With the volume of procurement pilot landing efforts to promote the reduction of drug prices

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With the volume of procurement pilot landing efforts to promote the reduction of drug prices

"Economic Information Daily" reporter was informed that the national drug "4 7" volume procurement pilot landing schedule has been determined. This means that for the first time, the joint bidding and procurement led by the National Medical Insurance Administration will soon be implemented with the results of volume-for-price exchange in my country's 1/3 pharmaceutical market, and negotiated drug prices will also usher in a substantial decline.

In November 2018, the Pilot Program for Centralized Procurement of Drugs organized by the State was formally adopted. It is determined that mass procurement will be carried out in four municipalities directly under the Central Government of Beijing, Shanghai, Tianjin and Chongqing and seven cities of Guangzhou, Shenzhen, Xi'an, Dalian, Chengdu and Xiamen, involving 31 procurement varieties of specified specifications.

According to people familiar with the matter, the pilot office will guide and promote the pilot cities to formulate pilot programs and supporting policies, and the timetable for fulfilling the bidding results on the supporting policies, contract signing and final implementation of the pilot has been clearly defined. At present, the "4 7" volume procurement pilot supporting policies are being stepped up, the Shanghai pilot will be launched before the end of January, the rest of the pilot follow-up. At the same time, before the implementation of the pilot policy, the purchase and sale contracts with volume must be signed and completed by the end of February, and the pilot scheme will be formulated in each pilot city and implemented successively by the end of March.

In terms of promoting the implementation of centralized procurement pilot cities, according to the above-mentioned people, supporting policies will include the supply of pharmaceutical companies, drug quality, drug companies' returns, pilot purchases, and incentives and restraint mechanisms for medical institutions.

Industry insiders said that they will strengthen the quality supervision of the whole cycle of production, circulation and use of the selected varieties, increase the frequency of sampling inspection, increase the accountability of illegal enterprises, and establish an enterprise inventory and suspension reporting system for the winning enterprises, and standardize the distribution behavior through agreements to ensure the stability of supply.

In terms of enterprise payment, the above-mentioned person disclosed that the medical insurance department will take the lead. Medical institutions should pay the enterprise payment in a timely manner according to the purchase agreement. The medical insurance fund should prepay medical institutions at no less than 30% of the purchase amount, and encourage the medical insurance fund to directly prepay the drug payment to the enterprise to mobilize the enthusiasm of the enterprise.

"To improve the incentive and restraint mechanism of public hospitals." The relevant person in charge of the pilot joint procurement office said that the medical insurance assessment and evaluation index system of medical institutions should be established and improved, and the use of selected drugs should be included in the medical insurance assessment and evaluation index system; the performance evaluation system of public medical institutions should be included, and the incentive and restraint mechanism of medical institutions and medical personnel should be established.

At the same time, the use of drugs into the management of medical insurance agreement, clear breach of contract liability and treatment, and the introduction of payment standard policy. It is clear that medical insurance pays for drugs with the same generic name and different commodity names according to the same payment standard, and guides people to use drugs rationally. And for hospitals that reduce the expenditure of the medical insurance fund due to the standardized use of the selected varieties, the total budget amount of medical insurance in the current year will not be reduced, and the balance will be left to the hospital in proportion to promote the reform of the hospital salary distribution system.

People familiar with the matter said that the landing of the 11 pilot projects is conducive to further exploring and improving the centralized drug procurement mechanism and the market-led drug price formation mechanism on the basis of the original Shanghai single pilot, measuring the financial pressure under the linkage of medical insurance in different regions, and judging the feasibility of policy implementation. Summarize experience and form a reform model that can be replicated and promoted. At the same time, the above-mentioned 11 places will also be the first to enjoy the results of the negotiations, involving a significant reduction in drug prices.

In December 2018, the results of the "4+7" volume procurement campaign were released in Shanghai. According to the National Joint Procurement Office, 25 of the 31 pilot generic drugs were selected, including 23 domestic drugs and 2 foreign drugs, with a success rate of 81%.

Under the substitution effect of domestic generic drugs, the price of drug selection decreased significantly. Compared with the lowest purchase price of the same drug in the pilot cities in 2017, the price of drug selection decreased by 52% on average, with the highest decrease of 96%, and the effect of price reduction was obvious. The original drug gefitinib tablets were reduced by 76% and fosinopril sodium tablets by 68%, which was more than 25% lower than that of neighboring countries and regions, and the "patent cliff" appeared.

"For the pilot, the most important thing at present is to implement it." The person concerned said frankly that the response from all walks of life in the pilot procurement with volume is generally good, but due to the adjustment of multi-party interests, it is bound to encounter some resistance. But it will not hinder us from unswervingly advancing. The main task in the future is to solve the possible problems of drug quality, supply, use, and corporate mergers and reorganizations.

The above-mentioned people pointed out that the centralized drug procurement mechanism will be summarized and improved, and the regions and varieties will be gradually expanded, so that the prices of drugs and consumables will be greatly reduced, so as to make room and create conditions for the price adjustment of medical services and the salary reform of medical personnel.

In addition, some people in the industry have reminded that in the near future, some non-pilot areas have clearly mentioned that it is necessary to regulate the behavior of price follow-up. "With volume procurement, is in the volume, and there is a series of supporting measures under the premise of the price reduction, so can not be rigid only ask enterprises to reduce prices. However, enterprises can on a voluntary basis, under the premise of cost control, the initiative to apply for price linkage to expand the market, in non-pilot areas at the price of 4 7."

"It can be predicted that the next step, drug prices will continue to decline." The above-mentioned people said that not only the above-mentioned 25 kinds of drugs with volume procurement, the full implementation of drug online public bargaining procurement will also bring obvious price reduction space.