Buy medicine is not higher than the hospital budget spending by thirty percent

Purchasing new rules could drop prices?

July 20, 2015 09:18 source: People's Daily print [number] [little] in size large core reading/mobile phone to watch the news

Previous drug purchase, high prices, high kickbacks from drug news didn't heard less, and even add the bribery cost of drug firms to drug prices, eventually patients suffer.

Recently, the national health development planning commission issued by the public hospital drug procurement notice, put forward the classification of procurement, procurement budget control in the hospital business spending of 25%, 30%, negotiating deals patent medicine, the tender "" double envelope system, to break with medicine medical mechanism, reducing drug prices artificially high, reduce the financial burden on the people use.

"On the implementation of the national health and family planning commission issued by the perfect public hospital drug centralized purchasing work guidance of notice, the full moon.

Notice for public hospital drug procurement operational guidelines are put forward. What is a drug classification procurement? Can the hospital budget under control? Patent medicine price is high, the government can group purchase cheap? Ignore the drug quality bidding meeting will not blindly down the price? People concern, the reporter interviewed national health and family planning commission, head of the drug administration department and relevant experts.

Ask to reduce the budget to buy medicine, public hospital sent money

Classifying medicine procurement is a major highlight of the notice, also gives the specific scope and the way of centralized purchasing. National health development planning commission, director-general of the department of drug administration Zheng Hong introduction, according to the particular way is by the hospital is not 80% below last year's actual usage of drug procurement plan, specific to generic names, types and specifications, and purchasing quantity every product specific rules, each drug purchase of dosage forms, in principle, shall not exceed 3 kinds, each corresponding specifications in principle no more than two kinds of dosage forms. Give preference to conform to the clinical pathway, into major diseases, major drug discovery projects, major projects of public health medicine, women, the elderly and children, give attention to two or morethings and other special groups' medical needs, and health care, new farming reimbursement policy.

Reporter noted that notice clear requirements, the hospital drug costs generally is not higher than 25% - 30% of the hospital business spending, in fact most of the public hospital medicine accounted for 40% or more, and public hospital compensation mechanism is not fully established, this case can implement purchasing budget so low?

Zheng Hong introduction, from the hospital drug expenses budget cycle control, reducing drug prices artificially high, reduce the cost burden. To achieve the goal, we must adhere to three medical (health care, medical treatment, medicine), combined with local actual research for public hospital reform pilot city to city to purchase the specific measures for the unit, and the medical insurance payment methods, medical service price, compensation system, and so on comprehensive supporting reform, policy formation resultant force.

Under the state council development research center, deputy researcher Jiang Yu thinks, hospital drug expenses general business spending no more than 25% - 25%, this is done to budget practises hard constraints on the source from the hospital. "This ratio based on several aspects: one is the current hospital medicine 43% or so, considering the excessive drug use and drug prices artificially high, there is a large decline in space; 2 it is national pilot cities is put forward to 2017 public hospitals medicine proportion fell to 30%; three is the developed countries accounts for between 10% - 20% than usual, fujian sanming to successfully implement comprehensive reform of public hospitals, such as medicine proportion also dropped to between 25% and 30%."

Jiang Yu puts forward, on the other hand, reduce drug costs, is to reduce part of the medical staff income. Want to let the medical staff income reached a reasonable level, but also need to further improve the public hospital compensation mechanism, through fiscal investment, reforming health insurance payment, the adjustment of medical service price, compensation directly with more financial and medical insurance fund to the work of medical staff, so as to radically cut staff income and drug expenses of interest relationship, let the medical staff have the motive force to the rational use of drugs.

Professor li ling of Peking University, said the reform health care, medical drug purchase link two links to cooperate. Public hospital compensation mechanism is still not changed to medicine still exists, the mechanism of medical insurance to pay by project is still in encourage hospitals and doctors expensive additional drugs, drug firms vicious competition phenomenon did not improve, simply introduce drug centralized purchasing, can't completely reverse the drug prices artificially high, need 3 d linkage, can realize policy effect.

2 q group-buying patent medicine, can cut down the price

Patent medicines, exclusive of the high price of medicine, many patients Shouting price is too high, difficult to handle. Notify implements five ways classification for drug procurement is put forward, including the exclusive patent drugs and drug production, procurement will be negotiation. To use negotiations to purchase drugs, in order to reduce the price too high, for the first time in our country.

It is estimated that our country imports sold in patent medicine has more than 60, patent period but no generic domestic exclusive species 150-150 kinds of western medicine, medical insurance directory of proprietary Chinese medicine sole there are more than 400 varieties. According to the roughly calculated, and the whole sales of patented drugs and exclusive varieties, in the market, there should be more than 600 one hundred million yuan to more than one hundred million 600 yuan. After policy implementation, this part of the drug can reduce the spending of more than 100 one hundred million yuan.

Zheng Hong introduction, national health development planning commission will start talks in the near future, establish the system of joint conference for negotiations between ministries, at the same time negotiations expert database and supervision of expert database is established. In the pilot, on the basis of summing up experience, gradually expanding the scope of the negotiations. Temporary not included in the negotiations for the pilot's patent medicine or exclusive varieties, the provinces according to existing pattern organization purchase, but all the medical institutions must implement zero rate of sales. Encourage a provincial cross-regional coalition talks, combined with the national regional economic development strategy, explore form a regional procurement prices to pay health care policy.

Jiang Yu said talks, procurement is the international a general for measures for the procurement of exclusive patent medicine, medicine is mainly the government play the advantages of the "team", even in an area the size of the market of a country, with a monopoly of patent medicine manufacturers negotiations, play the advantages of quantity is with preferential treatment, to control the price in a reasonable level.

Medical management of Beijing university, director of the center for international studies at Shi Lu, 'says negotiations pricing is one of the most important implement with quantity purchase, combination of quantity and price. "Negotiations main body, the operation mode can be restrained by system, after you talk is the key to truly implement. As long as the implementation in place, most of the drugs should be the trend of decline in the price." He said.

Three ask how to prevent low price is taken, cheap goods is not good

Put forward the notice, centralized purchasing "double envelope", in the use of essential medicines bidding hook quantity and price. Have basic drug price is low, the phenomenon of quality problems, known as the "low price is only take". How to avoid this kind of phenomenon?

Jiang Yu says, a "low price is only take" usually caused by two cases. One is, as a result of drug quality evaluation and supervision system is not perfect, composition of different enterprises producing the same drugs, although there are legitimate production approval, but the effect of drug quality produced there exist certain differences. If this case "at a low price is only take", can affect drug effect, even excluded the good quality drugs. The solution to this problem depends on perfecting the system of drug evaluation, strengthen the drug quality and prices comprehensive assessment, monitoring the whole process. Another case is that some drug malicious low-price bid, not unluckily drug production and distribution, in this case, to strengthen comprehensive evaluation in the bidding link, guide rational bidding enterprise, as well as the default enterprises increase the penalties.

"But from the point of essential medicines procurement situation in our country," low price is only take "is not very accurate." Jiang Yu said, starting from the basic drug bidding procurement in 2011, to the public hospital drug centralized purchasing, is through the "double envelope" system, evaluate the quality and price. "For the quality of similar drugs, of course, choose a lower price, this is common sense to buy things, take it for granted, not to say" low price is required. '"

Shi Lu article believes that the purpose of drug bidding procurement is not direct pursuit of the price. Key determinants of drug quality in production, the bidding procurement is on the premise of products conform to the standards for selection. Bidding is a market for promoting drug prices reasonable mechanisms, to respect the market rules, encouraging competition under the premise of fully, drug prices should be reasonable return.

"In the current enterprise quantity is numerous, under the condition of productivity gaps, formed by competition mechanism, the bidding price, will be really close to or even breakdown part of the cost of the enterprise." Shi Lu said, but the low efficiency of enterprise's elimination is normal phenomenon, under the market economy is conducive to end the state of the pharmaceutical industry for many years in our country, is conducive to long-term development of the industry.