Drug bidding procurement into the transition period will become the focus of large varieties


Release time:

2019-10-28

In the middle of the night on October 24, a pharmaceutical company received a short message from Fujian Ningde Medical Insurance Bureau, which generally means "the second round of joint negotiation plan and catalogue for Ningde joint price limit sunshine procurement of Ningde drugs have been uploaded to Ningde joint price limit platform for pharmaceutical equipment. Please download and check it and follow the notice". For pharmaceutical companies, under the background of gradual changes and adjustments in drug bidding and procurement, there will be more and more similar "midnight notices". Varieties with large amounts of clinical drugs and large medical insurance funds will surely become the focus of centralized procurement during the transition period. Priority focus.
 
In the past two years, the days of medical people have become more and more difficult. Climbing over the ridge, more and more challenges.
 
Under the premise of "controlling fees" and breaking the mechanism of "using medicine to support doctors", the trend of total control and structural adjustment of medical and health use is irreversible. Whether it is the two-vote system, generic drug quality consistency evaluation or "4 7", "joint procurement expansion" and even the recent rise in the limelight of DRGS, the relevant policies are subject to the overall situation of the relevant industry.
 
The new normal of medicine in the next few years is that the market growth rate will decline steadily and slowly. According to the ChinaDrugsStatistics from the Circulation Industry Development Report (2019 Edition) show that in 2018, there are seven major categories in the country.MedicineThe total sales of goods was 2.1586 trillion billion yuan, with a year-on-year increase of 7.7 after deducting non-comparable factors, and the growth rate decreased by 0.7 percentage points year-on-year. According to relevant data, in 2018, the three major terminals of drug sales in China totaled 1.71 trillion billion yuan, up 6.3 percent year-on-year, and the terminal growth rate showed a downward trend, driven by prescription outflow and graded diagnosis and treatment, the growth rate of primary medical terminals and retail terminals was better than that of public hospital terminals.
 
The pattern of drug sales in the hospital market is quietly changing. What changes on the surface is the market, but what returns to the "essence" in essence ". Starting from the 10th standard in Fujian in 2017, until 47 and the expansion of joint procurement, the price of drugs fell like a cliff, the profit margin in the pharmaceutical value chain dropped sharply, the growth rate became slower and slower, the substitution of generic drugs became inevitable, the structure of employees began to be adjusted on a large scale, and the division of labor became clearer and more professional. If the original clinical representatives and the "gunmen" of the development hospital did not have basic pharmaceutical and medical capabilities, if you don't understand the product, you only know how to drink and eat meat, then it is inevitable to be eliminated by the market.
 
For the pharmaceutical market, returning to value is the only way. Take the newly published national new version of the pharmaceutical catalog as an example, according to rough statistics, the number of traditional Chinese medicine injections itself is limited to varying degrees, restricted varieties, there are limited scope of use, limited indications and limited severe patients, and limited varieties generally have a larger market volume. In addition, all 20 drugs under national key monitoring have been transferred out. It is estimated that 470 approval numbers of 176 companies are involved, with a total market size of about 50 billion yuan. In this context, Zhejiang and other provinces and cities have successively formulated key drug use monitoring policies for large-dosage, high-price, and auxiliary therapeutic drugs, locking in irrational drug use behavior and regulating the drug use structure of medical institutions. In particular, as DRGS continues to accelerate its landing, medical institutions around the world are emphasizing clinical rational drug use, strengthening the management of the prescription review system for frontline doctors through various measures, and using evidence-based medical evaluation and pharmacoeconomic evaluation of drugs as an important basis for future guidelines, medical insurance catalog selection and medical insurance payment standards.
 
As for drug bidding and procurement, starting from 47 in 2018, signs of transformation have been shown. Until the expansion of joint procurement in 2019, the transformation of drug bidding is imminent. There are four main signs of transformation:
 
At the national level in 1., through 47 pilot projects and joint procurement expansion, the bidding policy of "mixing and kneading" will be implemented on the basis of "Fujian Sanming Alliance Procurement with Volume in Shanghai". Groups will carry out strong price negotiation. The volume and price will 1. full competition, centralized procurement and policy coordination, activate the use of medical insurance funds, adjust the drug use structure, de-channelize and implement real volume procurement.
 
2. at the provincial level, large-scale bidding and procurement based on provinces has gradually faded. It is more likely that the provincial level will further set the upper price limit through dynamic adjustment and formulate a unified procurement demand catalogue. On the basis of drawing lessons from the national 47 and joint procurement and expansion policies, prefecture-level cities or medical federations will implement volume procurement for non-evaluated varieties with high procurement amount and large consumption, and implement procurement share and winning bids.EnterpriseQuantity is linked, such as the draft of the bidding plan recently issued by Jiangxi. Another possibility is to entrust a third party to lead and "let go" to medical institutions and enterprises to negotiate prices. For example, Hainan has just issued a draft of the bidding procurement plan.
 
3. the prefecture-level city level. On the basis of the provincial price limit, the bargaining purchase is carried out again. For example, just introduced Fujian Ningde sunshine procurement.
 
4. GPO Group Procurement. Shenzhen, Guangzhou, Shanghai, Guangxi. By the prefecture-level city gradually expanded to the provincial level.
 
The change or status quo of the above-mentioned recruitment model, the biggest enlightenment to enterprises is that the decision-making should be rational, the market sales growth rate can not be blindfolded. Many enterprises in order to market quantity, work fast, full of tasks,HospitalThe development efforts were full. As a result, due to touching the ceiling of drug use in the hospital, they were removed from hospital overnight, suspended from sales, or entered the scope of recruitment and procurement (Fujian Ningde plan clearly stated that drugs with large sales amount in the area (except some clinical extraordinary specifications) should be re-used.Tender.
 
At the same time, due to the excessive purchase amount, a large range of hospitals have been included in the plan of public bidding and procurement. After entering the provincial centralized procurement link, they are facing a new round of substantial price reduction pressure. At the same time, closely related to drug bidding and procurement is the medical insurance payment price. From the current point of view, the biggest trend in the design of medical insurance payment price is to determine the medical insurance payment standard or limit according to the actual purchase and sale price (bid price) of drugs with large clinical consumption and high purchase amount, and the hospital will independently bid and negotiate the purchase price. The part of the hospital purchase price lower than the medical insurance payment standard is rewarded to the hospital, and the part higher than the medical insurance payment standard or limit is borne by the hospital, so as to improve the bargaining power of the hospital and the enthusiasm of purchasing low-cost drugs. As the price design of medical insurance payment is still in the transition period, there will still be some dividend release, how to grasp, the need for pharmaceutical companies to seriously think about.
 
In 2015, when Yao Zhao No.7 was issued, pharmaceutical companies were helpless: it was too difficult for enterprises to reduce prices. Four years later, suddenly looking back, the original policy of four years ago has given enterprises a lot of room for buffer: although the bidding group has been weakened, the status of the original research has not been greatly challenged; Although the bargaining position of hospital procurement has been strengthened, the price has not been fragmented. The sovereign treasure in "A Chinese Odyssey" once said, "once there was a sincere feeling in front of me. I didn't cherish it. I regretted it when I lost it. The most painful thing in the world is this". The classic line of this oath of eternal love actually gives the greatest inspiration to the medical people is a Yili style: although the market is not easy, it can be done and cherished. Live in the moment, every day is the best!