The trend has been set! Medical supplies | 'Zero difference' | Storm swept around

Medical Network August 2nd Although the specific implementation time of the medical consumables zero-rate policy and the platform for sunshine procurement have been clarified, the specific operational regulations for the compensation mechanism are still unclear.

After more than 60 years of implementation, drug The bonus policy has withdrawn from the historical arena. Nowadays, the cancellation of medical consumables has become a focus. Recently, the Sichuan Provincial Health and Family Planning Commission issued a notice requesting that all public medical institutions in the province implement zero-difference sales of medical consumables before the end of this year. New mechanism to adjust the price of medical services.

It is not difficult to see that the same as the path of canceling the drug add-on “local first, national advancement”, there is a storm of “consumer zero rate” everywhere.

Medical consumables, especially high-value consumables, are the hardest hit areas of 'excessive medical care'. The medical corruption cases that have been exposed in recent years have also revealed that the field of medical consumables is 'deep in water'. Liang Wannian, director of the National Health and Wellness Commission, said publicly : 'The cancellation of drug add-on is only the beginning. In the future, the price of drug consumables will need to be lowered to improve the service value of doctors.'

As early as October 2017, the National Development and Reform Commission released the 18th National Congress. medicine The special report on price reform, which clearly pointed out that in the future, the focus will be on the acquisition of consumables, the investigation of cost price, ex-factory, port and origin, the surrounding retail price is open, and the package price reduction strengthens the supervision of high-value medical consumables.

On November 10 of the same year, the National Development and Reform Commission issued the "Opinions on Comprehensively Deepening the Reform of the Price Mechanism", reaffirming the consolidation and elimination of the drug addition results, further eliminating the medical consumables, optimizing the price of medical services, and further reducing the price of medical supplies. , including cardiac stents, artificial knee joints, surgical gauze, surgical sutures, dental materials and other consumables, from 5%-10% to 0.

The so-called zero rate of medicines and medical supplies means that the hospital will follow the cost price. Tender The purchased medicines and medical consumables are sold to patients, and the hospital no longer raises the price. The 'zero difference rate' is to break the 'medical medicine' and 'medical medicine' to benefit the people, but it also directly affects the hospital's income composition. It is good to break the chain of corruption interests, but it is a disadvantage for hospitals to continue to maintain good financial operations.

Yu Baorong, Executive Director of the Center for Health Insurance and Health Economics, School of Insurance, University of International Business and Economics, said: 'The purpose of comprehensively eliminating the addition of drugs and medical consumables is to reform and enhance the value of doctors' labor through payment methods, and then establish a benign Sound hospital and doctor's compensation mechanism. '

According to incomplete statistics of the health sector, as of now, 14 provinces and municipalities have been fully or partially launched nationwide, and public hospitals have cancelled the medical consumables. Among them, Liaoning, Shandong, Hubei, Hunan, Guangxi, Ningxia, have clearly Cancellation of medical consumables this year.

List of relevant policies for 'medical consumables zero rate' in each province

In the past, because the procurement methods of medical consumables were not uniform, the information was not open and transparent, resulting in uneven quality of purchased products and high prices. The vice president and secretary general of China Price Association Hou Jia believes that medical consumables are in circulation. The average fare increase is 2 to 3 times, usually 3 to 4 times the price increase. medical instruments Different from medicines, the price is high, the high-value consumables are thousands of yuan, and these are ultimately paid by the patients, which seriously infringes the interests of patients, and is not conducive to the improvement of medical treatment in China. In the 2017 national medical reform work video conference, the original The National Health and Family Planning Commission has clearly announced that it will start centralized procurement of medical consumables. Since then, local exploration has been in full swing.

It is not difficult to see that the use of the Sun-hanging network mode for tendering is the main method used by provinces and cities to find out the types of purchases, quantity and price. At the same time, cross-regional joint procurement methods have also been developed. The Beijing-Tianjin-Hebei Union, which has been displayed for more than a year, has successively established the Sanming Alliance headed by Sanming City, Fujian Province, including Ningbo, Zhuhai, Wuhai, Yuxi and Hebei provinces, 'Husu Zhejiang皖闽's four provinces and one city alliance and the seven western provinces. In addition, Shanghai will also carry out Shanghai-Hong Kong cooperation procurement.

As the medical insurance payment reform enters a substantive phase, the control fees have been incorporated into the public hospital Annual assessment target.

On the one hand, localities are also exploring the compensation mechanism for 'high-value medical consumables included in medical service package charges', re-establishing medical service charging standards, indirectly controlling the price level of medical consumables, and finally achieving the zero rate of public hospital consumables while avoiding large hospitals. Frequently shouting the 'deficit' situation.

In the specific implementation process, some localities give medical institutions the autonomy to adjust the price of services. For example, the Liaoning Provincial Price Bureau and other four departments adjust the medical service price adjustment requirements, except for the items that clearly stipulate the maximum price limit. The service price is the benchmark price, the hospital can float up to 10% on the benchmark price, and determine the service price by itself within the limit.

On the other hand, all localities are also in line with the national minimum price limit network, online sun procurement and other principles, further reducing the cost of medical supplies and corruption.

In 2017, Shaanxi Province has completed the national minimum price limit purchase of 13 categories of high-value medical consumables in three batches, with the highest price drop of 98.7%, with an average decrease of 18.37%. In order to expand the effect, it also proposed Inter-provincial medical consumables procurement data was jointly constructed and shared, and an inter-provincial medical consumables procurement alliance including 10 provinces and autonomous regions was formed. Based on the data, the provinces and districts jointly negotiated prices, and the prices of high-value medical consumables purchased from the nets were Make a major adjustment every six months.

This year, Zhenjiang City, Jiangsu Province is also making efforts. After purchasing the prices of medical consumables in Nanjing, Suzhou, Taizhou and other places, the drug procurement office is based on the principle of low quality. The part of Zhenjiang City’s centralized procurement in 2017 is higher than that of the three cities. The price of medical consumables is reduced. In Zhenjiang City, the price adjustment of at least tens of products has reached 80% to 90%. Some products even drop to the end, with a drop of more than 99%. The purchase price has dropped from 1,000 yuan to a few yuan. .

However, the health sector has found out through the policy that although the specific implementation time of the zero-difference rate policy for medical consumables and the platform for sunshine procurement have been clarified, the specific operational regulations for the compensation mechanism are still unclear.

Under the pressure of medical control fees, the zero rate of drug consumables has made it difficult for many hospitals that have used the profit of pharmaceutical consumables as an important profit point. The transformation of medicines and consumables is a good way to return to the hospital. Roles, not profit-making tools, consumables will be more choices from a practical point of view, rather than only add-on or kickbacks. In the 'medical supplies zero-rate' storm, the parties in the storm, what to face What kind of problem? How to deal with it? The health community will continue to pay attention.