In addition to the two-vote system | What are the policies for high-value medical supplies?
Medical Network August 2, China's medical device circulation has been chaotic for a long time, compared with drug circulation, the competition pattern of device circulation is more scattered, especially in the field of high-value medical consumables, most of the sales model is the same as drugs, using agents The sales model, the layer of agency, has produced a lot of 'black water', when the expensive products are in the hands of patients, the price has been added several points.
With the increasing demand for clinical medical care, the drawbacks of the circulation of consumables have made the problem more prominent. Therefore, the country has also taken the lead in cutting high-value medical consumables. drug The same implementation of the 'two-vote system'.
Of course, the state's rectification of the high-value medical consumables industry is not only to squeeze the moisture of the intermediate link through the 'two-vote system', but also to improve the centralized procurement system, start high-value medical consumables negotiations, etc., to reduce its false high price. .
High-value medical consumables centralized procurement
Since 2010, some provinces (autonomous regions and municipalities) have successively launched government-led, provincial-based high-value medical consumables for centralized procurement, which has played a very positive role in regulating purchases and sales and reducing false high prices. '13th Five-Year' deepening medicine The Health System Reform Plan also proposes to carry out high-value medical consumables, inspection and testing reagents, centralized procurement of large-scale medical equipment, standardize and promote centralized procurement of high-value medical consumables, unify high-value medical consumables coding standards, and differentiate high-value medical consumables in different situations. Tender Procurement, negotiating procurement, direct online procurement, etc., to ensure that all aspects of high-value medical supplies procurement in the sun.
In 2012, the former Ministry of Health and other six ministries and commissions issued the "High-value Medical Supplies Centralized Procurement Work Specification (Trial)" (Wei Fa Cai Fa [2012] No. 86), which has a relatively specific guiding policy, but currently In addition, there are no other related policies. The policy is not clear, the thinking is not clear, and the lack of uniform catalogue codes for medical consumables, the evidence-based management and economic evaluation gaps, the industry standard lag and other basic work are relatively weak, and There are many factors such as the lag of the level of informatization construction, and there are still many specific problems in the promotion and implementation of centralized procurement in various places.
In response, some experts have put forward various suggestions:
1. Completion of basic shortcomings such as relevant standards.
2. Actively promote the adoption of quantity procurement.
3. Strengthen the top-level design of the policy mechanism.
4. Adhere to multiple measures and comprehensive measures.
5. Effectively improve the level of information security.
At present, with the launch and implementation of the two-vote system for drugs in various provinces and cities nationwide, provinces and municipalities have successively introduced a two-vote policy for consumables and implemented them.
Judging from the national character file, in 2016 and 2018, there were two national font files that proposed the implementation of the 'two-vote system' of consumables. The first is the 2016 correction of the unhealthy trend in the purchase and sale of medical products and medical services by the 9 ministries and commissions in 2016. The main points of special governance work, which proposed to implement the 'two-vote system' of consumables in the pilot provinces and pilot cities of medical reform; two years later, on March 20, 2018, the official website of the National Health Planning Commission published "On the consolidation and elimination of medicines The results continue to deepen the notice of comprehensive reform of public hospitals (National Guardian Reform [2018] No. 4), the "Notice" by the National Health Planning Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Development and Reform Commission, the Chinese Medicine Administration, the State Council Medical Reform Office Jointly issued, set the key areas and key links for deepening medical reform in 2018 and beyond, and clearly stated that it is necessary to gradually implement the 'two-vote system' for the purchase and sale of high-value medical consumables, 'the public hospital comprehensive reform national demonstration city, demonstration county ( City, district, flag) It is necessary to intensify reforms, first try first in key areas and key links, and take the lead in breaking through. 'This also means that the 'two-vote system' of consumables will be widely implemented nationwide in 2018.
In fact, as of July 2018, the implementation of the 'two-vote system' of consumables has gradually swept across the country like Sparks. According to statistics, Hebei, Shaanxi, Fujian, Hainan, Liaoning, Qinghai, Tianjin, Anhui, Gansu, Inner Mongolia, Jiangxi In 13 provinces and autonomous regions such as Guangdong and Sichuan, the relevant documents on the two-vote system of consumables have been issued. Although there are no provincial-level policies in Shanxi, Jiangsu, Henan, Hubei and other provinces, some cities and counties have also clearly issued medical consumables. Hospital procurement will implement a two-vote system. In addition, Heilongjiang Province issued the "Two-vote system for deepening the mutual recognition of inspection results of medical institutions at the same level and the implementation of inspection and testing reagents", which only stipulates 118 of the first mutual recognition of inspection results. The hospital implements the 'two-vote system' for diagnostic reagents, among which the consumables are 'consumables associated with clinical tests', rather than high-value medical consumables such as interventional implants in the strict sense.
Relevant documents on the two-vote system of consumables in all provinces of the country
It is understood that the 15 national public hospitals in the country comprehensive reform of the national model city and 30 public hospitals comprehensive reform of the national model counties (districts, cities, flags), the vast majority have not yet implemented the consumable 'two-vote system', but With the introduction of the national font file, these areas will also soon be implemented and become a national model.
High value medical supplies country negotiations
On September 7, 2017, the Health and Health Commission, the then National Health Planning Commission, issued the "Consultation on the National High-value Medical Consumables Price enterprise Notice of Application Work, initiated national negotiations for high-value medical consumables, identified drug coronary stent system, artificial hip joint prosthesis, implantable cardioverter defibrillator series (ICD), cardiac resynchronization therapy Series (CRT) as a pilot product for negotiation, adopting a market-for-price combination, a combination of ways and means, centralized public hospital (including military hospitals) market share of high-value medical consumables, negotiations with production companies to form a unified purchase price.
The so-called state negotiation is directly negotiated by the relevant state departments and production enterprises to determine a purchase price. Then, public hospitals across the country are purchasing at the same price. The first batch of pilot pilot varieties are mainly imported in China, so The introduction of this document is also considered to be a sharp price cut for high-value consumables. Referring to the situation of the national drug price negotiations in the past two years, the industry believes that the price of high-value consumables will also be around 50%. This also represents If the negotiation effect is obvious, all categories of high-value medical consumables will achieve a nationwide price cut.
