In November this year, the prices of drugs such as metformin, gliclazide and montelukast sodium will drop again. This change is attributed to the centralized procurement of drugs organized by the state. In August, the third batch of centralized drug procurement organized by the state, which is the largest by far, produced a successful result. A total of 191 products of 55 drugs were selected, with an average price reduction of 53%. The successful result will be implemented in November. Commonly used drugs such as metformin are among the drugs selected in centralized procurement.
Since December 2018, the centralized drug procurement organized by the state was piloted in 11 cities including Beijing and Tianjin ("4+7" pilot), the number of drugs purchased has reached 112, involving more than 200 selected enterprises. Centralized purchasing has greatly reduced the price of some high-priced but large-dosage good drugs, reducing the burden of patients’ medication. According to the agreed purchase volume, the annual cost dropped from 65.9 billion yuan to 12 billion yuan, saving 53.9 billion yuan. According to the reimbursement rate of 60%, it saved 21.6 billion yuan for patients and 32.3 billion yuan for medical insurance fund.
Relevant experts said in an interview with reporters that the core of drug centralized procurement is that the procurement office buys drugs on behalf of public hospitals. Generally, it is clear about the purchase quantity, and the lowest bidder wins the bid to reduce the price of purchased drugs. Through centralized drug collection, the masses will use low-priced and high-quality drugs for a long time. At the same time, through reducing costs and stabilizing demand for pharmaceutical enterprises, the drug circulation order will be further optimized and the industry ecology will be gradually improved. In the future, with the further promotion of centralized purchasing, the policy dividend will continue to "reduce the burden" for patients, and the problem of expensive medical treatment will be effectively alleviated.
Ms. Liu, a Shanghai citizen, is a lung cancer patient who has been treated with targeted drug gefitinib orally. "In the past, this medicine cost 60,000 yuan to 70,000 yuan in half a year. Now, as long as the individual pays a few hundred yuan a month, our family can afford it. The good national policy makes it no longer worry about seeing a doctor." Ms. Liu said.
Through centralized procurement with quantity, the price of drugs tends to be reasonable, and the accessibility of patients to drugs is greatly improved. The data showed that the prices of selected drugs in centralized procurement dropped sharply, with the original drug gefitinib tablets reduced by 76% and fosinopril sodium tablets by 68%. Not only did the original research drug "self-degrade", but the selected generic drug equivalent to the original research drug also "dived" greatly, which also forced the price reduction of similar original research drugs that were not selected in the market.
Practice shows that the selected drugs are popular in clinic, and the completion degree of agreed dosage is high. After the expiration of the "4+7" pilot project for one year, the average purchase amount of 25 selected drugs was 2.4 times, and the purchase amount of selected drugs accounted for 78% of the purchase amount of the same drug.
How to ensure the quality of drugs after price reduction? Experts said that the national centralized drug collection has a high threshold, which means that even if the price of the selected drug is low, the quality is guaranteed. Only generic drugs that have passed the consistency evaluation are eligible to compete with the original drugs in the next price. In this case, winning the bid is different from the previous "taking the lowest price" without distinguishing the quality level. In addition, after the election, the drug regulatory authorities will strengthen supervision and inspection and product sampling inspection, strengthen life-cycle quality supervision, and let everyone eat "safe drugs".
In order to ensure that centralized drugs enter the hospital, the medical insurance department has made it clear that the frequency and intensity of supervision and inspection should be strengthened for those drugs that are not selected and similar substitute varieties behave abnormally; For doctors whose prescription consumption has dropped significantly, it is necessary to strengthen interviews with doctors, and at the same time take measures to ensure that the selected products always maintain stable purchase and sale and timely payment.
Since the two batches of centralized procurement landed, the procurement progress of the selected products has been faster than expected, and the time for medical institutions to pay back money has been greatly shortened. This has played an important role in maintaining the cash flow of enterprises and promoting the resumption of production. After the recent announcement of the results of the third batch of national centralized procurement, the stock market reacted steadily. On the day of bid opening, the generic drug sector outperformed the broader market, indicating that the market recognition is getting higher and higher.
More importantly, centralized procurement has also profoundly changed the ecology of the pharmaceutical industry and promoted pharmaceutical companies to pay more attention to marketing transformation and R&D innovation. The data of key enterprises show that the proportion of sales expenses to operating income of some selected enterprises has dropped from 40% to about 5% to 10%; Some over-evaluated generic drugs have effectively replaced the original drugs.
"Centralized procurement is a broad and profound interest adjustment. The key is to have the strong leadership of the CPC Central Committee and the State Council to lead us to turn institutional advantages into governance efficiency." Hu Jinglin, director of the National Health Insurance Bureau, said that we will gather consensus on a larger scale and unswervingly push forward this work.
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