Zhejiang announced the "4 + 7" expansion plan, and the designated retail pharmacies of medical insurance participated?

On December 13, Zhejiang Medical Insurance Bureau issued the implementation plan for Zhejiang Province to implement the pilot project of centralized purchase and use of drugs organized by the state to expand the regional scope, and implemented the work of "4 + 7" expansion The implementation scope and procurement cycle should be clear It is worth noting that the scope of institutions encourages the voluntary participation of designated social medical institutions and retail pharmacies We will comprehensively implement the results of centralized drug procurement in the alliance area, further improve the ecology of the pharmaceutical industry, reduce the price of drug procurement, and reduce the burden on the public Zhejiang province implements the implementation plan of the pilot project of centralized purchase and use of drugs organized by the state to expand the regional scope In order to fully implement the work requirements of the pilot area expansion of the centralized purchase and use of drugs organized by the state (hereinafter referred to as the pilot area expansion), in accordance with the notice of the general office of the State Council on printing and distributing the pilot program of the centralized purchase and use of drugs organized by the state (GBF [2019] No 2), the notice of the State Medical Insurance Bureau and other nine departments on the pilot area expansion of the centralized purchase and use of drugs organized by the state The implementation plan is formulated in the spirit of the implementation opinions on the scope of the region (medical insurance Fa [2019] No 56) and the centralized procurement document of drugs in the alliance region (gy-yd2019-1) in combination with the actual situation of our province 1、 General requirements Guided by Xi Jinping's socialist ideology with China's characteristics in the new era, we thoroughly implemented the decision making and deployment of the CPC Central Committee and the State Council, and implemented the results of centralized drug procurement in the League area, further improving the medical treatment, through the implementation of the four guarantees, including ensuring quality, ensuring supply, ensuring the use and ensuring the repayment of the money, and implementing measures such as quantity purchase, strengthening whole process monitoring and adjusting payment standard The pharmaceutical industry should be ecological, reduce the purchase price of drugs, and reduce the burden of drug costs on the masses 2、 Implementation scope and procurement cycle (I) organization scope All public medical institutions and military medical institutions in the province We will encourage designated social medical institutions and designated retail pharmacies of medical insurance to participate voluntarily （2） Drug range 25 selected varieties in the list of selected varieties of centralized drug procurement in alliance region (Zhejiang) released by the joint procurement office （3） Procurement cycle Implement the procurement cycle uniformly determined by the state The purchase agreement is signed once a year 3、 Main task (1) implement the procurement task In strict accordance with the results of centralized procurement, the province's selected drugs (hereinafter referred to as selected drugs) will be put on the Internet in time to ensure the smooth implementation of online procurement of selected drugs The medical institution and the selected enterprise shall sign a purchase and sale agreement according to the selected price and the agreed purchase quantity to determine the rights and responsibilities of both parties During the agreement period, if the medical institution completes the agreed purchase volume of the current period in advance, the selected enterprise will continue to supply according to the selected price until the expiration of the agreement For the remaining consumption beyond the agreed purchase quantity, the medical institution can still purchase the online trading drugs with appropriate price in the provincial pharmacy purchase platform that is not selected It is strictly prohibited for medical institutions and selected enterprises to renegotiate the selected drugs in any form If there are more than three manufacturers that have passed (including deemed pass, the same below) the conformity assessment of quality and efficacy (hereinafter referred to as conformity assessment, the same below) for the same type of drugs selected, the online trading qualification of the drugs that have not passed the conformity assessment shall be suspended under the condition of ensuring supply (Provincial Medical Insurance Bureau and provincial health and Health Committee shall be responsible according to the division of responsibilities) (II) the agreed usage amount shall be completed Medical institutions shall give priority to the use of selected drugs and complete the agreed purchase volume within the agreement period in accordance with the purchase and sale agreement The medical institutions shall unblock the channels for the selected drugs to enter the hospital, include the selected drugs into the drug prescription set and the basic drug supply catalogue of the hospital according to the drug administration procedures and regulations, strictly implement the requirements for issuing prescriptions according to the generic names of drugs, ensure the priority of use, and shall not restrict the selected drugs to enter the hospital on the grounds of cost control, the requirements for the number of drugs used by the medical institutions, the review of the drug Affairs Committee, etc Hospital We will strengthen policy publicity for medical staff, rational drug use, and patient communication skills training, and guide them to give priority to the use of selected drugs Establish a linkage mechanism of monthly monitoring, notification and department information sharing, and strengthen the supervision and management of the purchase and use of selected drugs Strengthen the clinical risk assessment of drug use adjustment, and formulate response plans For the medical institutions that do not purchase and use drugs according to the regulations, the management shall be strengthened by means of interview and notification, and the punishment shall be given in the total amount index of medical insurance, reward and subsidy funds for the reform of public hospitals, the level evaluation of medical institutions, the qualification of designated medical insurance, and the objective responsibility assessment of the person in charge of medical institutions Medical personnel who do not use drugs according to regulations shall be seriously dealt with in accordance with the corresponding provisions of the prescription management measures and the hospital prescription evaluation management standard (Trial) (the provincial health and Health Commission and the provincial medical insurance bureau shall be responsible according to the division of responsibilities) (3) strengthen the quality supervision of the selected drugs Strengthen the quality supervision of the whole chain of drug production, circulation and use, strengthen the on-site inspection of the selected enterprises, urge the enterprises to rectify the items that should be rectified according to the inspection, and actively promote the construction of information traceability system of the selected drug production enterprises Carry out the sampling inspection of the whole varieties of the selected drugs, strengthen the monitoring of adverse reactions of the selected drugs, and ensure the quality and reliability of the selected drugs (the provincial food and drug administration is responsible for) (IV) ensuring the smooth supply of selected drugs The selected enterprises shall ensure to meet the agreed purchase volume demand of the selected drugs in our province within the purchase cycle, establish the emergency reserve, inventory and shutdown reporting system, and select the enterprises with distribution ability and good reputation to distribute the selected drugs according to the relevant regulations of online transaction product distribution management in our province In addition to the force majeure factors, the medium-sized enterprises with quality and supply problems shall bear the additional costs arising from the replacement of drugs, otherwise it will be deemed as dishonest behavior All products of the relevant dishonest enterprises shall not participate in the centralized procurement of drugs and medical consumables of all public medical institutions in the whole Province within two years In case of non-compliance with the agreement, failure to guarantee the quality and supply, compensation, punishment, withdrawal, alternative and emergency safeguard measures shall be taken accordingly to ensure the supply of selected drugs (the provincial food and drug administration, the provincial medical insurance bureau and the Provincial Department of Commerce shall be responsible according to their respective responsibilities) (V) implement the prepayment requirements for medical insurance funds Within 15 working days after the signing of the purchase and sale agreement, the medical insurance agencies at all levels shall prepay 30% of the agreed purchase amount of the current year to the medical institutions as the turnover fund for the medical institutions to pay the drug purchase funds to the enterprises As the first person in charge of drug payment settlement, the medical institution shall settle with the enterprise in a timely manner according to the provisions of the agreement, and the period from the acceptance of goods to the payment shall not exceed 30 days After the agreed purchase volume is completed, the medical insurance agencies at all levels shall continue to prepay the actual purchase volume of the selected drugs, and the medical institutions shall continue to ensure timely payment collection (Provincial Medical Insurance Bureau, provincial health committee and provincial finance department shall be responsible according to their respective responsibilities) (VI) improve the coordination mechanism between medical insurance payment standard and purchase price For the selected drugs within the scope of the medical insurance catalog, the selected price is taken as the payment standard of medical insurance For the original research drug, reference drug and generic drug that have not been selected under the same general name and passed the consistency evaluation, the payment standard of the selected drug shall be adjusted gradually within 2-3 years to the same as that of the selected drug For generic drugs that fail to pass the consistency evaluation under the same generic name, the purchase price and payment standard shall not be higher than the selected price Encourage the non selective enterprises to reduce their prices (the provincial medical insurance bureau is responsible for) (VII) improve the mechanism of medical insurance fund balance retention We will further promote the reform of payment methods for medical insurance, improve the incentive and risk sharing mechanism of "appropriate retention of surplus and reasonable over expenditure sharing", and encourage medical institutions to use selected drugs When the medical insurance department formulates the total amount control index of the annual medical insurance fund in 2020, it will not reduce the total amount control index of the current year due to the decrease of the cost of the selected drugs for the medical institutions that reasonably use the selected varieties, fulfill the purchase and sale agreement, and complete the agreed purchase amount If the balance of medical service revenue and expenditure of public medical institutions is formed, it can be used for medical staff's salary distribution as a whole in accordance with the requirements of "two permits" (allowing medical and health institutions to break through the current wage control level of public institutions, allowing medical service revenue to deduct costs and withdraw various funds according to regulations, which are mainly used for staff rewards) (the provincial medical insurance bureau, the provincial human resources and social security department, the provincial finance department and the provincial health and health commission are responsible for their responsibilities) IV organizational security (I) strengthen organizational leadership It is a major measure to deepen the reform of the medical and health system, and to solve the problem of difficulty and high cost of medical treatment for the people People's governments at all levels and relevant departments should attach great importance to and improve their political positions In line with the attitude of being highly responsible to the people, they should perform their duties in a coordinated manner and consolidate their responsibilities at all levels to ensure that the pilot expansion work can achieve the goal of reducing drug prices and promoting reform Establish a pilot expansion working group composed of provincial medical insurance bureau, Provincial Department of economy and information, Provincial Department of finance, Provincial Department of human resources and social security, Provincial Department of Commerce, provincial health and Health Commission, provincial market supervision bureau, provincial drug administration and other departments, be responsible for the organization, coordination, supervision and management of pilot expansion work, promote pilot expansion work as a whole according to the national unified deployment, study and solve the pilot expansion work implemented For major problems encountered in the process, we will strengthen policy coordination and assistance to relevant departments, medical institutions, pharmaceutical production and trading enterprises, and guide and promote local governments to do a good job in the pilot expansion The office of the pilot expansion working group is located in the provincial medical insurance bureau and is responsible for daily work （2） Implement departmental responsibilities The provincial medical insurance bureau takes the lead in organizing and implementing the pilot expansion, formulating the pilot expansion implementation plan and relevant supporting measures for medical insurance, improving the functions of the provincial pharmaceutical machinery procurement platform, and working with relevant departments to do a good job in monitoring and analysis, regular notification, supervision and inspection, summary and evaluation; urging the local medical insurance departments to do a good job in the signing of purchase and sale agreements, prepayment of medical insurance funds, total budget management, etc The provincial health and Health Commission is responsible for formulating supporting measures for implementing the use of selected drugs in medical institutions, guiding local health departments to strengthen the supervision of implementing the use of selected drugs in medical institutions, unblocking the access of selected drugs into hospitals and using policies, organizing training and publicity for medical institutions and clinical medical students, doing a good job in risk prevention and control of patients' rational use of drugs, and early warning of drug shortage information, We will put the use of selected drugs into the drug administration system and focus on supervision, and strengthen the use management of selected drugs and alternative drugs The provincial drug regulatory bureau is responsible for formulating supporting measures for the quality supervision of selected drugs, guiding local drug regulatory authorities to strengthen the quality supervision of the whole chain of production, circulation and use of selected drugs, strengthen the spot check and adverse reaction monitoring of selected drugs, and urging the production enterprises to report the production capacity to the joint procurement office in a timely manner The economic and credit department is responsible for the government reserve of emergency drugs, urging the enterprises in our province to implement the production and supply responsibilities according to the agreed purchase volume of the selected drugs, supporting the enterprises to carry out production technology transformation, and improving the supply guarantee capacity of the selected drugs The financial department shall be responsible for the examination and verification of the management of the prepayment and total budget of the medical insurance fund The human resources and social security department is responsible for guiding public medical institutions to promote the reform of the salary system The commercial department is responsible for strengthening the guidance of drug circulation The market supervision department is responsible for strengthening the crackdown on the acts of disturbing the fair competition in the market （3） Strengthen publicity and guidance According to their respective responsibilities, all relevant departments in different regions should strengthen policy interpretation and positive publicity, strengthen publicity and interpretation of consistency evaluation, and reasonably guide the society