Analysis of the impact on the antibiotic market from the basic drug system (part one)


Release time:

2015-03-03


The abuse of antibiotics has caused drug resistance and the birth of superbugs has attracted global attention, and China is the hardest hit area of global abuse. Therefore, in the future, due to the further strengthening of the dominant position of the essential drug system and the gradual tightening of the government's policy of restricting resistance, the management of antibiotics will only be further controlled and will not be relaxed in the future! Its basic drug system, antibiotic sub-line management, clinical path management, outpatient infusion restrictions, rational drug use management, medical insurance control fees and other policies will significantly affect the clinical choice of antibiotics, the clinical use of antibiotics will be further structural changes than in the past. In the future, the largest market for antibiotics will be the first-line, base drug status, clinical safety classic antibiotics. Its original research separately priced, non-basic drug class antibiotics will be strictly suppressed. Combined with the situation in Zhejiang, it is divided into two parts for comprehensive elaboration, the first part is mainly analyzed from the perspective of essential drugs:
"Priority base drugs as the leading use position, from the grass-roots level up to 2. three-level medical institutions to expand, up and down linkage.
1. In the Opinions of the National Health and Family Planning Commission on Further Strengthening the Management of Drug Allocation and Use in Primary Medical and Health Institutions:
"Continue to consolidate and expand the achievements of the implementation of the basic drug system"
"Insist that the government-run primary medical and health institutions are fully equipped with essential drugs"
"Encourage county-level public hospitals and urban public hospitals to give priority to the use of essential drugs, and gradually realize that all levels and types of medical institutions are fully equipped and give priority to the use of essential drugs."
"We must continue to increase the use of essential drugs and strengthen the dominant position in the use of essential drugs."
"Use the use of essential drugs and other drugs as an important content and evaluation index for assessing the implementation of relevant policies of the essential drug system by medical and health institutions and their responsible persons"
2. Guiding Opinions of the General Office of the State Council on Improving the Centralized Procurement of Drugs in Public Hospitals
"Establish and improve a comprehensive evaluation system for clinical medication focusing on essential drugs, and promote the standardization of drug dosage forms, specifications, and packaging."
"The centralized procurement of drugs as an important assessment content of the hospital and its responsible person, into the target management and hospital evaluation work"
3. Notice of Zhejiang Provincial Health and Family Planning Commission on Further Strengthening the Management of Drug Allocation and Use in Primary Medical and Health Institutions
"Continuously increase the use of essential drugs and strengthen the dominant position in the use of essential drugs"
"Insist that the government-run primary medical and health institutions are fully equipped with essential drugs"
"Encourage public hospitals at and above the county level to give priority to the use of essential drugs and commonly used drugs"
"After the completion and implementation of the new round of centralized procurement of essential drugs, the purchase amount of essential drugs and commonly used drugs in secondary general hospitals and Chinese medicine hospitals shall not be less than 50 per cent of the total amount of drugs purchased by that medical institution, not less than 30 per cent in tertiary B hospitals and not less than 25 per cent in tertiary A hospitals. Gradually, all levels and types of medical institutions will be fully equipped with and give priority to the use of essential drugs."
The above document policy content, we can see that the basic drug is the dominant position of clinical use in the future, unshakable. And the basic drugs gradually expand upward, up and down linkage, the second and third-level medical institutions will give priority to the selection of essential drugs, and the use of the proportion of strict control and supervision, will start from the implementation of the new standard.
The dean will be the first responsible person for the purchase and use of drugs, and the dean of the principle of antibiotic management will also be the first responsible person.
Zhejiang has always been a province where the implementation of the basic drug policy is relatively in place. According to the spirit of the document, the later implementation document will definitely encourage all medical institutions to give priority to the use of basic drugs. That is, Zhejiang's non-mainstream products (including separate pricing of non-basic drug status and original research products) will be strictly controlled and used, including medical institutions above the county level, as long as the basic drugs with the same chemical name are guaranteed to supply.
All medical institutions will prefer to choose the dosage form specification products with the identity of the base drug in the common name to comply with the base drug policy and complete the proportion of the base drug. At the same time, due to the control fee of medical insurance and the zero difference rate of drugs, the non-base drug and the high-priced drugs set by the original research order are further controlled.
Anhui Province, the pioneer of medical reform, also made it clear in the volume procurement documents that all medical institutions should limit the catalogue and the proportion of drugs used in the original research separately priced.
Also in Zhoushan area, in order to comply with the basic drug policy, all medical institutions, including tertiary medical institutions, choose the basic drug to use, and all the original research single antibiotics managed by the generic name of the basic drug are replaced by the basic drug with the same generic name. This is a policy trend signal!
"Adapting to graded diagnosis and treatment, Zhejiang grassroots can use 30% of non-basic drugs how to formulate principles
Graded diagnosis and treatment, resource sinking, chronic disease grass-roots management, etc., the National Health Planning Commission and the provincial health planning commission to allow some non-base drug health insurance products at the grass-roots level. Zhejiang stipulates a 30% amount ratio. Because it is mainly chronic diseases for grass-roots management, this part of the products will be mainly cardiovascular, respiratory, women and children and other Junior College products.
Zhejiang will certainly formulate a selection principle. Here focuses on the principles of antibiotics. Due to the tightening of the national policy on resistance restrictions, the National Health and Planning Commission has recently publicly stated that it will extend antibiotic management to the grassroots level, because the grassroots level has now become a management vacuum for the abuse of antibiotics and has become a disaster area.
Zhejiang officials have repeatedly said in public that antibiotics managed by non-basic drugs and traditional Chinese medicine injections with non-basic drugs are strictly prohibited from being used by primary medical institutions. Because the problem of antimicrobial resistance is related to the global human, traditional Chinese medicine injection is a safety issue. Therefore, Zhejiang will be strict with the use of antibiotics management principles
Therefore, the choice of non-basic drugs at the 30% grass-roots level will definitely exclude the antibiotics of non-basic drugs, including the original research on the management of non-basic drugs with the common name of basic drugs. Separately priced antibiotics will also not be used at the grass-roots level (Zhejiang regards separately priced products as non-basic drugs, unless they are reduced to the price of uniform pricing). Besides, the new 520 and supplements of antibiotics belonging to the management of basic drugs are sufficient, there are entirely alternative base drug antibiotics. If the grass-roots level really needs high-end antibiotics clinically, temporary purchase reporting can be adopted.
The centralized drug procurement program of Zhejiang 2014 also clearly describes:
Differentially priced products for use by medical institutions at and above the county level.
Under the premise of giving priority to the use of essential drugs, grass-roots medical and health institutions are allowed to use a certain amount of non-basic drug winning products in the medical insurance catalogue.
This also mainly refers to some cardio-cerebrovascular, respiratory, maternal and child and other chronic diseases specialized non-basic drugs for the grassroots to choose from.
Summary: From the policy guidance of the State Health Planning Commission and Zhejiang Health Planning Commission on the dominant position of the essential drug system, the linkage of the three doctors, the linkage of the upper and lower levels, etc., Zhejiang has always been more in line with the policy principles and the implementation of the basic drugs in place, and its basic drug antibiotics must be fully equipped from the grass-roots level to the upward linkage, and its secondary and tertiary medical institutions are also given priority, for antibiotics managed by non-basic drugs, including their separate pricing for non-basic drug management, the original research class of high-priced antibiotics will be restricted from entering the grassroots, and the use of such antibiotics in secondary and tertiary medical institutions will also be significantly inhibited. This policy trend is irreversible under the current guidance, and medical institutions will definitely affect the selection of antibiotics after the implementation of the new standard!