On January 10, the executive meeting of the State Council decided to carry out the normalized and institutionalized procurement of medicines and high-value medical consumables in batches to further reduce the medical burden on patients.The meeting pointed out that in recent years, the reform of centralized procurement of medicines and high-value medical consumables has been continuously advanced, and the market-oriented mechanism has effectively suppressed the inflated prices of medicines. Pharmaceutical companies put more energy into product development and quality improvement.
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In the next step, it is necessary to promote the normalization and institutionalization of centralized and volume-based procurement and accelerate the expansion of coverage, and continue to reduce the price of medicines to benefit patients.
The reporter noticed that in January 2021, the General Office of the State Council issued the “Opinions on Promoting the Normalization and Institutionalization of the Centralized and Volume-Based Procurement of Drugs”.
The Opinion proposes to improve the market-led drug price formation mechanism, give play to the role of medical insurance funds in strategic purchases, promote the normalized and institutionalized development of centralized drug procurement with volume, and improve the working mechanism of government organizations, alliance procurement, and platform operations. Guide the price of medicines to return to a reasonable level, and effectively reduce the burden of medicines on the masses.
Continue to promote the centralized procurement of medicines at the national level with a focus on chronic diseases and common diseases
The State Council executive meeting pointed out that it is necessary to focus on chronic diseases and common diseases, continue to promote the centralized procurement of drugs at the national level, and carry out provincial or inter-provincial alliance procurement of drugs outside the national centralized procurement. By the end of this year, there will be more than 350 medicines in each province at the national and provincial levels.
Wei Zining, editor-in-chief of “Healthcare Reform” and director of the Management and Development Research Institute of Sanyi Zhiku (Beijing) Hospital, told reporters that if drugs for chronic diseases and common diseases are included in the centralized collection, ordinary residents will feel more obvious about the reduced drug burden. For example, chronic diseases basically require long-term medication, and the inclusion of centralized procurement may benefit more patients and win patients’ support for the policy.
How important is the provincial or inter-provincial alliance procurement of drugs outside the national centralized procurement in various regions to reduce the drug burden on patients?
The reporter noticed that in October 2021, the State Council’s leading group of medical reform issued the “Implementation Opinions on Deepening the Experience of Sanming City, Fujian Province and Deepening the Reform of the Medical and Health System”. Work, gradually expand the scope of procurement, and strive to purchase more than 300 generic names of drugs by the end of 2022. At the end of the “14th Five-Year Plan” period, the national and provincial organizations in each province should have more than 500 generic names for drugs purchased in a centralized manner.
Wei Zining said that for the National Medical Insurance Bureau, if all the drugs in the medical insurance catalogue are included in the centralized procurement at this stage, one is not necessarily so energetic, and the other is that not every drug needs to be led by the National Medical Insurance Bureau.
Because the characteristics of medicines in different regions are different, for example, the medicines used in Tibet and Qinghai may not be commonly used in Guangdong, and there is a type of thalassemia in Guangdong, and the medicines used here may not be commonly used in other provinces.
Taking brucellosis as an example, patients may suffer from this disease only in Qinghai, Xinjiang, Inner Mongolia, Ningxia, Gansu, Shaanxi and other places where sheep are raised. This medicine is not used in any area. In this case, it is necessary for several western provinces and regions to jointly purchase.
“In other words, it is more targeted to carry out provincial or inter-provincial alliance procurement of drugs outside the national centralized procurement.” Wei Zining said that because the Chinese market is huge, the price reduction of provincial or inter-provincial alliance procurement must be ideal.
Conduct centralized procurement at the national and provincial levels for orthopedic consumables, dental implants, etc.
The State Council executive meeting also pointed out that it is necessary to gradually expand the coverage of centralized procurement of high-value medical consumables, and conduct centralized procurement at the national and provincial levels for orthopedic consumables, drug balloons, and dental implants that are of concern to the public.
The reporter sorted out and found that this is the first time that the national level has proposed to carry out centralized collection of dental implants.
In September 2021, the National Medical Insurance Bureau clearly stated in response to the suggestion of Li Xiaoli, a representative of the National People’s Congress, to “include the cost of dental implant materials into medical insurance”. .
Wei Zining said that the current dental implant market in my country is very deformed, which may be far more deformed than heart stents. The data shows that the price of a dental implant is about 6,000 yuan to 20,000 yuan. As heart stents, artificial joints and other consumables have been included in the national centralized procurement, the price reduction effect is obvious, and the voice of including dental implants in medical insurance is getting louder and louder.
According to the national centralized procurement plan, only medicines and consumables currently covered by medical insurance are eligible to be included in the centralized procurement. In the reply to this suggestion, the National Medical Insurance Bureau did not explicitly carry out the centralized collection of dental implants.
However, the National Medical Insurance Bureau also pointed out in the reply that it will standardize the price items of oral medical services and integrate items that are too divided and too detailed. Control the medical service items and the scale of charges that public hospitals set their own prices. Instruct localities to include implants in the scope of platform hanging nets, promote the price of various brands of implants to be transparent, and squeeze out water.
The industry generally believes that this means that high-priced consumables such as dental implants are expected to enter the medical insurance payment in some areas. The executive meeting of the State Council directly and clearly pointed out that the centralized procurement of dental implants that are concerned by the public is carried out at the national and provincial levels respectively.
Wei Zining said, “Once dental implants are included in the centralized procurement, the price reduction is expected to reach 60% to 90%. Different materials and different products may have different price reductions.”
In addition, this executive meeting also pointed out that the long-term and stable supply of the selected drugs and consumables should be guaranteed, and supervision should be strengthened to ensure that the selected products are not degraded in price and quality. Medical institutions should give reasonable priority to the use of the selected products. At the same time, implement the policy of retaining the balance of medical insurance funds for centralized procurement, promote the reform of the salary system, reasonably increase the income of medical personnel, and better mobilize their enthusiasm.
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