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| There are five trends in the first half of the year! Drug prices add downward pressure |
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| Author：中國銘鉉 企劃部 Release Time：2017-8-10 9:01:54 Number Browse：603 |
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Medical network - on August 9, according to the days the wind securities research report, by the middle of July, 2017, zhejiang, anhui, hunan, fujian, guangxi, tianjin, hebei, Inner Mongolia, heilongjiang, sichuan, Beijing and other 11 provinces and cities has already completed a new round of provincial drug centralized bid procurement. The 11 provinces, including jiangxi, ningxia and gansu, are in the process of finishing or partially completing. Seven provinces, including guizhou and jiangsu, are still in progress.
From the current provincial schemes, the recruitment model is developing towards decentralization and unitization. Provincial-level centralized recruitment platform is more equal to an access platform, and the price of purchasing on the provincial level is to be a new direction for the purchasing of local units or medical medias. On the other hand, health insurance is gradually embedded in drug recruitment, and more cities are offering to explore GPO procurement, and more and more cities and provinces have joined the purchase of trans-regional alliance.
With the emergence of new models and the more diversified the purchasing subject, the downward pressure on drug prices will continue to increase.
Trend 1 more cities explore GPO
Shanghai and shenzhen, who will be the promotion model?
In the first half of this year, guangzhou, foshan, and hubei province all offered to explore GPO mode after the GPO purchasing mode was implemented in Shanghai and shenzhen.
Among them, guangzhou will carry out GPO news to attract wide attention. Released on July 13, according to the guangzhou "guangzhou district public hospital comprehensive reform implementation plan", increase the quantity of medicines by city people club bureau to develop guangzhou (medical consumables) procurement and distribution policy of the organization and coordination of public medical institutions and drug (medical consumables) the function of centralized purchasing, increase city medical insurance services authority orgnaization of the specific organization and management in guangzhou pharmaceutical (medical consumables) the function of centralized purchasing. Relying on public resources trading center set up in guangzhou GPO platform, in accordance with the amount with centralized purchasing requirement, push the area of the guangzhou public hospital medicine, medical consumables unified group, centralized bid procurement, unified distribution of implementation.
Vision of the guangzhou, foshan GPO patterns, drug trading center in guangdong province, according to the website of guangdong province huang fei, director of the health development planning commission, provincial health office, deputy director of a line is due to the province medicine research center, explore "provinces and cities to build GPO model", will be in guangzhou and foshan in guangdong province for the pilot to explore platform to open "GPO zone" or "urban sub-center", innovative forms. And use "Internet +" to realize trans-provincial transaction, establish the third-party pharmaceutical electronic trading platform of south China, and go to the whole country to the world.
Currently, guangzhou and Shanghai and shenzhen have different GPO modes. Shanghai GPO is responsible for Shanghai medical health service center, and Shanghai sunshine medicine procurement. Prices are cut mainly in the supply chain, with a drop of about 20 per cent. Shenzhen GPO is responsible for procurement by the "all-drug network" and has been outspoken in reducing the total cost of medicines to more than 30 per cent. However, this year the national development and reform commission (NDRC) put forward a survey on shenzhen GPO. For this, the whole drug network says that it has completed the corresponding rectification work, the direction of shenzhen GPO mode remains to be observed.
The specific model of GPO in guangzhou will also look after the detailed rules. The three GPO modes mentioned above are worthy of the attention of the industry.
Trend 2 health insurance embedded recruitment
Gradually become mainstream, present the national promotion situation
The practice of embedding health insurance is attracting attention from sanming, fujian province. In 2013, sanming across the country set up the first medical insurance fund management center, take the lead to achieve the unity of "miho, medical tube center new drug purchasing price and settlement, the medical service price adjustment, urban and rural residents and urban workers audit and settlement of the designated health care organizations and the medical establishment that decide a dot medical behavior regulation and management audit.
The sanming model is encouraged at the national level and presented to the whole country. In 2016, started in the province to promote fujian sanming mode, was formally established in provincial health care management committee, undertake supervision and management of the medical insurance fund, medical service price negotiation and drug supplies joint procurement and settlement, the medical service behavior regulation and the responsibilities of the medical insurance information system construction, etc. In March 2017, fujian province launched a new round of the joint price limit sunshine procurement under the auspices of the medical insurance office.
Health-care embedding is also spreading elsewhere. Currently, zhejiang, tianjin, anhui, chongqing, gansu and other provinces and cities have said that they have combined medical insurance and drug recruitment. And shaanxi province, foshan, dongguan, zhuhai, zhongshan, hunan, hunan, jinzhou, liaoning province, will set up the municipal insurance fund management center.
Among them, according to the plan of foshan city, the new medical insurance fund management center will integrate and take the management of medical insurance, medical insurance fund pays, and management, the standard of medicare pay negotiations, drugs and medical consumables joint procurement and distribution and settlement management, the medical establishment that decide a dot protocol management and settlement. The health care center will also implement the "six unified" reform of drug and medical consumables unified catalog, unified distribution, unified procurement, unified budget, unified settlement and unified distribution of benefits.
In the industry point of view, health care deeply embedded mining is becoming a mainstream way, this way not only can effectively cut down the price through price leverage, can fully arouse the enthusiasm of medical institutions and avoid the formation of excessive.
Trend 3 provincial-level finalist, municipal real standard
Provincial level platform function desalination, city level purchase price again drop
The role of provincial-level platforms in drug recruitment is gradually fading, and provincial platforms are more equal to an access platform, and they will be purchased on provincial platforms at the provincial level.
On July 18, guangdong province issued the policy implementation plan for further reform and improvement of drug production and circulation, and explicitly promoted the procurement of drug sub-regions of public medical institutions. Guangzhou and shenzhen can implement group procurement (GPO) in the city. Other cities can be purchased by the municipal units in the province of the third-party pharmaceutical electronic trading platform.
Hebei province in the purchase of a new round of comprehensive drug, allowing pilot city of tangshan, handan, zhangjiakou, xingtai, cangzhou, hengshui, as the unit in the provincial drug procurement platform to purchase.
In the whole country, the participation of purchasing in the city has been gradually rising. Gansu said it would lower the price of drugs by taking measures in the city as a unit. Hubei province is clear provincial procurement platform will implement "purchase access" system. In the past, zhejiang and jiangsu province have been in the provincial bidding for the market price negotiation, forming a "provincial level, the city" model.
According to the general office of the state council issued "about perfecting the public hospital drug centralized procurement guidelines", although the province determines the direction of drug centralized purchasing for the unit, but also said in the public hospital reform pilot cities, allowed in the city on the provincial drug centralized purchasing platform to purchase.
It is understood that the number of pilot cities has reached 200, accounting for 57.5% of the country's 348 prefecture-level cities. In addition, a number of non-pilot cities have also expressed their encouragement to participate in the purchase price at the municipal level. The purchasing power of the city is growing stronger.
At present, the price of municipal procurement will be reduced by about 5% to 10% on the provincial level. According to the practice of some areas, the bid price in the pilot cities is lower than the price listed in the provincial level, and the price listed in the provincial level will be adjusted in the pilot cities. For example, liaoning and gansu have stipulated that the price of a pilot city is less than 5% of the price in the provincial level, and the price listed in the provincial level is low in the pilot city.
Trend 4 medical couplet purchase arisen
Increase the participation of medical institutions in bargaining
Since 2013, when the state first explicitly proposed to encourage the form of the medical association, various provinces and cities in the country have been exploring and piloting the medical intermodal model. By the end of 2016, there were 205 prefecture-level cities in the country, and more than 60 percent of the cities in the above cities.
At present, the state has made it clear that it will fully promote the construction of the medical association. In April this year, issued by the general office of the state council on promoting the development of the construction of medical association and guidance ", points out that various kinds of medical association will comprehensively launched in 2017 the pilot, tertiary public hospital to participate in and all play a role of leading, comprehensive reform pilot provinces each cities and grading treatment pilot cities built at least one has obvious effect of medicine. By 2020, based on the summary of the pilot experience, we will comprehensively promote the construction of the medical association and form a full-fledged medical system.
The procurement of medical medias is being rolled out nationwide, and guangdong, liaoning, shandong, Inner Mongolia, gansu and hubei are all offering to explore the procurement of medical medias in the latest medical reform or drug procurement scheme.
In the medical association mode, the leading hospital will be the core, which determines the drug variety in the medical association, which is the key to pharmaceutical enterprise marketing. In addition, the hospital will be able to achieve relatively uniform drug use. In 2015, Beijing promoted the construction of medical medias, and gradually unified the drug catalogs and regulations of core hospitals and communities in the area of regional medical association. And the basic drugs are gradually being released. This year guangdong announced that it would no longer limit the use of basic drugs in the base, and zhejiang increased its use of non-basic drugs from 30 per cent to 50 per cent last year.
It is worth noting that the procurement of medical institutions further enhances the participation of medical institutions in the centralized procurement of drugs, and the bargaining power of medical institutions as the subject of procurement and use will not be ignored. And it encourages the purchase of medical mediatals, which is further bargaining on the basis of centralized procurement.
Trend 5 encourages cross-regional procurement
Large procurement volume can greatly increase the bargaining chip
So far, the country has emerged more drug supplies, cross-regional joint procurement alliance alliance, sanming alliance, four provinces and one city in the western region medical consumables purchase cooperation alliance, beijing-tianjin-hebei consumables procurement alliance were set, the league is also constantly absorbing new members to join, coverage is more and more widely. The western union has added gansu, qinghai, xinjiang, hunan, heilongjiang and liaoning provinces from the first four provinces of shaanxi, sichuan, Inner Mongolia and ningxia. Members of the sanming alliance have included 19 prefectures and 31 counties.
In addition to recruiting new members, the alliance is pushing for the relevant procurement rules. In January 2017, the joint procurement plan of the beijing-tianjin-hebei medical consumables joint procurement platform was issued. The first selected heart stent, cardiac rhythm management, prevent adhesion, bleeding, artificial joints and stapling six types of medical consumables, bidding, negotiation, etc were used respectively to different way of centralized purchasing, partial classification to carry out the centralized purchasing work. In the end, the transaction price of the products in beijing-tianjin-hebei region was finalized, and the procurement results were carried out in a public hospital in the secondary level of three places.
At the end of May 2017, a joint meeting of the four provinces of fujian, zhejiang and anhui province made clear the division of labor in the promotion of health reform in the four provinces. Among them, we will promote the purchasing experience of medical consumables in ningbo city, zhejiang province, and select the medical consumables with large amount of 1 ~ 2 types and high price, and implement the joint procurement in a city of four provinces. In the procurement of drugs, fujian province led the selection of a number of original research and exclusive varieties with high prices, and implemented the joint procurement and price negotiation in a city of four provinces. Jiangsu province mainly completed the price of sharing medical services in a city of four provinces, the purchase price information of pharmaceutical consumables, and the regular information gathering and exchange of information.
According to industry estimates, cross-regional combined purchases increase the volume of purchases, significantly increase the bargaining chip, enhance bargaining power for the price of enterprise products, or bring further reductions. In the future, there will be more places to join the alliance procurement.
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