This year, the reform of normalized and institutionalized procurement of drugs and high-value consumables will continue to move towards a new stage of acceleration and expansion. By the end of 2022, an average of more than 350 drug varieties will be covered in each province, and orthopedic consumables, drug balloons, dental implants and other varieties will also be included in the centralized collection.
After the Spring Festival of the year of the tiger, the National Medical Insurance Administration held its first press conference at the state information office, focusing on the progress of deepening the reform of centralized procurement of drugs and high-value medical consumables. Chen Jinfu, deputy director of the National Medical Insurance Bureau, said at the regular policy briefing that at present, the national medical insurance bureau is planning the seventh batch of centralized procurement of drugs, and strive to issue a preliminary plan for centralized procurement of spinal consumables in the first half of the year. When the conditions are ripe, the bid opening can be carried out smoothly this year.
At the beginning of 2021, the executive meeting of the State Council deployed the normalization and institutionalization of centralized drug procurement. The executive meeting of the State Council held on January 10 this year carried out special deployment, requiring to promote the normalization and institutionalization of centralized volume procurement, speed up the expansion, and continue to reduce medical prices to benefit patients.
Liao Cangyi, associate professor of the school of politics and public management of China University of political science and law, told China business that under the background of achieving common prosperity, whether in or out of the medical insurance catalogue, it is normal for the medical insurance bureau to focus on reducing the medical consumption of insured people, such as dental implants. At the same time, under the normal and institutionalized collection, the national batch is limited, and the expansion of varieties and improvement of rules should also pay more attention to local centralized collection.
centralized belt purchase speed-up and expansion
Carrying out centralized drug purchase in a normalized and institutionalized manner is one of the nine major tasks of medical insurance determined at this year’s national medical security work conference. The national medical insurance administration clearly proposed that the total number of national and provincial centralized procurement drugs should reach more than 350 during the year, solidly carry out the centralized procurement of high-value medical consumables, promote local governments to actively carry out the centralized procurement of drug consumption, improve the ability of drug price management, realize the pattern of promoting the centralized procurement of chemical drugs, biological drugs and Chinese patent medicines in an all-round way, and further reduce the sales space with gold.
Chen Jinfu said that speed-up and expansion is the due meaning of normalization and institutionalization. In terms of variety speed-up, the seventh batch of drugs are being planned to be purchased in a centralized manner. From the situation in the past three years, including local centralized mining, the average number of centralized mining varieties in each province has reached 50, and the number of high-value medical consumables has reached 3. This year, the National Medical Insurance Bureau will guide local governments to promote leak detection and vacancy filling around large varieties and common diseases according to clinical needs, and strive to achieve more than 100 provincial centralized purchase varieties in each province, and cover 5 varieties of high-value medical consumables.
At the same time, the coverage of centralized mining should also be expanded. The original centralized collection mainly focused on chemical drugs. Last year, it expanded to insulin and artificial joints. This year, in accordance with the principle of “one product and one policy”, we will carry out centralized procurement of high-value medical consumables for consumables with many complaints from the masses and large space for price adjustment. This year, we are going to carry out centralized procurement of orthopedic spine consumables.
\u3000\u3000 “The centralized purchase of drugs is carried out in three sectors: chemical medicine, Chinese patent medicine and biological medicine. The high-value medical consumables focus on orthopedic consumables, drug balloons, dental implants and other varieties. By the end of 2022, through national organization and provincial alliance procurement, each province will cover more than 350 drug varieties, and the high-value medical consumables will reach more than 5 varieties, making it a new centralized purchase Adopt normality, so as to achieve the purpose of stabilizing social expectations and stabilizing the industry ecology. ” Chen Jinfu said.
Since the launch of volume procurement in 2018, six batches of drug volume procurement have been carried out so far, with a total of 234 drugs purchased, accounting for 30% of the total annual drug procurement of public medical institutions. The centralized collection of high-value medical consumables focuses on the two areas most concerned by the masses: cardiology and orthopedics.
In terms of the effect of centralized procurement, the average decline in the centralized procurement of the first six batches of drugs was 53%, the average decline in cardiac stents was 93%, and the average price reduction of artificial hip and knee joints was 82%, which effectively squeezed the space of virtual height. Judging from the cumulative results of the three-year reform, the state has saved more than 260 billion yuan in organizing centralized procurement. According to the drug price monitoring data carried out by the medical insurance bureau, the overall price level of drugs continued to decline in 2019 and 2021, reaching an average annual rate of about 7%.
Liao Cangyi said that the “14th five year plan” of medical insurance has put forward expected indicators, and more than 500 varieties will be purchased by 2025. From the signals revealed at this briefing, the expansion of volume procurement is not only the expansion of varieties, but also the expansion of coverage. For example, Chinese patent medicines without consistency evaluation and dental implants in non basic medical insurance could not be purchased in volume before, but this time it is clear that the expansion focuses on how to reduce the medical burden of Lbx Pharmacy Chain Joint Stock Company(603883) , so the medical insurance bureau will make a difference in these fields.
key areas determined by centralized purchase of high-value consumables
At the executive meeting of the State Council at the beginning of the year, it was determined to gradually expand the coverage of centralized collection of high-value medical consumables, and carry out centralized collection of orthopaedic consumables, drug balloons and dental implants concerned by the masses at the national and provincial levels respectively.
Chen Jinfu said that the recruitment of artificial hip joint and knee joint was carried out last year, and now the thorough research on spinal consumables is being carried out. There is a great demand for orthopedic clinic, but the standards are different, especially the composition of products is very complex. Therefore, how to form the procurement product group according to the needs of clinical medical treatment involves a very high technical link, and now the research scheme is under way. We will strive to have a set of preliminary plans in the first half of the year. When conditions are ripe, bid opening can be carried out smoothly this year.
In terms of drug balloons, the use of stents increased after centralized procurement, reaching 1.6 times of the agreed procurement. At the same time, the use of drug balloons has also increased significantly for a period of time. “Because the drug balloon has not been included in the centralized purchase, there is price space, so this one also has the component of virtual high. Last year, we carried out the centralized purchase of drug balloon in Jiangsu and other places, and this year we will expand to the whole country to block the space of virtual high.” Chen Jinfu said.
In terms of centralized collection of dental implants, the national medical insurance bureau decided to start with local exploration, and Sichuan organized an inter provincial alliance to study the procedures of centralized collection of dental implants. Now the scheme is basically mature, and the opinions of clinical, enterprises and local governments have been widely listened to. It is ready to launch such an alliance reform of centralized collection of dental implants in the first half of this year. Chen Jinfu believes that this is actually a centralized mining method for dental implant exploration under the guidance of the state.
centralized purchase does not pursue the lowest price
Zhu Minglai, director of the health economy and medical security research center of Nankai University, told China business that the effect of the volume procurement policy has been demonstrated, and the price level of pharmaceutical consumables has decreased significantly. Through the centralized procurement of medical insurance organizations, there is no problem in reducing the medical burden of patients. The next step is to effectively evaluate the implementation effect of this policy and establish a regular evaluation and audit system for the quality of drugs and devices.
Liao Cangyi said that in order to expand the scope of centralized procurement, we should first pay attention to the maturity of the rules of volume procurement, and fully let enterprises understand the original intention of the state to reduce the price of drugs and consumables. The continuous expansion of volume procurement will face the centralized procurement of some monopoly drugs, which will be more difficult than the previous batches. This requires the adjustment of centralized purchase rules. The basic principle of adjustment is to achieve the balance of interests among medical insurance, medical institutions, pharmaceutical enterprises and patients. Lbx Pharmacy Chain Joint Stock Company(603883) is to eat drugs with good quality and low price. The medical insurance fund should fully realize its strategic purchase. Medical institutions need to purchase drugs at the lowest cost. Enterprises also need to maintain a certain profit space, innovation enthusiasm and so on.
Shuey Rhon Rhon Chen Jinfu Bing dwen dwen is a big institutional innovation. This reform is not a single objective thing. It is a dynamic balance of multiple objectives. In other words, there should be a system integration, strict rules, scientific and fair “ice pier”, and multiple objectives, dynamic balance, multi benefit and future development.
In the past three years, the bidding rules of centralized purchase have also been iteratively optimized. The earliest “4 + 7” pilot is to select only one company and win the bid at the lowest price. In this way, the competition is very fierce. There is no substitute for the supply, and there is little room for clinical choice. In the second and third batches, we will gradually optimize, relax the competition pattern, balance use and supply, and appropriately maintain the competition rate, so as to make the price return reasonably.
“We don’t pursue the lowest price, and we are firmly opposed to running bidding, so we can’t achieve the balance of multiple dynamic goals. We don’t particularly anchor the international lowest price, because China is on the road to common prosperity. We Chinese can also take good medicine, and the medical insurance fund can afford this kind of medicine with reasonable price.” Chen Jinfu said.
