CCTV News:Sichuan’s medical reform combined with the characteristics of the province is worth learning and popularizing. Among them, the new "five-in-one" centralized procurement mechanism for medical equipment is the most concerned. What are the highlights? Five major issues will help you understand.
First, what is the "five in one"?
"Five-in-one" refers to the scope of Sichuan province’s supervision over the procurement of medical equipment in public hospitals. In the past, it was mainly concentrated in the field of drugs and high-value consumables. Now, a new five-in-one centralized procurement mechanism for drugs, medical consumables, medical equipment, diagnostic reagents and second-class vaccines has been formed.
2. What are the classified procurement methods of drugs?
Sichuan province is the first province in China to introduce the implementation plan of centralized drug procurement in public hospitals in strict accordance with national requirements. According to the five procurement methods stipulated by the state, a new round of centralized drug procurement was completed at the end of 2016. At the same time, combined with the actual situation, Sichuan Province has actively innovated and introduced other humanized management measures for limited online procurement, which has been well received by medical institutions and pharmaceutical companies.
3. What measures are taken to ensure the fair sunshine of "five in one" procurement?
For all parties, this is probably the core issue, and creating a fair environment is also the proper meaning of centralized procurement of medical equipment. Many tasks involved in Sichuan’s "five in one" centralized procurement are conducive to maintaining fairness and justice:
First, improve the management mechanism of evaluation experts. Sichuan has completed the establishment of a centralized drug procurement expert database, covering medicine, pharmacy, pharmacoeconomics and other aspects, with more than 5,000 people. Experts are randomly selected, and the selected experts are used in key procurement links to undertake consultation and evaluation.
Second, the qualification for purchasing high-value consumables has a low threshold. Compliance products can be sold online in Sichuan. The pricing of products is humanized, with the national provincial minimum purchase price as the reference price, which is not dynamically adjusted regularly. The concept of weighted average purchase price is introduced, which is automatically calculated by the system at the end of each month. Strengthening price supervision is also a guarantee for stable market prices and is conducive to the operation and production of enterprises.
Third, improve the supervision mechanism of medical institutions. Centralized procurement is not a simple material procurement, but also has the policy function of standardizing hospital logistics management and preventing corruption. Researcher Fu Hongpeng said that the formation of the five-in-one pattern has tightened the entrance of medical materials in medical institutions in an all-round way, from quantitative change to qualitative change, making centralized procurement truly an important means of supervision of medical institutions. In practice, the drug mining institutions in Sichuan province have moved forward the supervision barrier, engaged in post-supervision, and changed to early warning and correction before and during the event.
The specific performance is to monitor the purchasing data. For abnormal data, the medical institution will send a "Notice of Abnormal Purchasing Price Risk" every month, and the medical institution will make corresponding rectification feedback. It is also manifested in the irregular selection of medical institutions for supervision and so on.
Fourth, establish a medical equipment procurement information filing system, standardize the procurement behavior of medical institutions, and reduce the occurrence of commercial bribery. All medical and health institutions will upload the procurement results to the provincial drug mining platform according to regulations, and build a sunny and transparent trading market.
Fifth, the dynamic management of bad records in enterprises. To manage the bad records of medical equipment production and management enterprises. Du Bo, inspector of the Sichuan Provincial Health and Family Planning Commission, said that it is very serious to include bad records. If there are violations of laws and regulations such as unqualified quality, non-performance, inadequate distribution and non-performance after winning the bid, they should be included in bad records and publicized to the public. In accordance with the relevant regulations, the violations will be classified and dealt with, and the online qualifications will be cancelled and the bad records of enterprises will be given. For example, illegal pharmaceutical companies may be dealt with to stop selling or cancel the qualification of winning the bid. If a medical institution violates the management regulations, we will conduct an interview warning, and at the most severe time, we will ask the local authorities to investigate and deal with it through the discipline inspection system. Since 2016, a total of 63 pharmaceutical machinery enterprises have been listed in the general bad record, and 255 illegal products have been disqualified and publicized on the platform.
Sixth, improve the complaint handling mechanism. Enterprises and all walks of life can lodge complaints if they find or think that there is injustice in any link, and formulate corresponding implementation rules to standardize the handling process.
4. What about substandard drugs?
Du Bo, inspector of the Sichuan Provincial Health and Family Planning Commission, introduced at the media communication meeting that Sichuan is a populous province, and there are many kinds of diseases, even many rare diseases. The use of drugs may be very special, so it does not mean that drugs that have not won the bid are useless. Drugs that have not won the bid can still be purchased in limited quantities here.
Zou Jia, the Pharmaceutical Administration Department of Sichuan Provincial Health and Family Planning Commission, said that there is a standard for limited control, such as tertiary hospitals cannot exceed 10%, secondary hospitals cannot exceed 5%, and township hospitals cannot exceed 3%. The quantity is controlled to ensure that the winning products occupy most of the market, and a small number of markets give products that fail to bid, giving enterprises full market survival rights.
V. How effective is the work?
According to Du Bo, inspector of the Sichuan Provincial Health and Family Planning Commission, in 2006, the limited-price procurement of drugs was started, in 2014, the online procurement of high-value medical consumables was carried out, in 2015, medical devices were included in the provincial drug collection platform for record procurement, and in 2016, the second kind of vaccines and in vitro diagnostic reagents were included in centralized procurement. For more than 10 years, the comprehensive supervision of medical institutions’ "medicine" behavior has been basically realized, and breakthroughs have been made in the following two aspects.
First, the purchase price has been significantly reduced. According to statistics, after this round of drug bidding, the price of drugs under the same generic name decreased by an average of 42% compared with the online price 10 years ago, the varieties with the largest decline reached 94%, and the number of drugs with a decline of more than 50% accounted for 27% of the total online drugs. The sunshine procurement of high-value medical consumables has been implemented for three years, with an average annual decline of 7.35% and an average annual savings of 320 million yuan, which has played a positive role in alleviating the high cost of medical treatment and saving medical insurance funds.
Second, supervision is more timely and effective. The monitoring port of medical institutions’ "medicine" behavior has been constantly moving forward, which has changed from the original post supervision to timely warning and timely correction before and during the event, realizing real-time supervision of the whole process of medical institutions’ medical equipment procurement and use. Since last year, the provincial platform has issued 1391 early warning letters on abnormal prices of high-value consumables to 405 medical institutions, effectively controlling the occurrence of irregular procurement behaviors.
At present, the "five in one" medical equipment procurement in Sichuan Province has achieved initial results, but there is still a certain gap with people’s expectations. There is a long way to go. Only by continuing to push forward the medical reform series can patients, hospitals and doctors benefit and the reform win the hearts of the people. (Text/Yang Jing)
