Medical network - January 11 January 9 in the morning, national health development planning commission on the reform of the state council routine conference was held office "about the public medical institutions and drug centralized purchasing in the implementation of the implementation of the" two votes "opinion (try out)" on the official interpretation.
39 medicine you notice that the "opinions" have made it clear to 11 2017 comprehensive reform pilot provinces and 200 public hospital reform pilot city to be in accordance with the requirements of the "two votes" to implement, also encourage other areas actively promote, argues vigorously pushed across the country in 2018.
As early as in 2015, the state council general office has issued the about perfecting public hospital drug centralized procurement guidelines ", particularly encouraged all combined with the actual, create conditions for implementing "one vote". Special circumstances allow three votes, especially in remote and inaccessible place, but put an end to four tickets.
39 pharmaceutical jun in April this year the two votes to the large number of drug death! Eight provinces, 200 cities will introduce "analyzed the two votes to the influence of the drug.
At the conference, popular new fujian mode, become "two votes" execution model.
Popular fujian mode
As a comprehensive reform pilot provinces of fujian province, in the whole nation the first implementation of the "two votes". In 2009, in the provincial drug purchase supply work adhere to and seriously implement the "two votes" system, clear drug purchase bidding directly by the pharmaceutical producing enterprises, bypassing the intermediate links, unified purchase, unified distribution, unified pricing. At present, the fund has been implemented in fujian province 4 class as a whole, is a city divided into districts a procurement section.
Fujian province health department chief Zhang Xuanhua points out, the number of shipping enterprises in fujian province from 200 to the present 62, improve the concentration degree of pharmaceutical distribution enterprises, reduce the circulation cost.
Clear drug purchase in fujian province to recruit production enterprises, unified distribution pattern, make the responsibility of the production enterprises and circulation enterprises jointly and severally. Clear the first and second ticket distribution cost difference between the standard and implement into two test methods. Through the relevant departments of supervision, contain hang votes go phenomenon, regulate the behavior of the drug circulation.
For basic drugs, cancel the fragmentation distribution mode, implement the provincial unified distribution, after implementing the province unified distribution, distribution cost reduced to 3% from 5% - 5% - 5%, so the shipping cost is saved, means that the drug prices are down.
Fujian do after the establishment of health care, quickly issued two files, the first is "about a further blow to diddle medical insurance fund and the violation of patients' behavior notice, do not implement the" two votes ", falsely making out VAT invoices for tickets, money laundering, the production of drug supplies through the agent to reserve underwriting, layers of agents and sales promotions for rebates or property by a representative of the pharmaceutical methods such as bribes to promote health care fixed-point medical institutions and medical personnel, bribery medical security system management personnel, don't keep good faith, without justifiable reasons not on time delivery, etc, are recorded in the "blacklist". Drug supplies distribution business if we do not implement the "two votes", falsely making out VAT invoice, help illegal drug, money laundering, malicious cooperate medicine material production enterprise bribery of medical staff, also recorded in the "blacklist".
In addition, in order to promote implementation of the "two votes", the second file, is the provincial health care physicians code management, set up the health care physician code base, from the system specification doctors not disorderly prescriptions, expensive medicine, not accepting kickbacks, lay a foundation for the implementation of "two votes".
Two votes execution way resistance and long
In fact, the earliest put forward two votes is the provinces of guangdong, as the country's largest pharmaceutical market, two votes but slow execution, put forward early factors hindering the research on the two votes in guangdong is quite complicated.
The personage inside course of study thinks, the sound of two votes effective operating mechanism, the government regulation in place. Have factory quote us the unreasonable low price, for example, to participate in drug bidding and put down other manufacturer, the winning again after delivery, etc. For these behaviors, to formulate regulations and rules.
Reform of the state council for full-time, deputy director of the national health and family planning commission TiGaiSi secretary liang wannian, really want to let two votes the ground there are a few points is the most critical:
One is the must strictly enforce the rules of the drug procurement paper management. The most critical one, must strictly implement instrument management regulations. "Two votes" from the invoice of the actual, from the source control, the pharmaceutical production enterprises, circulation enterprises and medical organizations, how to management the invoice, in the "notice" has put forward specific requirements.
The second is to create the conditions to encourage local support the implementation of the "two votes". One aspect is to support the construction of national, regional pharmaceutical logistics park and distribution center, we need to promote more warehouse distribution, together to allow pharmaceutical trading enterprises take different positions, in the provincial cross-regional use in this enterprise eligible drug warehouse, etc., various local governments should cooperate closely, allowing different position, to allow multiple cooperating warehouse distribution, but don't make out an invoice, to support the reform policy.
Three is to strengthen "two votes" the implementation of the supervision and inspection. Requiring drug centralized bid procurement agencies to implementation of the "two votes" as tender bid of drug companies and distribution of the necessary conditions. Is the tender with promise enterprise must implement the "two votes". When making the bidding documents, also want to put the "two votes" as the prerequisite, this is from the source control.
Four is to strengthen policy interpretation, create a good social atmosphere. "Two votes" is a significant reform in the field of circulation, must be the meaning of the necessity of the reform, reform, reform to people the benefits of clear. Why do we need to let our enterprise can understand the implementation of the reform.
The future will face a wide range of fly storm
In accordance with the regulations of the file, the food and drug supervision departments will be the implementation of the "two votes" into the regulatory content, in the future in the daily inspection, tracking, inspection, flight check, will put the medicine circulation of goods, books, tickets, and the consistency of checks as the key content.
Found the problem, to recruit the mining department at the provincial level local situation; Suspected of violating the relevant provisions of the drug GMP, GSP, feed the agency will investigate and expose lawfully; Suspected crime, the case will be handed over to the public security department for investigation.
On May 3, 2016, the national food administration of drug safety announcement, ask around to illegal drugs circulation management behavior to carry out the centralized control.
Country requirements, all pharmaceutical wholesale enterprises to carry out the inspection first, whether there is any suspicion of this enterprise affiliated, go comparing the problems of 10 aspects, such as inspection, corrective actions and plan, introspects and rectification report on May 31, 2016 submitted to the provincial food and drug regulatory authorities. Provincial food and drug regulators, according to the enterprise inspection and rectification of targeted, a key to the implementation of the supervision and inspection. Then, place the regulation in the field of circulation.
Prior to that, "problem vaccine case" will call "ticket" problem to the pharmaceutical industry. At present many provinces have begun to "call" in the field of drug circulation, "ticket" release regulation schemes, "subordinate" and "tickets" the time has come for a big improvement.
Recently, the anhui province food drug administration on specific deployment, drug supervision departments at all levels will be through the daily inspection, tracking, inspection, risk classification regulation, flight check, carry out of pharmaceutical wholesale enterprises within their respective jurisdictions, public medical institution to perform "two votes" conducting supervision and inspection work, key check whether there is any, call "ticket" phenomenon; Whether there is a serious violation of the drug supply quality management norms "behavior; If there is a violation of the stipulations of the "two votes". And check the information to be public, in violation of provisions of exposure, will be investigated in accordance with the law.
Predictably, the two votes, under the full implementation of pharmaceutical circulation field will once again usher in the storm.
"About in the public medical institutions and drug centralized purchasing for the implementation of the" two votes "opinion (try out)"
For implementation of the general office of the central committee of the CCP, the state council on forwarding the deepening medical and health system reform leading group of the state council on further promoting the deepening medical and health system reform experiences of the several opinions > notification (hall word [2016] 36) "and" the general office of the state council concerning the deepening the reform of medical health investment will notice priority task in 2016 (the hair [2016] 26 date) regulation, promoting the public medical institutions and drug procurement to carry out the "two votes", opinions are formulated.
One, fully aware significance to implement the "two votes"
In public medical institutions and drug procurement to implement the "two votes" is we will deepen reform of the medical and health system, promote the healthy development of the medicine industry major step, is should standardize the order of drug circulation, compression of circulation, reduce the artificially high prices of important gripper is purifying the circulation environment, hit "money laundering", is the effective means to strengthen the supervision and administration of medical market, is the guarantee of urban and rural residents medical security, maintenance, the inevitable requirement of the people's health. All localities and departments must stand in the height of the country and the people's fundamental interests, is conducive to promoting the development of medicine industry transformation and upgrading from the big picture, to unify thought and action to the central decision-making, according to the division of responsibility, initiative, to take on responsibilities, close cooperation, to promote the "two votes" ground work.
Second, the definition of "two votes"
Two votes is refers to the pharmaceutical production enterprise to open an invoice of enterprises and circulation enterprises to open an invoice of medical institutions. Pharmaceutical production enterprise of the integration of trade and industry or group of enterprises to establish sales only wholly owned or holding of this enterprise (group) pharmaceutical business company (national only a commercial company), foreign drug domestic general agent (the national only a general agent) can be regarded as production enterprise. Medicine circulation group within the enterprise to a wholly owned subsidiary (holding) or a wholly owned subsidiary (holding) transfers between drug is not seen as a vote, but only allowed to open up an invoice. Pharmaceutical production, circulation enterprises according to the principle of fairness, lawfulness, honesty and credit reasonable price levels. Encourage public medical institution and pharmaceutical producing enterprises direct settlement drugs, pharmaceutical production enterprises and circulation enterprises and settlement distribution costs.
In response to the outbreak of natural disasters, major, major events and the patient (rob) save the special circumstances, such as emergency purchasing drugs or national pharmaceutical reserve drugs, can special treatment.
Circulation of narcotic drugs and the psychotropic drugs of category I still according to the regulations of the state.
Third, the "two votes" scope of implementation
Public medical institutions and drug procurement gradually implement the "two votes", encouraging other drug purchase of medical institutions to implement the "two votes". Comprehensive reform pilot provinces (autonomous regions and municipalities) and the public hospital reform pilot cities to take the lead to implement the "two votes", implement the "two votes" encourage other region, to 2018 fully implemented throughout the country.
Four regulations, strict enforcement of drug distribution bills
Pharmaceutical production, circulation enterprises sell drugs, shall be in accordance with the relevant provisions of the invoice management of the special invoices for value-added tax or VAT invoice (hereinafter generally referred to as the invoice). The sales of the drug shall, in accordance with the drug management and the quality control standard (drug GSP) asked attached with the cargo of peer list, purchase of the invoice (as well as the listing, similarly hereinafter), annul name shall be just walk with along with the cargo flow direction in order, payment, amount.
Buy medicine, medicine circulation enterprises should take the initiative to ask for bill to the pharmaceutical production enterprise, the invoice must be issued by the pharmaceutical producing enterprises. When the arrival of the acceptance, should verify invoices, the supplier with goods peer list with the actual purchase drugs varieties, specification, quantity, etc., check in and establish purchase drugs acceptance record, do the ticket and cargo, the bill. For invoice with with the cargo list do not conform to the requirements of the relevant provisions of the state, or invoice, along with the goods is not consistent between the peer list and purchase drugs, may not check incoming. Drug distribution in invoice and related bills, save shall, in accordance with the relevant regulations.
In public medical institutions carrying out "two votes" drug procurement, centralized purchasing agency by purchasing documents, to implement the "two votes" as the prerequisite. For bidding and procurement of medicines, to verify the pharmaceutical production enterprise qualification, bid directly by the pharmaceutical producing enterprises. Participate in drug centralized purchasing of production and distribution enterprises in the tender document to make the implementation of the "two votes" promise, otherwise the tender invalid. Execute other purchasing way purchasing drugs, also must be specified in the purchase contract the requirements of the "two votes".
Public medical institutions in drug check incoming, it must be identified ticket, goods, and the account agreement shall be put in storage, use, not only to the distribution of drug circulation enterprises demand, verify invoices, also should be required to circulation enterprises, issue the seal of the original purchase and invoice copy, provided by the production enterprise of two pieces of invoice the name of the medicine circulation enterprise, drug batch number of content related to each other, and as a public medical institution pay drug payment vouchers, incorporated into the financial management of archives. Each drug varieties to provide at least once a purchase invoice copy. Encourage conditional area to use electronic invoice, through the information means to verify "two votes".
Five, create conditions to support the "two votes" fall to the ground
, the relevant departments in all localities should actively for the "two votes" fall to the ground to create favorable conditions. To break the interests barrier, break regional protection, speed up the cleaning and abolished in enterprise registration, drug purchase, cross-regional operation, choice of distributors, chain operation, as well as hinder the healthy development of the medicine circulation industry of unreasonable policies and regulations. All local governments to support the network system, good reputation for quality, delivery capability of large pharmaceutical circulation enterprises to carry out local drug distribution work. Support the construction of national, regional pharmaceutical logistics park and distribution center, promote medicine circulation enterprises, warehousing and transport resources effectively integrate, multiple cooperating warehouse distribution, allow the medicine circulation enterprises take different positions, in the provincial trans-regional use in this enterprise eligible drug warehouse. According to the principle of distance, linkage between urban and rural areas, encourage support regional drug distribution of urban and rural integration, through "the last kilometer" rural drug distribution. For special remote township (town) or village, traffic inconvenience, pharmaceutical, medical and health institutions distribution allows medicine circulation enterprises on the basis of the "two votes" to open a pharmaceutical sales invoice, in order to ensure effective supply of the basic drugs.
Sixth, strengthen the "two votes" the implementation of the supervision and inspection
The provinces (autonomous regions and municipalities) drug centralized purchasing mechanism is to strengthen the supervision and administration of drug centralized purchasing work, does not according to the provisions of the "two votes" drug production enterprises, circulation enterprise, cancel the qualification of bidding, bid and distribution, and included in the drug purchasing record.
Family planning, traditional Chinese medicine health administrative departments should strengthen the public medical institution to perform supervision and inspection of the "two votes", lax to line (card), "two votes" to carry out the default payment for goods is not in place, and have made no medical institutions to criticized, until the responsibility shall be investigated for relevant personnel.
Food and drug supervision and administration of pharmaceutical production, circulation enterprises to carry out supervision and inspection, in addition to check the enterprise to carry out the "measures for the supervision and administration of the drug circulation and the drug supply quality management norms" and other relevant provisions, and shall implement the "two votes" is the enterprise incorporated in the scope of inspection. To the enterprise in violation of the "two votes" requirements, the food and drug regulatory department shall timely notify the province drug centralized purchasing agency. Suspected of a crime, transferred to public security organs in accordance with the law.
The tax authorities should strengthen the pharmaceutical production, circulation enterprises and medical organizations of invoice management, strengthen inspection of tax evasion in accordance with the law.
All relevant departments should make full use of information technology means, strengthen the supervision and inspection, the implementation of the "two votes" establish a sound regulation of cross-sectoral, cross-regional joint response and coordination mechanism, promoting drug centralized purchasing platform (public resources trading platform), drug tracing system and credit system construction platform, interconnection, data sharing, information related to realize interconnection and regulatory standards, mutual recognition processing results, to promote and strengthen information disclosure, fair show, widely accept social supervision, the relevant state department will implement the "two votes" conduct the special supervision and inspection of implementation.
Seven, strengthen policy propaganda
Around to strengthen policy interpretation, propaganda and guidance, easy to understand, vivid image, the purpose of the extensive publicity and implementation of the "two votes", the practice and meaning of positive response to social concern, to promote the "two votes" build good public opinion atmosphere. |
