For a long time, the centralized drug procurement platforms in various provinces have been independent of each other and operated in isolated networks, and there is no interconnection of data. A small number of enterprises take advantage of the information gap between provinces to formulate unfair and discriminatory policies, and even individual drugs are several times different. Limited to information technology means, the competent authorities mainly relied on "discovering together, dealing with them together, specific problems, and dealing with specific problems" in the past, and the results were not ideal.
However, with the construction and improvement of the national medical security information system, the software and hardware conditions for breaking through the inter-provincial information barriers have gradually matured.
Recently, the National Health Insurance Administration issued the "Notice on Promoting Fairness, Integrity, Transparency and Balance among Drugs with the Same Generic Name and Brand Name at the Provincial Level" (hereinafter referred to as the "Notice"), making it clear that by the end of March 2024, the unfairness and discrimination between provinces will be basically eliminated for the "four same drugs" (that is, drugs with the same generic name, manufacturer, dosage form and specifications).
This means that the past marketing-centric development model of the pharmaceutical industry has begun to be marginalized, and the vicious competition centered on "marketing power" such as drug rebates will be replaced for a long time, and the healthy competition centered on "product power" such as innovation value, quality and efficacy will be continued.
Eliminate the inter-provincial unfairness and discrimination of the "four same drugs".
The notice said that at present, all localities have completed basic tasks such as unified data information, data partitioning, and partition management according to deployment, but the analysis found that a small number of enterprises and a few drugs have the problem of using inter-provincial information to implement unfair and discriminatory problems.
For example, folic acid tablets, a commonly used medicine of a company, are 12 yuan per bottle in most provinces across the country, but in some provinces, the net has reached more than 30 yuan, and the price difference of more than 20 yuan cannot explain its rationality and necessity. Similar anomalies** are unfair to the local people and medical insurance**. The person in charge of the National Health Insurance Bureau's ** Recruitment Department said.
In fact, based on the objective differences between provinces, such as transportation distance, market size, transaction conditions, and payment collection efficiency, it is normal for there to be slight differences between provinces, but a small number of enterprises have formed the phenomenon of "abnormally high in some areas" by taking advantage of the information gap between regions.
The National Health Insurance Administration has made it clear that it will summarize the first-class data of drugs sold online on the centralized procurement platform in all provinces across the country, focusing on the "four same drugs", that is, drugs with the same generic name, dosage form, specification and manufacturer, and the first-class level of centralized distribution and active transactions will be counted and pushed to the provincial medical insurance bureaus and local centralized drug procurement institutions as monitoring results.
The notice requires all localities to compare the local network with the monitoring results, investigate and find outliers that significantly deviate from the monitoring results, urge and guide enterprises to correct unfairness and discrimination, and promote the return to a more fair range.
According to the reporter, in the "Notice" issued this time, a special sorting has been carried out on the five types of drugs, including: the return of conventional drugs to the monitoring price or below the network;The state organizes centralized procurement of selected drugs to implement the agreement in **provinces**, and reasonably coordinates and implements the agreement in non-** provinces;Provincial and inter-provincial alliance centralized procurement and successive selected drugs will implement the agreed price in ** provinces, and reasonably coordinate in non-** provinces;Medical insurance negotiation or bidding for drugs shall implement a unified national medical insurance payment standard;Drugs in inactive areas are automatically associated when a transaction is activated.
At the same time, the National Health Insurance Administration issued four major suspension measures, including: suspending the acceptance of applications for low-cost drugs to withdraw from the network;Suspend the acceptance of applications for drugs that are higher than the actual purchase price of medical institutions;Suspend the acceptance of applications for over-evaluated drugs that do not meet the requirements;Assess the fairness of online drugs** in individual provinces.
In addition, the National Health Insurance Administration clarified in the document that for products that have passed the consistency evaluation, the following four situations will be suspended**: the registration of manufacturing process changes has been completed, and the network is higher than the median of the monitoring price of other over-evaluated drugs with the same generic name, or higher than the monitoring price of the original drug and reference preparation;The registration of manufacturing process change has not been completed, and the network is higher than the median monitoring price of other over-rated drugs with the same generic name, or higher than 60% of the monitoring price of the original drug and reference preparationThe original drug or reference preparation is not marketed in China, and the subsequent drug is listed on the network more than the monitoring price of the first over-rated enterpriseOther circumstances that do not meet the requirements of the rules for the listing of over-evaluated drugs in the region.
In terms of specific operations, the person in charge of the above-mentioned National Health Insurance Bureau said: "Local medical insurance bureaus and centralized procurement agencies should contact and interview relevant enterprises in a timely manner for the unfairness and discrimination found in the investigation, and ask the enterprises to take the initiative to correct deviations and treat all regions fairly in terms of quality." ”
It is a partial correction, and it is not a general sharp price reduction
In recent years, the National Health Insurance Administration has carried out a lot of work related to drugs, such as centralized drug procurement, medical insurance catalog negotiation, and online drug governance, etc., the fundamental starting point is to support and promote fair, open and legal market competition, and maintain normal order.
The governance of the drug network also takes the promotion of fair competition in the market and the maintenance of good order as the most fundamental starting point, emphasizing correction and stop loss, and promoting fairness, integrity, transparency and balance, rather than one-sided pursuit of price reduction. The person in charge of the above-mentioned National Health Insurance Bureau said.
At the same time, the National Health Insurance Administration emphasized that the monitoring price is not the lowest in the country, but from the existing transactions, using statistical methods, using the median, mode, etc. to find out the fair transactions. The monitoring price itself is the level that the enterprise can set independently and can guarantee, and it is within the affordable range of the enterprise.
In other words, for enterprises, it is a balanced region, a local correction, and there will be no general sharp price reduction.
It is worth noting that the construction and improvement of the national medical security information system has laid the foundation for the implementation of this document.
Since September last year, the National Health Insurance Administration has organized various localities to carry out actions to improve the quality of the data of drugs linked to the network, summarized all the drugs that have been listed on the network, retained the data of active transactions, and transferred the data of the first data that has not been actively traded for a long time to the background management. On the basis of ensuring that the data is true, complete and reliable, and the information is interconnected, the National Health Insurance Administration has statistically analyzed the distribution of drugs on the network, and sent the concentrated and representative distribution of each drug to all localities as the monitoring results, so as to help all localities conduct systematic investigations on potential unfairness and discrimination.
The Health Insurance Bureau has taken a number of measures for the implementation of this document. First of all, the supervision and inspection of drugs have been strengthened to ensure the fairness and transparency of inter-provincial drugs. Secondly, it has strengthened coordination and communication with the medical insurance departments of various provinces, and unified drug procurement standards and reimbursement policies to reduce the differences in drug ** between regions. A market source said.
* |China Medical Insurance.
Edit |Fu Meiru Zhang Wenqing.
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