Zhejiang has perfected the access and exit mechanism of consumables, and the record purchase has become a history

Medical Network, February 22 News On February 9, Zhejiang Medical Insurance Bureau issued the "Zhejiang Medical Consumables Centralized Procurement Product Dynamic Adjustment and Reform Plan" (hereinafter referred to as the "Plan").
The "Plan" clearly defined the need to improve and establish a centralized procurement of products.
Mechanisms such as access, replacement, supplementation, and withdrawal are implemented for medical consumables that belong to the scope of centralized procurement in the Zhejiang Pharmaceutical Equipment Procurement Platform
.
In principle, it will be carried out twice a year and will be implemented from March 15, 2021
.

Improve platform access, replacement, supplementation, and exit mechanisms.

It is understood that Zhejiang Province has been the first to carry out centralized procurement of medical consumables since 2011, and has formed a model that combines centralized procurement and sunshine procurement.
There are currently 14 categories of centralized procurement products, and sunshine hanging nets.
7 categories of products
.
At present, the centralized procurement of medical consumables still has disadvantages such as complex bidding and listing procedures, lack of market-based bidding mechanism, no exit mechanism, and partial catalog incompleteness.
Medical institutions and patients have certain needs for some vacant products and new products, and the original recruitment needs to be reformed.
Adopt the model, improve the platform access and exit mechanism, further improve the price formation mechanism of medical consumables, and improve the performance of the medical insurance fund
.

　　1.
Improve the access mechanism
for centralized procurement products.
The "Plan" clarifies that products with new secondary catalogs or secondary catalogs without online trading products, products with obvious price advantages, and Sunshine linked products can be converted into centralized procurement products according to the following pricing principles Apply to hang the network:

The access of the above 3 types of products will be carried out on demand according to different types of medical consumables, 1-2 times a year
.
Existing transaction record purchase products can be converted into online products, and record purchases will no longer be carried out in the future
.

　　2.
Establish a centralized procurement product replacement and supplement mechanism.
Those
belonging to the same enterprise to update or supplement specifications and models can be listed on the Internet based on the principle of not higher than the current online transaction product price and not higher than the national minimum price if the following conditions are met.

.
1) replacement products to be in function, scope, structure and properties of the composition, and other aspects of the specification is complete and is now trading product line consistent with or better than the current line-traded products
.
After the network is connected, the trading of current online trading products will stop; 2) The supplementary specifications and model products must be the same registration certificate as the current online trading product, and the functions, scope of application, and structural performance composition must be consistent
.
After listing, the online trading products can continue to be traded
.
There should be a reasonable price difference relationship when products with different loading volumes are involved
.

　　3.
Establish an exit mechanism for centralized procurement products.

One is to establish a market-based exit mechanism through various methods such as carrying out mass procurement and implementing competitive bidding for medical consumables with similar medical insurance codes
.
The second is to establish a mechanism for enterprises to actively apply for withdrawal
.
At the same time, it is clear that various behaviors such as untimely supply that affect the clinical use of the hospital shall be dealt with in accordance with relevant regulations such as the price of medicines and the credit evaluation system for recruitment and procurement
.

　　4.
Explore the self-purchasing system of public medical institutions
For products that are not centrally purchased on the platform for clinical needs, public medical institutions are allowed to negotiate with the company to determine the purchase price within the 5% limit of the settlement amount of medical consumables in the previous year (the children’s specialist hospital can be expanded to 10%) in accordance with the principle of fairness.
The drug equipment procurement platform purchases on its own
.

　　The trend of price reduction of medical consumables will continue.
The
"Plan" mentioned that "products that have a significant price advantage compared to products that have been traded online in the same second-level catalog (different from imported and domestic products, including sets)", need not be higher than the same second-level catalog 70%/56%/88% of the weighted average price of the product in the previous year, not higher than the lowest price of the second-level catalog product, and not higher than the national lowest price
.
This means that mature products can only be sold online only when they reach the lowest price
.
Based on past dynamic adjustment experience, there are not a few cases of high-value medical consumables "half-cut" or even "ankle-cut"
.
In January 2021, the "Announcement of Shaanxi Province on the Dynamic Adjustment and Audit Results of Medical Consumables" issued by the National Drug Supply Assurance Comprehensive Management Information Platform showed that Abbott, Poco International, Shanghai MicroPort, Lepu, Cook, Fresenius The prices of 118 high-value consumables of 22 companies including Sri Lanka were lowered again, with the highest drop of 78%
.
In August 2019, the Shaanxi Provincial Pharmaceutical Equipment Centralized Procurement Network issued the "Notice on the Announcement of the Partial Adjustment Results of the Dynamic Adjustment of Orthopedic Implantable Medical Consumables", which showed that the Kirschner needles of a medical device company in Changzhou City dropped from 350 yuan to 28 yuan.
The price drop was as high as 92%; the price of the distal plug and the intermediate device of a Beijing artificial joint company dropped as much as 91%, from 850 yuan to 80 yuan, and from 1200 yuan to 111 yuan
.
In addition, including Kirschner wires, a total of 62 specifications of orthopedic implant products have dropped by more than 50%
.
It is not difficult to see that the purpose of this dynamic adjustment is still to force a reduction in the price of medical consumables
.
As the medical reform continues to deepen, a larger range of consumables is the general trend, and the national minimum price has dropped again and again.

.
In the future, homogenized products will face more intense price competition
.

　　Innovative products have more "bargaining powers".
The
"Plan" clarifies that "new secondary catalogs or products with no online trading products secondary catalogs" will be purchased and linked to the Internet (winning bids) in 10 or more provinces based on the province.
, Not higher than the lowest price in the country; if there are less than 10, after negotiating with at least 5 tertiary hospitals in our province, it will not be higher than the lowest price negotiated on the premise that it is not higher than the lowest price in the country
.
The new second-level catalog must be quite different from the existing second-level catalog in terms of function, scope of application, structure and performance composition, etc.
, and it shall be determined after expert argumentation
.
The price of innovative products only needs to be no higher than the national lowest price or no higher than the negotiated lowest price, and does not need to be lower than the lowest price of the second-level catalog product, and 70%/56%/88% of the previous year's weighted average price of the same second-level catalog product
.
In other words, upgraded and innovative products have the opportunity to create a secondary catalog through differentiated advantages, thereby gaining pricing advantages
.
With the continuous advancement of medical reform, the trend of price reduction of medical consumables has been irreversible, and mature products will enter the era of meager profit
.
Therefore, for companies , continuously improving their innovation capabilities and launching non-standardized and differentiated innovative products will help alleviate the pressure brought by the big price cuts of mature products
.
In fact, companies have also realized the importance of transformation
.
Take Lepu Medical as an example.
In recent years, the performance of Lepu Medical has been under pressure due to the price cuts in the centralized procurement of medicines and consumables
.
In the fourth quarter of 2020, affected by the national procurement of coronary stents, Lepu Medical suffered a loss for the first time
.
Drugs and consumables were successively affected by centralized procurement, and Lepu Medical began to substantially increase R&D investment.
In 2018, it began to substantially increase R&D expenditures, which happened to be the first year of the implementation of drug procurement
.
Increased to 8.
09% in 2019
.
In the first three quarters of 2020, Lepu Medical’s R&D expenditure amounted to 466 million yuan, a year-on-year increase of 30.
59%
.
For the centralized procurement of coronary stents, Lepu Medical focused on the development of "interventional non-implantation" products, forming a "cutting balloon + drug balloon and cutting balloon + bioabsorbable stent (NeoVas) product combination"
.
The new product may effectively make up for the decline in revenue brought about by the purchase of traditional metal brackets
.