The National Health Insurance Administration announced on the 27th that as of December 31, 2023, 26 pharmaceutical companies have been rated as "particularly serious" and "serious" dishonesty. Why are these companies assessed as dishonest? Which untrustworthy behaviors will be rated as "particularly serious" or "serious"? What impact will the dishonesty assessment have on the enterprise? The person in charge of the relevant department of the National Health Insurance Bureau was interviewed by reporters.
Why are these companies assessed as dishonest?
According to the "Guiding Opinions on the Establishment of a Credit Evaluation System for Pharmaceutical ** and Recruitment" and other documents previously issued by the National Health Insurance Administration, it is required that the untrustworthy behaviors such as drug kickbacks, monopoly price increases, and disruption of procurement order of enterprises will be assessed according to the severity of the circumstances, and the qualification for online procurement will be suspended to a certain extent.
According to the person in charge of the relevant department of the National Health Insurance Bureau, the credit evaluation system of medicine and procurement is like the "traffic rules" in the field, and the first and business behavior of enterprises in the drug market must comply with the market rules of fairness and legality, honesty and credit, and consistent quality and price.
The announcement is the 26 pharmaceutical companies that have been assessed as "serious" and "particularly serious" since the implementation of the pharmaceutical ** and procurement credit evaluation system. According to reports, 25 of them are because of commercial bribery such as kickbacks, such as Zunyi Baiyi Pharmaceutical*** to a county people's hospital to give kickbacks and other "benefit fees", equivalent to 355 yuan160,000 yuan. North China Pharmaceutical Co., Ltd. is due to the non-implementation of the procurement contract and the selection of products in the centralized procurement as agreed, which has seriously affected the local clinical medication.
Which untrustworthy behaviors will be rated as "particularly serious" or "serious"?
The credit evaluation system for pharmaceuticals and procurement divides enterprises' untrustworthy behaviors into four levels: "general", "moderate", "serious" and "particularly serious". Taking drug kickbacks as an example, "the cumulative amount of bribes paid in the same case is more than 500,000 yuan but less than 2 million yuan, or the amount of bribes offered in a single transaction is more than 300,000 yuan but less than 2 million yuan" is considered "serious" dishonesty; "The cumulative or single amount of bribes in the same case is more than 2 million yuan" is a "particularly serious" untrustworthiness.
In the case of bribery in the judicial decision, although only the amount of kickbacks for a certain drug in individuals, individual units, and individual regions was exposed, it actually reflected the degree of inflated drug **, and the money sent by pharmaceutical companies to rebate and implement commercial bribery in the final analysis still had to be squeezed out of the inflated drug consumables, and in the end, it was the medical insurance and the people who bore the burden that should not have been.
What is the impact of the credit rating results of these companies?
Generally, "dishonest pharmaceutical companies will be reminded and warned in writing, which is equivalent to making small mistakes and focusing on criticism and education;
For example, the provincial pharmaceutical procurement platform will mark the relevant drugs with untrustworthy information, medical institutions will receive risk reminders when placing orders for procurement, and enterprises will be restricted from participating in activities such as centralized procurement of drugs and medical consumables organized by the provincial pharmaceutical procurement platform, bidding and online procurement;
"Seriously" untrustworthy pharmaceutical companies will be subject to more severe substantive constraints, such as suspending the networking, bidding or distribution qualifications of specific products involved in the case, although only individual drugs and individual provinces where the untrustworthy behavior occurs are affected, but it has already had a certain impact on the enterprise;
Particularly serious" untrustworthy pharmaceutical companies will face the restrictive measures of suspending all drug consumables from being listed on the network, bidding or distribution qualifications in the province where the case occurred.
The person in charge said that "punishment" is not the goal, and the key is to guide enterprises to standardize their behavior and protect the legitimate rights and interests of the insured. The pharmaceutical** and procurement credit evaluation systems also give a clear path for untrustworthy enterprises that make mistakes to correct their mistakes, such as enterprises can repair their credit through practical behaviors such as price reduction and price refund. For example, the official website of the National Health Insurance Administration, "** Procurement Credit Evaluation "Serious" and "Particularly Serious" Untrustworthy Assessment Results (Phase 1)" publicized a company, because of the problem of giving rebates was rated as "serious" dishonesty, the company reduced the price of the drugs involved in the case, and reduced the amount of rebates for each box of drugs, so as to effectively repair its own credit rating and achieve the continued normal ** related drugs.
*: National Health Insurance Administration.
Editor: Mo Fan.
Process Editor: Guo Dan.