Non-base drug bidding price will face challenges, double envelope system or more popular

The article “Convergence of Basic Drug Regimes in Adjustments and Changes” was published on December 26 last year. It talks about the possible changes in the basic drug system and drug tendering in 2012 (ie, the adjustment of categories and the expansion of basic medical institutions; county and county The above medical institutions are equipped with basic drugs; changes in the subject of tendering; price-plus regulation for the base medicine; quality evaluation system for the base medicine; promotion of cheap base medicines only attract quality without attracting price, etc.). Combined with recent research, the author believes that there are still four trends that require attention.

Drug price readjustment

At the end of 2011, CCTV’s report on the high drug prices and the emergence of price cuts once again focused the industry’s focus on drug prices. As a result, the NDRC initiated the investigation of drug ex-factory prices and introduced the “Drug-to-goods” rule. The move is considered to be the prelude to price cuts in 2012.

What are the prices of essential medicines and non-essential medicines formed through drug bidding? Because there is no objective and uniform measure, it is always the focus of controversy. The author believes that the level of drug prices is the final say, and only the price formed under full market competition can be used as the basis for judgment. If this price is used as the basis for the judgment, it is not difficult to see that the price level formed in the current bidding for base drugs has been similar to this, but there are still some products with higher prices, and some products have prices lower than market prices. However, the price level formed in non-base drug bidding is relatively high. As the NDRC mentioned in its public statement on the high drug prices, due to different bidding methods used by different regions, the implementation of the “double envelope system” in the provinces is not the same, leading to the current situation.

The author judges that further reduction of drug prices is still the subject of a new round of implementation and tendering of the base drug system. In the new round of changes, policies and local practices will further take into account quality. In 2012, non-base drug bidding prices will face challenges.

The "double envelope" system is more popular

Since the implementation of the basic drug bidding is No. 56 document, the implementation of the non-base drug tender is the No. 64 document. The requirements of the two documents are different, and the scope of implementation and the effect of price reduction are also different. The emergence of irrational drug price incidents and price cuts is likely to make policies more prone to "double envelope" bidding. In 2011, Qinghai Province took the lead in adopting the “double envelope system” in non-primary drug bidding; it is reported that Beijing is brewing and discussing related programs; other provinces also have discussed the application of the “double envelope system” in non-base drug bidding.

The author judges that the tendering methods for base drugs and non-base drugs may converge further in 2012, and the “double envelope system” will be used more extensively in tendering. However, it should also be noted that this is not a panacea for solving the problem of inflated drug prices. It requires a series of supporting measures to achieve the goal of policy design. In the "double envelope system", the setting of technical targets will become the biggest attraction in 2012. How to realize quality priority has become a major difficulty in implementation.

Base drug and non-base drug joint bidding

Due to the inconsistent timing of the implementation of basic drugs and non-base drugs, most provinces adopted separate bidding in 2011, and some provinces also adopted methods of joint bidding between county-level and above and primary-level medical institutions, such as Hubei, Yunnan, and Shanghai. city).

With the increasingly urgent requirements for the use of essential medicines in the proportional distribution of medical institutions at or above the county level, the use of essential medicines is not only unique to primary medical institutions. Linked bidding has become an objective need. According to the author’s judgment, such There will be more and more bidding methods in 2012.

How to solve the difference between the No. 56 article of the basic medicine tender and the No. 64 article of the non-base drug tender will become the highlight of the joint bidding. Although the country may not renew the new specifications for tenders in the near future, the provinces will definitely formulate the bidding rules that are in line with the actual conditions of the provinces by referring to the guidelines in the above two articles.

"Integration of strokes" price-linked

The combination of recruitment and price-linking is a thought and solution that has been summarized through many years of practice in drug bidding. Although both Circular 64 and Circular 56 have requirements, the actual implementation is in the basic drug bidding in 2011.

In 2011, 26 provinces (cities) across the country implemented or promulgated centralized procurement management methods for essential drugs in accordance with this idea, and achieved certain results. However, the analysis of the specific implementation of the situation across the country, the author found that many provinces of the recruiting and mining unity and quantity and price linked only form and no substance. If the phenomenon of non-acquisition still exists after the move, there will be no specific amount in the bidding, and there will be a huge gap between the number of tenders and the actual number of purchases.

The combination of recruiting and mining with the quantity and price is the essence of centralized drug procurement, and the actual operation is difficult. First of all, the inconsistency of recruiting and recruiting units and the difficulty in implementing them in a unified manner are difficult points. To solve this problem, we must change the mechanism. Second, the inherent relevance of drug use and doctor's prescriptions often makes it difficult to guarantee that the quantity of tender commitments is linked to actual use. This issue is particularly prominent in non-essential drugs.

Recently, the Ministry of Health further emphasized in the “12th Five-Year Plan” of the new medical reform that it is necessary to comprehensively promote centralized procurement of drugs. Unified drug procurement platform and procurement methods, implementation of quality priority, integration of recruitment, price and price linked. The procurement of consumables and equipment shall be gradually incorporated into the scope of centralized tender procurement. For some patented pharmaceuticals, high-value consumables, and large-scale equipment, the company shall explore centralized procurement for domestic and foreign manufacturers, and implement centralized procurement based on international price for imported products. It can be seen that the combination of recruitment and quantity, price and price will become a major attraction in 2012.

The "12th Five-Year Plan" of the new medical reform must comprehensively promote the centralized procurement of drugs. Unified drug procurement platform and procurement methods, implementation of quality priority, integration of recruitment, price and price linked. The procurement of consumables and equipment shall be gradually incorporated into the scope of centralized tender procurement. For some patented pharmaceuticals, high-value consumables, and large-scale equipment, the company shall explore centralized procurement for domestic and foreign manufacturers, and implement centralized procurement based on international price for imported products. The combination of recruitment and price and quantity and price link will surely become a major attraction in 2012.