Medical network - on January 11, since no. 7, no. 70 is released, a new round of drugs in their shoulders, and define the classification of purchasing, introducing new approaches such as negotiations. , according to data of 27 provinces and municipalities have released a new drug centralized purchasing plan. 23 provinces during the bid opening in 2016, the implementation of the new procurement plan including fujian, guangxi, hainan, guangdong, Shanghai and other nine provinces.
Overall look, various provinces and cities in 2016 for mining scheme shows the "joining together of two standard, price linkage, with quantity purchase" of new trend. Some cities also bold innovation, such as Shanghai, shenzhen, GPO purchasing more cities to carry out the second negotiation, purchasing alliance between the provinces and cities.
As health care research center, tsinghua university visiting professor GengHongWu concluded in 2016 for mining ten features: centralized purchasing from centralization to decentralization, highlight cities subject; Limit tighter, take your lowest price for the provinces and the median price trend; Grouping optimization bidding, weaken the "foreign medicine" super national treatment; Standard double envelope bidding, business standard in prices as a basis; Subjective points to reduce technical bid evaluation, some new indexes; Price linkage, dynamic adjustment, the league joint bidding, negotiation; Not the winning, centralized purchasing new listed products opened the green channel; "Hook, belt quantity purchase quantity and price" alternative secondary bargaining expression; The centralized purchasing of pilot city level varies, flowers; Supplies, reagents, equipment with drug centralized purchasing requirements.
For forecasting the trend of drug centralized purchasing in the future, a senior industry researcher sinopharm dry RongFu said during a conference, "drug for mining will down the quantity and price trends, narrow provinces common drug procurement directory, a lot of drugs could not be into the directory and lose the opportunity of entering the market. At the same time, the medicine market access and bidding procurement and sales had broken link, under the new way of drug purchase almost one."
GengHongWu think will present ten trend: the price is still the national, provincial and pilot areas the main tone of the centralized purchasing; The transformation of government functions and devolution, the main body status of hospital institutions return; From policy to practice, the status of health care in the centralized purchasing gradually highlights; With quantity procurement into normal, municipal, medical couplet of bargaining and other ways; Try to cross-regional joint procurement, there will be a different type of procurement alliance; Place protection violation of fair competition in the market policy needs to be further correct; "Two votes" scope continues to expand, "three votes" or even no votes will appear; National medicine GuanPing units and provincial centralized purchasing platform interconnection price transparency; Explore the new model, drug delivery and the GPO sourcing will emergence of a variety of forms; Classification of procurement, implementation step by step, will further expand the scope of hung directly net.
Is expected in the future there will be more and more areas to break the traditional bidding mode. To this end, the reporter in 2016 drug called hot spots, to explore the trend of the 2017 drugs for mining.
1, more areas to explore GPO
GPO originating in Shanghai. Pointed out in Shanghai as early as the beginning of 2015, draw lessons from foreign practice of group purchasing organization, the choice of part not the implementation of centralized bidding in medical insurance directory drug varieties and at its own cost, promote the reform of pharmaceutical group procurement mode and medical apart, explore the GPO with social third party drugs, giving full play to the advantages of market, establish joint negotiation mechanism, optimizing the supply chain, drug purchase prices artificially high compression space, reduce the total cost of drug supply. Until now, Shanghai has released three batch of drug group purchase announcement, the first batch of GPO sourcing of antimicrobial drugs, the overall decline in about 20.8% of the purchase amount.
Another declared the GPO purchasing shenzhen, completely out of drugs in guangdong province electronic trading platform. The truth, "centralized purchasing of drugs in 2016, total cost than in guangdong province in 2015 drug purchase the same amount on electronic trading platform product gauge drugs decreased by more than 30% of the total cost." At present, the shenzhen city has announced 2 batch purchasing directory.
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GPO sourcing is on the basis of the drug centralized bidding, recycling quantity and price "hook" squeeze out the moisture in the virtual high prices. Through directory GPO merger, joint selection, improve concentration, thereby reducing drug prices. The implementation of the GPO both have explored.
GPO mode for Shanghai, the Shanghai purchasing alliance ming-kang zhong, director of the expert group convener, huashan hospital pharmacy department explained as "supply chain reengineering", change the previous drug through commercial channels into the hospital "- the doctor - patient pharmacy" still exist after the status of the internal supply chain, realize the integration of internal and external integration, and in accordance with market rules, the cost compensation received by the hospital.
Shenzhen scheme killer is incorporating the city public hospital drug catalogue for "a two specifications of three dosage forms," directory dosage form integration will reduce bidding grouping, manufacturers more competitive. With analysis of the industry that import the original patent medicine reduction will not big, more than domestic production, purchasing amount is big, the quality level is not high drug or face a steep price.
Although the future there will be more areas to explore GPO mode, but it is difficult to "emergent" GPO in 2017.
2, medicine exchange bargain to expired patent medicines
As a weather vane, the guangdong medicine by "interim measures for medical institutions and drug trade in guangdong province", much attention has been paid to start on September 2, 2016, on January 1, 2017 formally implemented. This is for the first time since 2013, the drug by running change. New rules clear, the drug is no longer divided into quality level, the quality of basic medicine is divided into four levels. The most notable is, in the third level medical insurance directory drugs drug trading rules proposed initiative comparison coefficient are used to determine whether expired patent medicine can be winning. It is reported, comparison coefficient is in tension measurement.
Traditional Chinese medicine (TCM) in addition, the end of November, 2016, China formally launched in wuhan, will provide a concluded contract, including product display, trading, clearing, finance, logistics, big data, such as "Internet + medicine supply chain" multi-dimensional service, through medicine circulation, achieving full online electronic transaction. The scope of services including private hospitals, social retail pharmacy.
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The introduction of guangdong comparison trading rules, can make the expired patent medicine in domestic generics quality has not been generally promote transition period and still enjoy a relatively high price, not directly to spell price no advantage and outbid; But because of its bid price is restricted by the coefficient of price comparison, must be in the original bid price incentives, not higher than the domestic high-quality generic drug prices too much. Expert analyzes believed that expired patent medicine in guangdong, the reduction is expected to 15% ~ 30%.
The practice of medicine by guangdong, will undoubtedly have a demonstration effect.
Traditional Chinese medicine (TCM) and China by tend to financial services across the supply chain, the third party logistics operation support and other value-added service.
3, regional union continues to expand
In 2016, various regional alliance.
"Sanming alliance" recruits members, at present a total of 28 covers 15 cities, demonstration county and create qinghai huzhu county, in guangdong, fujian, zhejiang, hebei, Inner Mongolia, qinghai, yunnan, shanxi and henan province.
In addition, shaanxi, sichuan, Inner Mongolia, ningxia, qinghai, gansu formed in six medical consumables purchase "western union". Shanghai neighboring fujian signed agreement in four provinces and one city, a clear will be paid by drug supplies procurement, health care, medical service price reform, personnel salary, health industry development, etc, to carry out the policy coordination; Beijing-tianjin-hebei places also signed a joint public hospital medical consumables purchase framework agreement.
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Since the state encourages the cross-regional joint procurement, the country has multiple drug consumables in trans-provincial joint procurement alliance, coverage is more and more widely. Experts say, the league by a province or city as the center, such as the league of sanming sanming, western union in shaanxi province, formed a pattern to lead, to follow up. Alliance formed between provinces and cities, as well as the purchasing data connectivity will further reduce the price.
Can foresee, in the future, there will be more joint procurement.
4, "the second negotiation"
Start bargain "secondary" the most radical of zhejiang, in hangzhou, shaoxing and ningbo, wenzhou, on the basis of the pilot announced in November 2016 in the province pilot cities to promote the "second negotiation", set up in the province of centralized purchasing regulation and medical and health institutions independent purchasing organic combination drug centralized purchasing new mechanism, clear the dominant position of public hospital in drug purchase and negotiation.
Another kind of bargain "secondary" is a finalist at the provincial level after cities price negotiations. Such as "the second negotiation" in jiangsu province, is the provincial platform selected by means of quality control and price for a batch of provincial finalist, the final price is everywhere in the city with the amount of the purchase in the form of price negotiation.
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The state council "about perfecting public hospital drug centralized procurement guidelines" clear, in the public hospital reform pilot city, allowed in the city on the provincial drug centralized purchasing platform to purchase. This means that the pilot cities are independent bidding for "secondary bargaining", and the current reform pilot city expanded to 200.
The aim of the "secondary bargaining" or leave the lower drug prices. Ningbo traditional joint procurement price fixing, on the basis of bid price reduction by 15.5% on average. For the unit with the cities in anhui province, on the basis of the net to bargain "secondary", the decline in demand is very high.
A wider range of "secondary bargaining" will further lower drug prices, but the pressure is more and more big drug firms, is more "the secondary bargaining trap". But the "secondary bargaining" has won policy allows, the future is undoubtedly a new normal.
5, "two votes" real power
In April 2016, the state council to carry from production to distribution and circulation to all medical institutions to open an invoice "two votes". Since then, the "two votes" have appeared in the provinces related documents. Besides has the implementation of the "two votes" fujian, anhui, shanxi, hunan, qinghai are released files, landing in sichuan, chongqing, ningxia has released draft, guangdong, hebei, jilin and other places also shows that will be executed. A few days ago, the healthcare reform office under the state council in conjunction with the national health and family planning commission, the food and drug supervision bureau, the national development and reform commission, ministry of industry and information technology, the ministry of commerce, the state administration of taxation and the state administration of traditional Chinese medicine department issued "on drug procurement in the public medical institutions in implementing the implementation of the" two votes "opinion (trial) notice.
Notable is, zhejiang did not perform a "votes", but the information flow, business flow, capital platform, "the unity of" third-rate has to have the technical requirement of the implementation of "one vote".
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According to industry analysis, anhui "two votes" file is most consistent with national philosophy. Only is put forward, in the province within the industry sales of the business enterprise, import general agent (only one), drug marketing authorisation holder trust or wholesale pharmaceutical production enterprise to sell drugs are regarded as for manufacturing enterprise; Is indeed a remote mountainous area (area), pharmaceutical trading enterprises can be based on "two votes" to open a pharmaceutical sales invoice.
Shaanxi province is in the implementation of the "two votes" at the same time, the number of distributors is compressed, and distributors first option to the medical institutions.
"Two votes" trend, the circulation will be reduced, the circulation industry further concentration. Pharmaceutical marketing model will have a huge change, terminal team less, mainly base agent, through layer upon layer to the terminal operation of industrial enterprises will suffer.
6, medicare pay highlights the central role
In November 2016, the medical insurance payment standard for the end of the comment, files, is about to come on the medical insurance directory will be introduced together. Is delayed for more than a year, but paid for health care reform core engine, on the policy side progress finally make a sound.
Then, anhui announced the basic medical insurance payment reference price adjustment measures for implementation of medical insurance drugs, and according to the national minimum price adjustment in medical care payment reference price, varieties of direct screening the sale price to pay for health care reference price. It is understood that the anhui province existing medical insurance payment reference price drugs 5441 rules, including a large quantity of procurement before 1500 products accounted for 74% of total purchase amount. Contrast in the medical insurance payment reference price in anhui province and the provincial price, 1500 product gauge in 1500 for the lowest price, accounting for 57%.
In addition to the mode of anhui, chongqing, sanming, also has been clear about the medical insurance payment standards, many governments post offered to promote the reform of health care to pay.
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In 2017, as the medical insurance payment standard, called mining pattern of big changes will occur. Pay for health care standards, the influence of sinopharm shares advanced industry researcher do honor rich profound understanding.
Health insurance payment standard, he argues, will further expanding the scope of the direct net purchase, supply and demand both sides directly online trading in a mainstream position, bidding procurement gradually focus, procurement negotiations become the norm. Of the payment guide price management, clearing payment policy, payment methods, payment standard three concepts. Have the policy should be the first, and then, the payment method, finally forms the payment standard. Medical insurance payment methods including pay by project, single macro-reforms, capitation payment, etc. Health care payment standards may be in the city as a whole the area. |
