With the normalization and institutionalization of national centralized procurement of drugs and medical consumables, the national and local centralized procurement of medical consumables has been continuously explored and promoted, the centralized procurement rules have been optimized, the scope of centralized procurement has been further expanded, and the price of products has dropped significantly. At the same time, the medical supplies industry ecology is also improving.
We will work hard to normalize collective mining
In June 2021, the National Medical Insurance Administration and other eight departments jointly issued the Guidelines on 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 issued, which put forward new norms and new directions for the centralized procurement of high-value medical consumables in bulk.
In October of the same year, the Leading Group for Deepening the Reform of the Medical and Health System of The State Council issued the Implementation Opinions on Deepening the Reform of the Medical and Health System by Deeply Popularizing the Experience of Sanming City of Fujian Province, which indicated that all provinces and inter-provincial alliances were encouraged to carry out or participate in centralized procurement of drugs and consumables at least once a year.
In January this year, the Executive meeting of The State Council decided to normalize and institutionalize the centralized procurement of high-value medical supplies in large quantities to continuously reduce pharmaceutical prices and accelerate the expansion of coverage. Local governments are encouraged to carry out provincial or inter-provincial alliance procurement, and carry out collective procurement of orthopedic consumables, drug balloons, dental implants and other products of public concern at the national and provincial levels respectively. Subsequently, The State Council policy routine briefing for this system was explained. At the briefing, Chen Jinfu, deputy director of the National Medical Insurance Administration, said that by the end of 2022, more than 350 drug varieties and more than 5 high-value medical consumables will be covered in each province (region and city) through national organizations and provincial alliances.
In September 2021, the second batch of state-organized collection of high-value medical consumables for artificial joint will be launched. In accordance with the principle of “one product, one policy”, this collective procurement has carried out innovative exploration in the way of reporting quantity, procurement quantity agreement, selection rules, weight rules, accompanying services and other aspects. According to the National Medical Insurance Administration, a total of 48 enterprises participated in this round, of which 44 were selected by households, with a winning rate of 92 percent and an average price cut of 82 percent.
At the same time, local authorities are also actively carrying out pilot work. According to statistics, from January 2021 to February 28 this year, 389 collective procurement projects of medical consumables (including reagents) were implemented nationwide, including 4 national projects, 231 provincial projects, 145 municipal projects and 9 other projects. A total of 113 new projects (involving medical consumables 88 special projects, reagents 7 special projects, medical consumables + reagents 18 special projects), including 3 national projects, 67 provincial projects, 38 municipal projects, 5 other projects.
It can be seen that 2021 is not only the year of improving the policy and formulating the system for centralized procurement of medical consumables, but also the year of implementing relevant policies and systems.
The range of varieties has been further expanded
In 2021, 24 more medical consumables were intensively collected, including 18 high-value medical consumables and 6 low-value medical consumables. From the point of view of the national collection of varieties, coronary stent, artificial joint and so on have achieved nationwide coverage; From the perspective of provincial varieties, coronary dilatation balloon, iOL, cardiac pacemaker, stapler, coronary guide wire, indwelling needle, ultrasonic knife head and so on have covered many provinces.
In 2021, some provinces, such as Anhui and Henan, explored centralized procurement of clinical test reagents in bulk. Shandong and Jiangxi have included clinical testing reagents in the scope of the network. It is worth mentioning that Anhui province has selected chemiluminescence reagents, a large market segment in the field of immunodiagnosis, to carry out centralized procurement with a total of 145 products in 23 categories of 5 categories. Among them, 88 products of 13 enterprises were selected, and the average price of related products decreased by 47.02%. In addition, Guangdong and 11 other provinces have carried out alliance procurement of novel Coronavirus (2019-NCOV) test reagents. Among them, the average prices 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 started price linkage.
It is noteworthy that although the centralized procurement of medical consumables and reagents is carried out frequently in various provinces, the number of varieties involved is still insufficient compared with the clinical needs. In accordance with the requirements of the “fourteenth Five-year Plan for Universal Medical Security” issued by The General Office of the State Council, the national and provincial high value medical consumables should be further increased in the future.
Alliance sourcing is becoming more diverse
In 2021, the inter-provincial alliance will produce 18 procurement projects, covering 31 provinces (autonomous regions and municipalities) and Xinjiang Production and Construction Corps. Among them, the larger beijing-Tianjin-Hebei “3+N” alliance (with the largest number of members, 23), 13 provinces led by Inner Mongolia Autonomous Region, 12 provinces led by Henan and Jiangsu provinces, 9 provinces led by Jiangxi Province; In addition, there are also the Chongqing-Guiyun-Henan Alliance, The Shandong jin-Hebei-Henan Alliance, the Chongqing-Guiqiong Alliance, the Zhejiang-Hubei Alliance and the Yangtze River Delta Alliance.
From the perspective of provinces’ participation in inter-provincial alliances, Guizhou province will participate in the largest number of alliances in 2021, up to 9. Shanxi Province and Chongqing followed closely with 8 participating alliances. Ningxia Hui Autonomous Region and Henan Province both have 7 coalitions.
In addition, the intercity alliance has also made good progress. In 2021, there will be 18 inter-city alliance procurement projects, mainly in Jiangsu, Shanxi, Hunan, Guangdong, Henan, Liaoning and other provinces. What is noteworthy is that the cross-level cooperation form of province and city appeared for the first time: In November 2021, Huangshan City of Anhui Province joined the alliance of 16 regions led by Guangdong Province to carry out centralized purchasing of ultrasonic cutter head.
It can be predicted that, driven by policies, local alliances will have more diversified procurement methods and more varieties will be recruited in 2022, which is an inevitable and mainstream trend.
Normal intensive mining will change the industry ecology
At present, the centralized procurement of medical consumables is gradually entering an intensive period: the country organizes the centralized procurement of high-value medical consumables with large clinical dosage and high cost; At the provincial level, some high and low value medical consumables should be intensively purchased. Prefecture-level procurement is mainly for varieties other than national and provincial collective procurement projects. The three parties play their respective roles and carry out intensive procurement of medical consumables from different levels. The author believes that the in-depth promotion of medical consumables intensive procurement in China will promote the continuous improvement of the industry ecology, and will have the following development trends.
First, as the core goal of China’s medical system reform at the present stage is still to reduce prices and control costs, centralized procurement has become an important starting point and breakthrough. The linkage between quantity and price and the integration of recruitment and acquisition will become the main characteristics of medical consumables intensive procurement, and the coverage of regional scope and variety range will be further expanded.
Second, alliance procurement has become the direction of policy support and the trigger mechanism of national alliance procurement has been formed. The scope of inter-provincial alliance collective purchasing will continue to expand and gradually concentrate, and will further develop towards standardization. In addition, as an important supplement to the form of collective mining, the inter-city alliance collective mining will also be promoted steadily.
Third, medical consumables will be collected by stratification, batch and classification, and more detailed evaluation rules will be established. Access to the network will become an important supplementary means of collective procurement, so that more varieties of medical supplies can be purchased through the platform.
Fourth, the rules of collective purchasing will be constantly improved to stabilize market expectations, price levels and clinical demand. Strengthen the use for use, highlight clinical selection, respect the market pattern, improve the participation of enterprises and medical institutions, ensure product quality and product supply, escort the use of products.
Fifth, low-price selection and price linkage will become an important direction of medical consumables collection. This will help to 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, credit evaluation results will become an important standard for medical consumables enterprises to participate in collective procurement and medical institutions to select products. In addition, self-commitment system, voluntary reporting system, information verification system, hierarchical punishment system, credit repair system will continue to establish and improve.
Seventh, the collective purchase of medical supplies will continue to be promoted in coordination with the implementation of the “surplus” system of medical insurance funds, the adjustment of the medical insurance list of medical supplies, 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 collective purchasing will continue to improve, and their purchasing behavior will also change.
Eighth, the intensive purchase of medical consumables will promote the reconstruction of the industry pattern, greatly increase the industrial concentration, further improve the business ecology, and standardize the sales rules.
(Source: Medical Network)
Post time: Jul-11-2022