Health & Beauty

As the national centralized procurement of medicines and medical consumables has entered the stage of normalization and institutionalized implementation, the national and local centralized procurement of medical consumables has continued to be explored and promoted, the centralized procurement rules have been continuously optimized, the scope of centralized procurement has been further expanded, and product prices have dropped significantly. At the same time, the ecology of the medical consumables industry is constantly improving.

Vigorously promote the normalization of centralized procurement

In June 2021, the National Medical Insurance Administration and other eight departments jointly issued the "Guiding Opinions on Carrying out the Centralized Procurement and Use of High-value Medical Consumables Organized by the State". Since then, a series of supporting documents have been formulated and promulgated one after another, proposing new norms and new directions for the centralized procurement of high-value medical consumables.

In October of the same year, the State Council's Leading Group for Deepening the Reform of the Medical and Health System issued the "Implementation Opinions on Further Promoting the Experience of Sanming City, Fujian Province and Deepening the Reform of the Medical and Health System", which pointed out that provinces and inter-provincial alliances are encouraged to carry out or participate in the concentration of drugs and consumables at least every year. 1 purchase each with quantity.

In January this year, the executive meeting of the State Council decided to normalize and institutionalize the centralized procurement of high-value medical consumables, continue to reduce the price of medicines and speed up the expansion; Products that are of concern to the masses, such as dental implants, are collected at the national and provincial levels respectively. Subsequently, the State Council's regular policy briefing explained this institutional arrangement. At the briefing, Chen Jinfu, deputy director of the National Medical Insurance Administration, said that by the end of 2022, through the procurement of national organizations and provincial alliances, each province (autonomous region, city) will cover more than 350 varieties of drugs, and the varieties of high-value medical consumables will reach 5 or more.

In September 2021, the second batch of centralized procurement of high-value medical consumables organized by the state for artificial joints kicked off. In accordance with the principle of "one product, one policy", this centralized procurement has carried out innovative explorations in terms of quantity reporting method, procurement quantity agreement, selection rules, weight rules, and accompanying services. According to data from the National Medical Insurance Bureau, a total of 48 companies participated in the centralized procurement, of which 44 were selected, with a selection rate of 92% and an average price reduction of 82%.

At the same time, local governments are also actively carrying out pilot work. According to statistics, from January 2021 to February 28 this year, a total of 389 medical consumables (including reagents) centralized procurement projects were implemented nationwide, including 4 national-level projects, 231 provincial-level projects, 145 municipal-level projects, and other projects. 9, with a total of 113 new projects (88 special projects involving medical consumables, 7 special projects for reagents, and 18 special projects for medical consumables + reagents), including 3 national-level projects, 67 provincial-level projects, and 38 municipal-level projects. 5 other items.

It can be seen that 2021 is not only the year for the improvement of the centralized procurement policy and the formulation of the system for medical consumables, but also the year for the implementation of the relevant policies and systems.

The range of varieties is further expanded

In 2021, compared with the previous year, there will be 24 new types of medical consumables, including 18 high-value medical consumables and 6 low-value medical consumables. From the perspective of the national centralized collection, coronary stents, artificial joints, etc. have achieved nationwide coverage; from the provincial centralized collection, coronary dilation balloons, intraocular lenses, cardiac pacemakers, staplers, coronary guidance and guidance Silk, indwelling needles, ultrasonic cutter heads, etc. have now covered many provinces.

In 2021, some provinces will also explore and carry out the centralized procurement of clinical test reagents, such as Anhui, Henan, etc.; Shandong and Jiangxi have included clinical test reagents in the scope of hanging on the net. It is worth mentioning that Anhui Province has selected a sub-field with a large market size in the field of immunodiagnosis - chemiluminescence reagents, and carried out centralized and volume procurement, including a total of 145 products in 5 categories and 23 subcategories. Among them, 88 products from 13 companies were selected, and the average price of related products dropped by 47.02%. In addition, 11 provinces including Guangdong have launched alliance procurement of new coronavirus (2019-nCoV) detection reagents. Among them, the average price drop of nucleic acid detection reagents, nucleic acid rapid detection reagents, IgM/IgG antibody detection reagents, total anti-detection reagents, and antigen detection reagents decreased by about 37%, 34.8%, 41%, 29%, and 44%, respectively. Since then, more than 10 provinces have launched price linkage.

It is worth noting that although the centralized procurement of medical consumables and reagents in various provinces has been carried out more frequently, the number of varieties involved is still insufficient compared with clinical needs. In accordance with the requirements of the "14th Five-Year Plan for National Medical Security" issued by the General Office of the State Council, in the future, the centralized procurement of high-value medical consumables at the national and provincial levels should further increase.

Alliance procurement is becoming more and more diverse

In 2021, the inter-provincial alliance will produce a total of 18 procurement projects, covering 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps. Among them, the Beijing-Tianjin-Hebei "3+N" alliance (which has the largest number of members, has reached 23), the 13-province alliance led by the Inner Mongolia Autonomous Region, the 12-province alliance led by Henan and Jiangsu provinces, and the The 9 provincial alliances led by Jiangxi Province; in addition, there are also the Chongqing-Guizhou-Yunnan-Henan Alliance, the Shandong-Shanxi-Hebei-Henan Alliance, the Chongqing-Guizhou-Qingong Alliance, the Zhejiang-Hubei Alliance, and the Yangtze River Delta Alliance.

Judging from the participation of provinces in inter-provincial alliances, in 2021, Guizhou Province will participate in the largest number of alliances, reaching 9; Shanxi Province and Chongqing follow closely with 8 alliances; Ningxia Hui Autonomous Region, Henan The number of provinces participating in the alliance is 7.

In addition, the centralized procurement of the inter-city alliance has also made good progress. In 2021, there will be 18 inter-city alliance procurement projects nationwide, mainly in Jiangsu, Shanxi, Hunan, Guangdong, Henan, Liaoning and other provinces. It is worth noting that the form of cross-level cooperation between provinces and cities appeared for the first time: in November 2021, Huangshan City, Anhui Province joined the alliance of 16 regions led by Guangdong Province to carry out centralized procurement of ultrasonic tool heads.

It is foreseeable that, driven by the policy, in 2022, the local alliances will have more diversified procurement methods and more and more varieties of procurement. This is an inevitable trend and a mainstream trend.

Normalized centralized procurement will change the industry ecology

At present, the centralized procurement of medical consumables is gradually entering an intensive period: the state organizes centralized procurement of high-value medical consumables with large clinical usage and high costs; the provincial level conducts centralized procurement of some high and low-value medical consumables; The varieties other than the national and provincial centralized procurement projects will be purchased with quantity. The three perform their respective duties and actively carry out the centralized procurement of medical consumables from different levels. The author believes that the in-depth promotion of the centralized procurement of medical consumables in my country will promote the continuous improvement of the industry ecology, and there will be the following development trends.

First, because the core goals of my country's medical system reform at this stage are still price reduction and cost control, centralized procurement with volume has become an important starting point and breakthrough. The link between volume and price and the integration of recruitment and procurement will become the main features of the centralized procurement of medical consumables, and the coverage area and variety will be further expanded.

Second, alliance procurement has become a policy support direction, and a national joint procurement trigger mechanism has been formed; the scope of inter-provincial alliance centralized procurement will continue to expand and gradually concentrate, and will further develop in the direction of standardization; in addition, as an important supplement to the form of centralized procurement, municipal The international alliance centralized procurement will also progress smoothly.

Third, the centralized procurement of medical consumables will be carried out in layers, batches and classifications, and more detailed evaluation rules will be established. Access to the net will become an important supplementary means of centralized procurement, so that more varieties of medical consumables can be purchased through the platform.

Fourth, the rules of centralized procurement will be continuously improved, aiming at stabilizing market expectations, stabilizing price levels, and stabilizing clinical demand; strengthening procurement for use, highlighting clinical choices, respecting the market pattern, increasing the participation of enterprises and medical institutions, and ensuring product quality and quality. Product supply, escort product use.

Fifth, low-cost selection and price linkage will become an important direction for the centralized procurement of medical consumables. This will help purify the operating environment of medical consumables, accelerate the import substitution of domestic medical consumables, improve the current stock market structure, and encourage the development of domestic innovative medical devices in the field of health economics.

Sixth, the credit evaluation results will become an important criterion for medical consumables companies to participate in centralized procurement and medical institutions to select products. In addition, the self-commitment system, the active reporting system, the information verification system, the graded punishment system, and the credit restoration system will be continuously established and improved.

Seventh, the centralized procurement of medical consumables will continue to advance in coordination with the implementation of the system of "retention of surplus" medical insurance funds, the adjustment of medical insurance catalogues for medical consumables, the reform of medical insurance payment methods, and the reform of medical service prices. It is believed that under the coordination, restriction and drive of policies, the enthusiasm of medical institutions to participate in centralized procurement will continue to increase, and their procurement behavior will also change.

Eighth, the centralized procurement of medical consumables will promote the reconstruction of the industry structure, the industry concentration will be greatly improved, the business ecology will be further improved, and the sales rules will tend to be standardized.