Drug price liberalization, drug recruitment and change
After the liberalization of drug prices, the price department became the first gateway to control drug prices. In this context, how to improve and perfect the centralized drug procurement method? On December 23, at the symposium on centralized drug procurement sponsored by the relevant parties, the participating experts expressed their views.
Centralized procurement direction can not be shaken
Mao Zongfu, dean of the School of Public Health of Wuhan University, said that in the era of government pricing of drugs, the centralized drug procurement department is in fact on the basis of the maximum price of drugs, through the method of linking quantity and price, to further depress drug prices. After the liberalization of drug prices, the maximum price will no longer exist, and the pressure on centralized procurement will be even greater.
Experts at the meeting believed that the essence of drug price liberalization is price reform, which is to establish a new drug price discovery mechanism. Practice and exploration have proved that centralized drug procurement is a good measure in line with the law of market economy development, and the specific methods of centralized procurement should be continuously improved on the premise of adhering to this general direction.
Shi Lu Wen, director of the International Research Center for Pharmaceutical Management of Peking University, pointed out that the essence of centralized drug procurement is to discover and control drug prices through quantity and price linkage. For drugs with high prices, the centralized drug procurement department has the responsibility to lower the price by exerting the advantage of quantity. "Quantity for price" is in line with the law of market economy. We should not deny centralized procurement and simply decentralize the power of drug procurement just because we are not sure about the purchase volume. If the hospital can achieve the price that the provincial drug procurement platform can not get through the second bargaining, this is obviously an unreasonable phenomenon that violates the law of market economy.
Experts at the meeting said that by improving the construction of the platform, and then accurately grasping the amount of drug procurement, is the key link to achieve volume procurement and volume price linkage. At present, Shanghai has begun to pilot the implementation of drug procurement led by the medical insurance department, to achieve the hospital drug information database and medical insurance platform docking, and then grasp the hospital's overall drug procurement volume, thus forming a band procurement, to maximize the compression of drug price space.
Centralized procurement of drugs will be carried out in categories.
The reporter learned from the forum that at present, the adjusted and improved centralized drug procurement method is being submitted to the State Council for study. According to reports, the biggest highlight of the new program is the implementation of classified procurement of drugs.
According to the improved plan, the "double envelope" procurement method is still implemented for drugs with concentrated hospital consumption and sufficient market competition, and the reasonable price of drugs is found by exchanging quantity for price. For low-cost drugs and first-aid drugs, the policy will give support, liberalize prices under the premise of controlling the market negotiation space, and negotiate prices entirely between hospitals and manufacturers, so that the market can stimulate the vitality of drug manufacturers. For the use of small and clinically necessary drugs, continue to implement fixed-point production. For patented drugs and exclusively produced drugs, it is necessary to explore the establishment of a national negotiation mechanism, implement national and local hierarchical negotiations, learn from international negotiation experience, and find reasonable prices for such drugs. For drugs with obviously low prices, drug regulatory departments should strengthen comprehensive assessment, hold the bottom line of drug quality, and let problem enterprises withdraw from the market as soon as possible. For drugs strictly controlled by the state, planned management will continue to be implemented and strictly controlled by government departments.
After calculation, 80% of the hospital's drug varieties are still purchased by the hospital itself, which fully reflects the guiding ideology of ensuring clinical drug demand and mobilizing the participation of hospital drug procurement.
Fu Hongpeng, director of the Drug Policy Research Office of the Health Development Research Center of the National Health and Family Planning Commission, pointed out that centralized drug procurement is not the golden key to solving all the problems in the medical reform. The fundamental way to solve the problem is to deepen the reform and realize the linkage of medical insurance, medical care, and medicine. Advance together. In order to mobilize the endogenous enthusiasm of hospitals to participate in the centralized procurement of drugs and reduce the false high prices of drugs, it is necessary to implement the hospital compensation mechanism, reform the medical insurance payment mechanism, and improve the distribution incentive mechanism of medical personnel.
The administration should stick to its role
Fang Zhiwu, a member of the Medical Reform Expert Advisory Committee of the State Council, proposed that to discuss drug procurement policies, we must first define who is the buyer and what role the government departments, especially the provincial bidding and procurement departments, play. He believes that under the conditions of a market economy, the seller is a pharmaceutical company and a wholesale agent, and the actual buyer's representative is a hospital that performs 80% of the purchase volume. They replace patients and the medical insurance department in performing the buyer's functions. The health administration, as the competent body, also has the identity of the buyer's representative.
Fang Zhiwu said that the health administrative department should not fade out of the centralized procurement of drugs. If the administrative department can strictly abide by its buyer's role and adhere to the premise of equality between buyers and sellers, then its regulatory role in the centralized procurement of drugs is irreplaceable, and the seller has no right to ask the buyer's representative to withdraw. At present, the root of the contradiction between buyers and sellers is that the hospital administrative authority has a dual identity, as a government department, it has the power to make rules, but also serves as the buyer's representative, often mixing the identity of the administrative leader and the buyer's identity. The complaints in the industry mainly stem from the forced interference of government departments in the rules of buying and selling.
Fang Zhiwu believes that the key to solving the problem is that government departments should avoid getting involved in the specific process of drug trading, strictly implement the trading rules formulated at the national level, and should not change or destroy the existing trading rules at will.