Medical network - on January 11, on January 9, national health development planning commission held a regular press conference, interpret the reform do such as 8 department under the state council has released "on drug procurement in the public medical institutions in implementing the implementation of the" two votes "opinion (try out)".
"Opinions" requirement, the public medical institutions and drug procurement gradually implement the "two votes", encouraging other drug purchase of medical institutions in the implementation of the "two votes". Since 2017, 11 national comprehensive reform pilot provinces (autonomous regions and municipalities) and 200 public hospital reform pilot city take the lead to implement the "two votes". Implement the "two votes" encourage other region, to 2018 fully implemented throughout the country.
Reform of the state council for full-time, deputy director of the national health development planning commission TiGaiSi secretary liang wannian, "two votes" is an important reform measures, medicine field goal is to reduce the drugs circulation, make the middle price transparency, further reducing drug prices artificially high, ease the burden.
Q: how to squeeze drug prices water?
- middle price reduce circulation compression
"Two votes", refers to the pharmaceutical production enterprise to open an invoice of enterprises and circulation enterprises to open an invoice of medical institutions.
"Notice" requirements, pharmaceutical production, circulation enterprises sell drugs shall be in accordance with the related provisions of invoice management, issue special VAT invoice or commercial invoice, the invoice of purchase, annul name shall be just walk with along with the goods, payment flow direction, the amount is consistent.
Buy medicine circulation enterprises should take the initiative to ask for bill to the production enterprise. Public medical institutions must verify when drug check incoming ticket, storage of goods, the account three consistent before, use. Public medical institutions should not only to charge distribution pharmaceutical circulation enterprises, validation, invoices, also should be required to circulation enterprises issued by the production enterprise to provide the evidence of the purchase invoice, in order to confirm each other. Encourage conditional area to use electronic invoice, through the information means to verify "two votes".
In public medical institutions to implement the "two votes" in drug purchase, standardize the order of drug circulation, compression of circulation, reduce the virtual high prices of key, is purifying the circulation environment, hit "money laundering", is the effective means to strengthen the supervision and administration of medical market.
Liang wannian, past drug from manufacturer to medical institutions have a lot of links, some four votes, five, or even more, layers of overweight, pushing up medicine prices, sales to the medical institutions. People want to pay more, also want to pay more medical insurance fund. "Two votes", from the perspective of the circulation field, the link of compression, in the middle of the moisture greatly reduced. Drugs from the manufacturer to the hospital, the hospital into what is the price, what is selling price, the middle process open two votes, the tax authorities to see how much each ticket with price. Is conducive to timely discover violations of make out an invoice, and processing.
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 conscientiously implement the "two votes".
Commissioner of health do YaoXie procurement and distribution regulation of fujian province Zhang Xuanhua said, drug purchase is no longer the circulation enterprises bidding, direct production enterprises, make the responsibility of the production enterprises and circulation enterprises jointly and severally. And unified distribution, reduce the distribution chain. Determined at the same time, the production enterprise to issue the invoices for the first ticket distribution enterprises, distribution enterprise to the medical institutions to issue the invoices for the ticket. Clear distribution cost price difference between two standard, implement "see two test one", namely to see the second votes to test first, see if implement the "two votes", to look at the difference between the two is very big. Through regulation and curb hang votes go phenomenon, regulate the drug circulation.
Zhang Xuanhua says in fujian public selected 11 basic drug distribution enterprises as a basic drug distribution enterprises, the province each procurement area distribution enterprises should not more than 10. This to promote the integration of the pharmaceutical distribution enterprises, the provincial distribution enterprises from more than 200 the number of reduced to the current 62, reduces the cost of circulation. For essential medicines, cancel the fragmentation distribution mode, implement the provincial unified distribution, distribution cost reduced to 3% from 5% - 5% - 5%. Does the price down.
Fujian province has also established health care physician code library, from the system specification doctors not referring, expensive medicine, not accepting kickbacks.
Q: how to curb falsely making out invoice?
- strengthen "two votes" inspection because of irregularities
Zhang Xuanhua said, medicine circulation mess need multilateral joint governance. Fujian province have set up a new health care do in fujian province. Fujian province health care for health care related policy and the supervision and management of the medical insurance fund, medical service price negotiations adjustment, joint procurement and distribution of drug supplies and settlement management etc.
"About a further blow to diddle medical insurance fund and the violation of patients' behavior notice provisions, do not implement the" two votes "drug supplies production enterprises, through the agent sales agent to reserve underwriting, layer upon layer, recorded in the" blacklist ". Pharmaceutical material distribution enterprise does not implement the "two votes", falsely making out VAT invoice, help ticket money laundering, illegal drug manufacturers are also recorded in the "blacklist".
Liang Wannian said the drug centralized bid procurement agencies to implementation of the "two votes", as the drug companies bidding the bidding and delivery conditions. When bidding enterprise must promise to implement the "two votes". When making the bidding documents, also want to put the "two votes" as the prerequisite. Medical institutions at the time of purchase, not only request distribution companies to provide invoices, distribution companies must also be asked to provide production enterprise that one vote, and validated.
The state administration of taxation goods service tax, deputy inspector gilles, points out that the state administration of taxation has opened this year the national inspection platform for VAT invoice. From January 1, invoice for hospital to buy drugs, all units and individuals can be through the inspection platform to make out an invoice date of the invoice and the purchase and sale of information, name of medicines, medicine, the specifications, quantity, unit price, amount and so on carries on the examination.
State food and drug supervision administration of medicine, supervision department jian-hua ding thinks, at present there are 12000 national pharmaceutical wholesale enterprises, through the implementation of the "two votes", in the future there will be some non-standard enterprises facing elimination.
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. Discover problems, to the local recruit mining departments at the provincial level; Alleged violation of the relevant provisions of the drug, the agency will investigate and exposure in accordance with the law.
Q: how to ensure drug supplies?
Can open three votes - remote areas special treatment emergency situation
Since the implementation of the "two votes" drug "out of stock" problems? "Notice" requirements, 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.
Liang wannian, allowing some very remote and inaccessible places to open a ticket, is the drug supply to ensure that these areas. But only for towns and townships or village-level medical institutions distribution, remote areas of public medical institutions at or above the county level or to perform a "two votes". The cut not too big.
"Notice" requirements, and departments in all localities should actively for the "two votes" create favorable conditions to the ground and break local protection, support the construction of national, regional pharmaceutical logistics park and distribution center, promote the pharmaceutical circulation enterprises, warehousing and transport resources effectively integrate, multiple cooperating warehouse distribution, allow drug distribution enterprises take different positions such as policy measures.
In order to ensure the "two votes" smooth, guarantee the timely and effective drug supply, "notice" also made special provisions for some special cases.
It is conform to the development trend of modern pharmaceutical enterprise, trade and industry of pharmaceutical production enterprise or the integration of the group enterprises only sales of the pharmaceuticals of enterprises to set up wholly owned or holding companies (only 1 business companies nationwide) and foreign drug domestic general agent (the only one domestic general agent) can be regarded as production enterprise.
Of drug circulation group enterprise to a wholly owned subsidiary (holding) or a wholly owned subsidiary (holding) transfers between drug is not seen as a vote, but most allow open an invoice. Pharmaceutical production, circulation enterprises should be in accordance with the principle of fairness, lawfulness, honesty and credit reasonable price levels.
2 it is to respond to natural disasters, major outbreaks, major events and the patient (rob) save the special circumstances, such as emergency purchasing drugs or national pharmaceutical reserve drugs, can carry out special processing.
Three is the circulation of narcotic drugs and the psychotropic drugs of category I, still according to the regulations of the state. |
