For the industry, although 2015 has not become the year of drug bidding, it is a real year of drug bidding policy. 2015 is coming to an end and 2016 is coming. Facing the real drug bidding year of 2016, it is necessary for us to make a comprehensive review of the drug procurement situation in 2015. The author summarizes several templates such as drug bidding, medical insurance and price.
Drug Bidding
Key words: No. 7, No. 70
The release of the document laid the "classified procurement" model; at the same time, Document No. 70 stipulates that all provinces must complete a new round of bidding and procurement by the end of November 2015. Therefore, provincial procurement projects based on No. 7 and No. 70 have been flocking since September 2015. As of December 28, 2015, 18 provinces have started and basically purchased in batches. In addition, Guizhou and Liaoning have announced plans, Shandong and Hubei have publicized drafts for soliciting opinions, while Hebei and Henan provinces have only issued relevant response documents. There is no movement in Tibet.
It can be seen that the provincial plan has basically landed, but at present, more provinces are the first to carry out women and children to Junior College generic drugs, emergency (rob) rescue drugs procurement, followed by double envelope bidding procurement, more is expected to be in 2016 to directly linked to the net and other forms of one after another to complete the bidding procurement.
In terms of pilot cities, the number of pilot cities has increased to 100 in 2015. According to statistics, Anshan, Shaoxing, Ningbo, Hangzhou, Wenzhou, Shenzhen, Sanming, Anhui, Shanghai, Xinyu, etc. are less than 1/3. It is expected that large-scale procurement in pilot cities will be carried out in 2016, which requires attention.
Moreover, according to national regulations, if the transaction price of the pilot city is significantly lower than the provincial bid-winning price, the provincial bid-winning price should be adjusted according to the transaction price of the pilot city. At present, some provinces, such as Sichuan and Guizhou, have made it clear that the price difference of more than 10% will be adjusted according to the low price. Therefore, the price control of the pilot city is still the key.
It is also worth noting that Sanming medical reform is the star of the new medical reform. At the end of 2015, this medical reform star became extremely dazzling. At present, Inner Mongolia Wuhai, Zhejiang Ningbo has joined forces with Sanming, joint cross-regional procurement, the national price directly down.
In addition, it is worth noting that Shanghai, Guangdong, and Chongqing have basically taken shape in the above three places, whether it is the drug exchange model or the GPO model. The model will not change in the short term, but we must pay attention to the response of the three places to No. 7 and No. 70. Relevant regulations issued by the document. For example, Shanghai publicized the implementation opinions on centralized drug procurement in Shanghai public hospitals (Draft for comments), and recently launched the drug group procurement (GPO) platform; Chongqing issued the notice on improving the centralized drug procurement in public hospitals.
Generally speaking, 2015 is the year of drug bidding policy, while 2016 is the real year of bidding! The new round of bidding and procurement carried out by provinces in response to documents 7 and 70 will most likely not be fully implemented until 2016.
drug price
Keywords: Cancellation of pricing
Since June 1, 2015, the National Development and Reform Commission has canceled most of the drug prices set by the original government. On October 21, the National Development and Reform Commission announced the "Central Pricing Catalog". Only two drug pricing items were retained-the highest ex-factory prices and the highest retail prices of narcotic drugs and first-class psychotropic drugs, and the blood station supply prices for citizens' clinical blood. Since the liberalization of drug prices, the drug price formation mechanism of the highest retail price set by the NDRC will no longer exist, and will be taken over by medical insurance and bidding, with the NDRC acting as a monitoring role.
In order to control drug prices, in 2015, the industry issued the ''Notice on Doing a Good Job in Key Monitoring of Drug Prices'' (discussion draft). It is planned to monitor varieties based on medical insurance catalogs, focusing on monitoring patents and exclusive products, with large market sales, Drugs with high clinical use frequency and high social attention, and published a list of monitored varieties. At present, the national official documents have not been released, it is worth noting that some provinces such as Hubei, Anhui has released the relevant monitoring varieties.
In addition, the Health Planning Commission led the drafting of the "establishment of drug price negotiation mechanism pilot work program" also spread in the industry. The plan proposes to concentrate the market share of patented drugs and exclusive production drugs in public hospitals across the country, and unify price negotiations with drug manufacturers. It has been reported that the state has negotiated five varieties. In view of the fact that the official website of the state has not issued relevant documents, the industry is still waiting and watching; in addition, Zhejiang, Jiangsu, Jiangxi and other places have explored first, and the price reduction negotiation of patents and exclusive drugs has been practiced, which is worth noting.
Medicare
Keywords: medical insurance payment, medical insurance directory
The implementation rules of medical insurance drug payment standards stipulated by the state to be issued before the end of September 2015 have not yet surfaced.
The recent industry outflow of national-level health insurance payment standard rules guidance (December 19, 2015 edition). Compared with the previous discussions and opinions solicitation, it has changed a lot. The general idea is: 1) In principle, the payment standard is formulated according to the common name, starting from the drugs that pass the consistency evaluation of drug quality or have less quality difference, and the unified payment standard is formulated according to the minimum pricing unit for drugs with the same common name (the same dosage form and specification), and gradually calculate the payment standards for different dosage forms and specifications of drugs under the same common name by means of price difference; for those who have not passed the evaluation of drug quality consistency or do not have the conditions to formulate payment standards according to the common name due to large quality differences, they can formulate their own payment standards according to the drugs produced by different enterprises. 2) The payment standard is mainly determined by factors such as the actual market transaction price and purchase quantity of drugs. It is also possible to explore the introduction of factors and methods such as price comparison of similar drugs, price reference in other regions, and pharmacoeconomic evaluation. The average price of the corresponding product regulations is calculated by means of weighted average application digits or quantiles, and the payment standard is determined on this basis. 3) The payment standard shall be uniformly formulated by the province as a unit. In principle, it shall be adjusted once every 1 to 2 years according to the actual market transaction price of drugs, medical insurance fund and patients' affordability, actual supply and use of drugs and other factors. 4) If the actual sales price of drugs in designated institutions is lower than the payment standard, the medical insurance fund shall pay the expenses on the basis of the payment standard, and the insured shall pay the expenses on the basis of the actual sales price.
The guidance document on national health insurance payment standards was issued in 2016, which is almost beyond doubt. What is more undeniable is that it is a general trend that the payment standard of medical insurance is linked to the bid price and actual transaction price of each product. Due to the increased authority of the medical insurance co-ordination area, pharmaceutical companies will have to pay close attention to the local medical insurance policy, especially the changes in drug prices and payment methods, and the management costs will increase; but the sales channels they face will also expand.
In addition, in addition to the long-awaited medical insurance payment standard policy, the integration of the three insurances will first realize the integration of the two insurances, and the new version of the medical insurance catalog that has not been adjusted for 6 years will also become the focus of the industry.
Other
Keywords: Hierarchical diagnosis and treatment Restriction Adjuvant medication
In September 2015, the State Council issued a guidance document on graded diagnosis and treatment. Graded diagnosis and treatment means that the flow of patients will be transferred on a large scale within two or three years, and will shift from tertiary hospitals to primary medical institutions. However, many chronic disease drug companies are not prepared for this. Therefore, the discovery of solutions around the pain points and itch points of primary care, linked to academic promotion projects, will be an important direction for the transformation of prescription drug marketing.
This year, Yunnan, Beijing, Jiangsu, Shanghai and other places have flowed out of the list of restricted auxiliary drugs at the provincial or prefecture level or individual hospitals. Although there is a definition of auxiliary drugs, there is no clear standard. Many drugs have certain therapeutic value in a certain disease field, and they become auxiliary drugs when they step out of this field. There are no clear boundaries and measurable standards for adjuvant and therapeutic drugs. Under the policy background of medical insurance fee control and zero price difference of drugs, hospitals have adopted various ways to reduce drug expenses, with auxiliary drugs and antibiotics being the first to bear the brunt. Hangzhou, Jiangsu and other places have even proposed to cancel outpatient infusion, which are all strong medical insurance fee control and hospital drug restriction signals. Each product is in a "big competition" environment, and it is no longer a head-to-head dispute over similar products. It depends on who can take the road of rational use of drugs through academic promotion and correct the name of their products in this environment.
Conclusion >>>
Generally speaking, 2015 is the year of bidding policy, 2016 is the real year of bidding, and it is also the year of medical insurance policy! Under the background of the landing of various schemes and the liberalization of prices, it can be predicted that the bidding and government leaders will be busier, busier and busier in 2016!