Although the effect is obvious, for more than half a year, many medical institutions have no inner motivation for the use of the selected drugs Due to insufficient publicity, some patients have no clear understanding of the selected drugs If the problems in the transitional period cannot be solved in time, it will interfere with the arduous task of drug price adjustment, thus affecting the implementation of the overall medical policy In this context, the leading group of the State Council for deepening the reform of the medical and health system has officially printed and issued several policies and measures on further deepening the reform of the medical and health system through the centralized purchase and use of drugs The implementation of the measures, from the basic level, is to "improve the quality level of drugs, ensure stable supply, improve the efficiency of payment for drugs, and adjust The key measure to motivate the enthusiasm of medical staff is to "further build consensus, deepen the reform of three medical linkage, further clarify the direction of centralized procurement, clarify the reform path, help guide local governments to further improve awareness, and firmly deepen the confidence and determination of medical reform" Among them, the measures emphasizes the optimization of medical service price and the promotion and implementation of medical insurance payment standard, clarifies the confusion between doctors and patients from different levels, and strengthens the determination and confidence of medical institutions to "push" and patients to "buy" Grasping the bull's nose of centralized drug purchase and changing the overall situation through a breakthrough can not only positively affect the income structure of medical institutions, but also change the competition pattern of pharmaceutical manufacturing industry It can not only actively enhance the integration, systematization and coordination of the three medical linkage, but also make the policy benefit to the patients Centralized purchase of drugs is no longer about drugs It is about centralized purchase Since the new situation has given birth to the new decision-making will of medical security, the potential of centralized purchase will become the key factor for fueling, boosting and increasing salaries At that time, a single spark started in Sanming, and now, the three medical cooperation "can start a prairie fire" From 2015 to now, drug purchase is a big change every year, but no matter how, the shadow of medical insurance payment standard is more and more active According to the 2016 draft of relevant national medical insurance payment standards, the ultimate goal of establishing payment standards is to help gradually establish a market-oriented drug price formation mechanism, On the other hand, relevant policies continue to emphasize that the formulation of medical insurance payment standards should "improve the drug use behavior of medical institutions and patients, and promote the use of drugs with definite curative effect and reasonable price on the premise of ensuring medical quality by designated medical institutions" From the original intention of the formulation of medical insurance payment standard, on the one hand, we should resolutely implement the requirements of reducing "drug proportion" and "medical insurance fee control", on the other hand, we are worried that "there is no good medicine at a low price" Therefore, the drugs with "accurate curative effect and reasonable price" have become the active ones to be used In this hesitation, as far as the relevant provinces are concerned, the medical insurance payment will inevitably start to go wrong In the 16 + 1 belt purchase in Anhui Province, medical insurance compensation can be obtained for the drug price difference reduced by the hospital belt purchase; in 2017, Fujian sunshine purchase, 1719 varieties pay zero payment for the settlement price of medical insurance payment Facts have proved that the uncertain medical insurance payment policies of all provinces do not take into account all aspects, but bring more confusion and confusion to the medical insurance payment policies With the establishment of medical insurance bureaus in 2018, medical insurance payment standards will be regarded as an important fulcrum of drug price adjustment, and the "direct management" of prices will move towards "indirect control" Although the relevant policies of the national health insurance payment standard have not been issued substantially at present, but in 2018, the relevant supporting policies are gradually starting from the perspective of "price reduction of anticancer drugs" and "special procurement negotiation for generic drug consistency evaluation" At the same time, the provinces are also accelerating the formulation of the health insurance payment standard We should make medical insurance payment rules, build incentive mechanism, and turn medical institutions into the main force of medical insurance fee control under the premise of rational drug use Taking sunshine purchase in a southern province as an example, from the past two consecutive years of drug purchase to the current provincial dynamic adjustment, the reference price of medical insurance payment and the maximum sales price limit and purchase price of drugs are forming a relatively consistent price ecological closed loop, which is both organic linkage and continuous rolling.