Consumables GPO Procurement, Come! Affect a large number of companies

Medical Network March 19 hearing spent more than 20,000 yuan to do an operation, in fact, there are thousands of yuan in fact there is room for price cuts. A doctor in Shenzhen told the Southern Reporter: Take the 'portal venous disconnection' as an example, the operation itself Although the fee is 4464 yuan, the cost of the cutting and closing device used in the operation is 10,000 yuan. If the cost of the equipment can be reduced, the price space adjustment structure will be released. This is a good thing for patients and doctors. .

Following the start of Shenzhen last year drug After the Group purchases, this year, there are new developments in Shenzhen's health care reform. Shenzhen will start a pilot reform of the centralized procurement of medical consumables in public medical institutions. Through the “group purchase” model of public medical institutions, the “moisture” in the cost of medical consumables will be squeezed out. While reducing the burden on the public, we also continued to optimize the income structure of Shenzhen Public Hospital.

In the procurement of medical consumables, similar varieties vary widely in terms of materials, specifications, and models, and there are also huge differences in prices.

During this year's National Conference, the National Committee of the Chinese People's Political Consultative Conference member Ge Junbo cited the example of a heart stent as an example. Bidding After the market price was 9,000 yuan/piece, the same product price in another province could be as high as 13,000 yuan/piece. The same situation also existed in Guangdong. The reporter searched relevant data and found that dental implants were taken as an example. in purchase In the quotation, the lowest price is 1800 yuan, the highest is 5220 yuan.

On the one hand, there is a wide variety of prices. On the other hand, the opacity of the existing procurement channels has also made the hospital a little bit 'communicating'.

At present, there are two main modes for purchasing medical consumables in Shenzhen Public Hospital. On the one hand, it is purchased through the provincial platform, and on the other hand, public hospitals invite tenders on their own. From the current state of public hospital procurement, most large-scale public hospitals purchase through self-bidding. The provincial platform is not much.

We talked about why we do not purchase through the provincial platform. There is a person in charge of the hospital equipment department called 'use of trouble'. 'In practice, if we need a consumable, we usually look for it. proxy The dealer inquires about the coding of consumables on the provincial platform. After entering the code on the provincial platform, it still needs to communicate offline. After the parties agree, they can purchase through the provincial platform. 'The responsible person stated that in the procurement of the provincial platform, The specific quotation for consumables can't be seen, so it's even more difficult to compare goods and purchases.

In the face of the current situation of medical consumables, this year Shenzhen will initiate pilot reforms of centralized procurement of medical consumables in public medical institutions. Through trials, Shenzhen strives to establish three-level and two-level public hospital The proportion of health materials income to medical income is controlled at around 10% and 5% respectively.

According to the "Draft Shenzhen Municipal Public Medical Institution's Measures for Centralized Purchasing and Transaction of Medical Consumables and Transaction (Trial)" and the "Draft Action Plan for the Pilot Project for the Reform of Centralized Purchasing of Medical Consumables in Shenzhen Public Medical Institutions (Trial)" (hereinafter referred to as "Consultation Draft") , Shenzhen will adopt the 'sales procurement, purchase by class, package price', the procurement cost of medical consumables that will be included in the scope of centralized procurement will 'significantly decline' before the reform. In a specific operation, Shenzhen will publicly purchase third parties. Purchasing agency and technical service (hereinafter referred to as “agency”), organized by an agency to compile medical consumables procurement catalogs, carry out brand selections, price negotiations, etc. Brand selection is the 'downsizing' of existing procurement catalogs. Compressing the moisture content of consumables, ultimately reducing the cost of purchasing supplies.

In fact, this has been an early attempt in Shenzhen's health care reform. Taking pharmaceuticals group procurement as an example, through 'promotional procurement', the overall reduction in the number of drugs in the second group's procurement catalog is 22.57%, of which two manufacturers are more competitive. The strong variety decreased by 47.45%, and the anti-infective class decreased by 36.4%.

Since we want to 'reduce' on the list, it also means that some of the currently used consumables will not enter the catalog. In this regard, doctors working in the front line also have concerns. The head of the hospital consumables procurement department said that The actual use of consumables also involves specification issues. If the catalog is too thin, it will not achieve the effect of slimming, but if the points are too rough, it is difficult to meet the clinical needs.

At the same time, 'each doctor's habits are different, such as the same surgery, some doctors are more familiar with a certain brand of catheter, and others are the other. In general, in the use of consumables, there are still a lot of personalization The needs of the. 'Shenzhen People's Hospital director of spinal surgery Yang Dazhi said that Shenzhen is currently carrying out medical and health 'three projects', the future, along with the public medical institutions centralized procurement of medical supplies, whether the 'three engineering' team and Shenzhen It is also worth paying attention to the influence of local doctors for cooperation.

With regard to these concerns, the reporter learned from the City Health and Development Commission that on the purchase of consumables, after starting the centralized procurement of medical consumables from public medical institutions, hospitals can still purchase consumables through provincial platforms and other channels, which guarantees the hospital's right to choose independently. Ensure the doctor's personalized needs.

Within 20% of total annual purchases, public medical institutions can purchase special, rare but clinically necessary medical consumables, as well as new medical consumables with clinical use value that can be promoted. This measure also ensures hospital autonomy.

In addition, regarding how to determine the procurement catalog, the person in charge of the relevant division of the Municipal Health and Development Planning Commission stated that 'it is a difficult problem' and therefore, in the future, the implementation steps of centralized procurement of medical consumables will also be difficult for Shenzhen.

Doctors hope to reduce the burden of medical treatment and hope to reflect the labor value of doctors

At present, the income structure of public hospitals is mainly composed of medical personnel's technical services, medicines, materials, inspections, tests, etc. In 2012, Shenzhen took the lead in canceling drug additions in public hospitals in major cities in China. Last year, Shenzhen passed the reform of the pharmaceutical group procurement. Reduce drug prices, reduce drug costs 1.537 billion yuan, through the first phase of medical service price adjustments, reduce the price of large-scale equipment inspections, reduce patient spending 30 million yuan. Based on this, the second phase of medical service prices launched in Shenzhen last December Adjustments will raise the prices of medical services items that embody the value of medical personnel and technical services in the four categories. The expected expenditure on medical treatment between 'two drops and one liter' will decrease by about 754 million yuan.

For a long time, the pricing system of public hospitals in our country has the problem of unreasonable structure: high drug prices, large-scale inspections, and high prices for inspections, and the price of medical services embodying the value of medical workers’ medical services is low, resulting in a price structure of medical services. The brain is upside down, and the knowledge value of medical staff is seriously underestimated.

'For patients, they want to reduce the burden of medical care. As a doctor, they want their work to be worthwhile. How to coordinate the relationship between the two requires adjustments to the structure. ' Bao Shiyun frankly stated, 'With a portal vein cut off For example, although the surgical charge is 4464 yuan, the cost of the cutting and closing device used in the surgery is 10,000 yuan. If the cost of the equipment can be reduced, the price space adjustment structure will be released. This is for patients and doctors. Are all 'good things'.