Yao Jianhong, health and Family Planning Commission: drugs cannot be alienated as profit-making tools

Source: Phoenix review 2016-11-23 from production, sales to use, how to control drug price involves bidding First, according to the current production regulations in China, bidding is only one way of drug procurement, not the only way If the clinical dosage is large enough to form full competition, it is necessary to invite bids for procurement The term of the document is called centralized bidding procurement, that is, centralized bidding procurement with the province as the unit The composite medicine or rescue medicine is directly purchased through Internet rather than bidding There are also some low-cost drugs whose profits are relatively small If the manufacturer does not earn money, it may not be willing to produce them The state will directly price them on a daily basis, and I will give you how much money in a day to ensure the scale of profits and encourage their production Second, the main direction and goal of the bidding, summarized in 12 words, are quality first, reasonable price and timely supply First of all, the quality of bidding should be guaranteed If the quality of drugs can not be guaranteed, the bidding will lose its significance First of all, it should meet the GMP standard stipulated by the state The price should be reasonable, but not necessarily the lowest This bidding is called "two envelope system" When each enterprise submits a bid, it shall submit two marks The first is to submit a quality bid, which is called a commercial bid There is a special evaluation standard for the quality After the quality bid is qualified, it will enter the next bid The next bid only depends on the price, and the lowest price can win the bid First of all, we need to ensure the quality, which does not mean that we can win the bid only by the price In terms of quality, it depends on the situation If there are more enterprise newspapers, for example, there are 100 enterprise newspapers, domestic ones and foreign ones, they will be stratified, and all provinces generally adopt a stratified approach Layer by layer, make different technical requirements and control standards, each layer has corresponding requirements, and then enter the next link After drug recruitment, we must ensure the timely supply of drugs If we say that the price is very low and we won the bid, but we are not willing to supply, then the bidding is also a mere formality Manufacturers themselves can find ways to push drugs to various medical institutions In addition, the situation of drugs in China is different from that in foreign countries In China, hospitals are important sales terminals, with drug sales accounting for 70% to 80%, and retail pharmacies accounting for relatively small shares In some western countries, on the contrary, retail pharmacies are important drug sales terminals Of course, this situation is also related to many factors The common people are willing to believe in the hospital and are more willing to buy drugs in the hospital Doctors mainly sell drugs in the hospital It has nothing to do with historical habits, management and control factors, etc In recent years, we have made a lot of efforts in terms of price On the one hand, the supply chain of all public medical institutions should gradually cancel the drug mark up According to the current national policy, by 2017, all public hospitals need to carry out comprehensive reform, among which the elimination of drug markup is a very important link On the other hand, we should gradually implement some good measures, such as the "two vote system" That is to say, from the production enterprise to the circulation enterprise, from the circulation enterprise to the hospital, to reduce unnecessary intermediate circulation links, and then reduce the false high price of drugs The effect of the two vote system is obvious Now some provinces are pushing forward this work In this year's State Council's medical reform task arrangement, it is also clearly required that the relevant places should carry out this practice, summarize the experience after the implementation, see its advantages and guard against some possible deficiencies Third, regulate the rational use of drugs Don't let people spend money and take medicine To use good medicine, not necessarily the most expensive medicine, to solve the problem of common people's disease oriented Finally, it comes down to the point that all of our control aims to achieve one goal, which is to return to the essential attribute of drugs It is a tool for curing diseases and saving people, and cannot be alienated as a tool for profit, no matter in the production, sales or use links All of our reforms are aimed at returning medicine to the most essential attribute of curing diseases and saving people, rather than using it as an economic tool This is also a good thing for the pharmaceutical factory, because if the whole system is good, it will increase the intention of people to use drugs and achieve the purpose of standardized treatment The impact of the new system on pharmaceutical enterprises is positive There are more than 5000 pharmaceutical manufacturing enterprises in our country Some researchers say that too many enterprises lead to small scale of production and profit and unfair competition The two vote system allows legal enterprises to develop in the direction of large-scale and large-scale, and encourages these high-quality enterprises to become bigger and stronger The two ticket system also reduces the intermediate link There are three links between drugs and patients: production link, two ticket system (flow link), and use link after entering the hospital Only with the joint efforts of the three links can we optimize the drug cost, improve the level of research and development, and standardize the use of drugs The key point of the two vote system is the second link, but at the same time, we should regulate the use of drugs and improve the production capacity of drugs in China Local experience is the source of deepening reform Recently, Fujian Province established the medical insurance office The functions of medical insurance management of urban and rural residents of the former personnel department, new rural cooperative medical system and drug bidding and purchasing of the health department, drug distribution system of the Department of Commerce, medical assistance of the Department of civil affairs, and price adjustment of medical services of the property price bureau all belong to the medical insurance office This approach can better realize business flow and linkage without coordinating multiple departments Based on its experience, No 36 document proposes that local governments can set up pilot medical insurance fund management centers to undertake comprehensive treatment, and require urban and rural residents to complete the integration of medical insurance by the end of this year, so as to realize the "six unifications" The ultimate goal is to better improve the operation efficiency of the medical insurance system, and also make the medical insurance policies and medical and pharmaceutical functions coordinate with each other After observing the operation of Fujian Medical Insurance Office for a period of time, we can sum up its benefits Document No 36 summarizes the experience of Sanming, Jiangsu, Fujian, Anhui, Qinghai and other places in Fujian Province It is not groundless for the central authorities to write documents Experience is the source of wisdom Sitting in the office can't write documents Only when there is a broad line of practice can documents be written Many practices and explorations have been carried out in various localities Those successful experiences have the following characteristics: first, the reform has a clear understanding and conforms to the national policies If it doesn't, it may be a blind struggle We should thoroughly understand the major policies of the country and carry out effective exploration on the premise of conforming to them Second, the reform should be replicable If this experience can only be applied in one place for a while and cannot be used in other places, it can only be a flash in the pan and cannot be replicated Third, there should be operability Only 1% of people learn too complex things, others can't I can use 90 of the 100 you mentioned, which is operability If all these theories are very advanced and cannot be explained in a popular way, they will not be reproducible and operable So we measure local experience from these perspectives, and then rise to national policy As for the dissemination of experience, I have summed up three sentences for reference only First, if you have no one, you have no one, even if you have only a little experience Second, if you have one, you are better Sometimes, you are better For example, in other places, you may only have five aspects of reform, and I have done ten aspects Third, if you have one, you are better But I have my own Kung Fu, and I am better than others More excellent.