Drug price liberalizes drug promotion

After the release of drug prices, the price department became the first hurdle to control the price of drugs. In this context, how can the centralized drug procurement approach be improved and improved? On December 23, at the symposium on centralized drug procurement organized by related parties, the participating experts delivered their opinions.

Central purchasing direction can not be shaken

Mao Zongfu, dean of the School of Public Health of Wuhan University, said that in the era of pricing of pharmaceuticals, the centralized procurement department of medicines is actually lowering the prices of medicines through a price-price-linked approach based on the maximum price of drugs. After the price of medicines is released, the maximum price will no longer exist and the pressure on centralized procurement will be even greater.

Experts at the meeting believe that the essence of drug price liberalization is price reform and it is necessary to establish a new drug price discovery mechanism. Practical exploration proves that centralized drug procurement is a good measure that conforms to the laws of the development of the market economy. It should continue to improve the specific methods of centralized procurement under the premise of adhering to this general direction.

Shi Luwen, director of the Center for International Management of Pharmaceutical Administration at Peking University, puts forward that the essence of centralized drug procurement is the discovery and control of drug prices through linking quantity and price. For high-priced drugs, the centralized drug procurement department has the responsibility to exert pressure on the price to reduce prices. “Volume change” is in line with the laws of market economy. We cannot deny centralized purchases and simply decentralize the procurement of medicines because the current level of procurement is inaccurate. If the hospital can achieve the price through the second bargaining, the price that the provincial drug procurement platform cannot get is clearly an irrational phenomenon that violates the laws of the market economy.

Experts attending the meeting said that by improving the construction of the platform and accurately grasping the volume of drug purchases, it is the key link to realize the linking of quantity, price, and quantity. At present, Shanghai has begun trial implementation of drug procurement by the medical insurance department, linking the hospital's drug information database with the medical insurance platform, so as to grasp the overall drug procurement volume of the hospital, and thus form a quantitative procurement to minimize the price of drug excesses. space.

Drugs centralized procurement will be classified and carried out

The reporter learned from the symposium that, at present, the centralized procurement of pharmaceuticals after adjustments and adjustments is being submitted to the State Council for research. According to reports, the biggest highlight of the new program is the implementation of classified procurement of drugs.

According to the improved plan, the “two-envelope” procurement method is still adopted for medicines with concentrated use of hospitals and adequate market competition, and a reasonable price for drugs will be sought through price change. For low-cost medicines and first-aid rescue medicines, the policy will provide support, and prices will be liberalized under the premise of controlling the market negotiation space. Hospitals and manufacturers will negotiate bargaining prices completely, allowing the market to stimulate the vitality of drug manufacturers. For a small amount of clinically necessary drugs, fixed-point production continues. For patented drugs and exclusive production of drugs, it is necessary to explore and establish a national negotiation mechanism, implement national and local stratification negotiations, learn from the experience of international negotiations, and find a reasonable price for such drugs. In view of the apparently low prices of drugs, the drug administration department must strengthen comprehensive assessments and support the bottom line of drug quality so that problem companies can withdraw from the market as soon as possible. As for the strict control of medicines, the state will continue to implement program management, which is still strictly controlled by the government.

According to calculations, 80% of hospital drug types are still purchased by the hospital itself, which fully reflects the guiding ideology of ensuring clinical drug demand and mobilizing hospital drug procurement participation.

Fu Hongpeng, director of the Drug Policy Research Office of the National Health and Family Planning Commission’s Health Development Research Center, pointed out that centralized drug procurement is not the golden key for solving all problems in medical reform. The fundamental solution to the problem is to deepen reforms and realize the “three-medicine” linkage of medical insurance, medical care, and medicine. Promote together. To mobilize the endogenous enthusiasm of hospitals to participate in centralized drug procurement and reduce the price of drugs inflated, it is necessary to implement a number of reforms such as the hospital compensation mechanism, the reform of the medical insurance payment mechanism, and the improvement of the distribution and incentive mechanism for medical personnel.

The executive department should abide by its own role

Fang Zhiwu, member of the State Council’s Medical Reform Expert Consultation Committee, proposed that in order to discuss the drug procurement policy, it is necessary to first define who is the buyer and what role the government department, especially the provincial bidding and procurement department, plays. He believes that under the conditions of a market economy, the seller is a pharmaceutical factory and a wholesale agency company, and the actual buyer representative is a hospital that executes 80% of the procurement volume. They replace the patient and the medical insurance department in performing the functions of the buyer. The health administrative department as the competent authority also has the identity of the buyer representative.

Fang Zhiwu said that the health administrative department should not fade out the centralized procurement of drugs. If the executive branch can strictly abide by its buyer's role and insist on the premise of equality between buyers and sellers, then its supervisory role in the centralized procurement of drugs is irreplaceable. The seller does not have the power to require the buyer's representative to withdraw. The root cause of the current contradiction between the buyer and the seller is that the hospital administrative agency has a dual status. As a government department, it has the power to make rules and also serves as the buyer's representative. It often confuses the administrative leadership identity with the buyer's identity. Complaints in the industry are mainly due to the forced intervention of government departments in trading rules.

Fang Zhiwu believes that the key to solving the problem lies in the fact that government departments should avoid the specific process of intervening in drug transactions. They must strictly implement the trading rules formulated at the national level, and should not arbitrarily change or destroy existing trading rules.