31 kinds of drugs in 11 places or welcome centralized price reduction under the purchasing policy with quantity.

　　Recently, the "National Pilot Program for Centralized Drug Procurement" was officially passed, and it was determined that the procurement with quantity will be carried out in four municipalities directly under the Central Government of Beijing, Shanghai, Tianjin and Chongqing and seven sub-provincial cities of Guangzhou, Shenzhen, Xi ‘an, Dalian, Chengdu and Xiamen, involving 31 procurement varieties with specified specifications.

　　According to industry insiders, price-for-price and quantity-for-quantity procurement are conducive to the decline of drug prices in the context of drug quality determination. On the one hand, it really realizes the integration of recruitment and recruitment, eliminates the space of "secondary bargaining" in hospitals and avoids the transaction cost brought by "secondary public relations" of enterprises. On the other hand, after the market price of drugs in these 11 places is determined, it will be a reference for other regions and will further reduce the drug price level in other regions.

　　Purchasing with quantity truly realizes "integration of recruitment and procurement"

　　Previously, the "4+7 Drug Centralized Procurement Document" issued by Shanghai Sunshine Pharmaceutical Purchasing Network showed that the pilot area appointed representatives to form a joint procurement office to implement centralized procurement on behalf of public medical institutions in the pilot area, and the daily work and specific implementation were undertaken by the Shanghai Pharmaceutical Centralized Bidding and Procurement Affairs Management Office. And conduct bargaining negotiations on December 6.

　　Jin Chunlin, director of the Shanghai Health and Healthy Development Research Center, said earlier that the core of quantity procurement is to exchange quantity for price and money for price. Compared with previous procurement, there is now a refund to ensure the purchase quantity and ensure the market, which makes the price drop significantly. At the same time, reduce the sales cost of enterprises. "The sales cost accounts for a high proportion in the drug price, and the purchase volume is determined. Enterprises don’t have to work as doctors and hospitals, which can save the transaction cost of enterprises, purify the circulation environment, reduce the drug price, and the rebate problem can also be solved."

　　Some insiders said that in the past, the centralized bidding and purchasing process of drugs generally used the system of "separation of bidding and purchasing". The bidding office was only responsible for bidding the price, and it did not involve the quantity of drugs and the payment of funds. The hospital was responsible for the final purchase and payment. Hospitals still have the right to choose after bidding, leaving room for "second bargaining" for hospitals.

　　"This purchase with quantity, the purchase and sale contract is confirmed at one time, and it is truly realized ‘ Combination of recruitment and recruitment ’ 。” The above-mentioned people said that under the background of "integration of recruitment and recruitment", the space of "secondary bargaining" in hospitals has been eliminated, and the transaction cost brought by "secondary public relations" of enterprises has also been avoided, which is conducive to reducing drug prices.

　　"The quality of patients’ medication will be greatly improved." Gong Bo, deputy director of the Medical Insurance Department of Shanghai Municipal Bureau of Human Resources and Social Security, said that the centralized procurement of drugs organized by the state has set a high threshold for suppliers, and the bidding drugs must be original drugs and generic drugs that have passed the consistency evaluation of the quality and efficacy of generic drugs in National Medical Products Administration to ensure the therapeutic effect.

　　"Price for quantity" substantially promotes drug price reduction

　　According to the analysis of Guojin Securities, according to the procurement volume and the historical average bid price announced this time, the scale of the pharmaceutical market is more than 7 billion yuan, and the "4+7 cities" together account for about one-third of the national market, which will have a strong attraction for pharmaceutical companies. Through market-oriented bidding among enterprises, it will fully play the role of exchanging prices for quantity. In addition, some insiders admit that the purchase price of the above drugs is likely to be enlarged to the whole country, forming a national price linkage.

　　For enterprise quotation, the document is clear, the reporting enterprise must quote according to the minimum purchase unit of the main product specification, and the declared price of the same product with the enterprise must comply with the price difference rules. It is also emphasized that the declared price should reflect the cost factors saved by this centralized procurement, and in principle, it is lower than the lowest purchase price of the same variety of this enterprise in the pilot area at the end of 2017.

　　According to the procurement documents, no matter how many companies in a variety are shortlisted, only one company will enter the final bargaining negotiations, and the lowest bidder can enter. Specifically, if there are more than three enterprises that meet the declaration conditions, the declared price of the pre-selected varieties meets the relevant requirements of this quotation, and after confirmation by both parties, they will be qualified to be selected; For varieties with less than or equal to 2 enterprises that meet the declaration conditions, the pre-selected varieties are ranked in the forefront in the decline in the declared price, and they are qualified to be selected after confirmation by both parties; If not, refer to the average decline of other fully competitive varieties in price negotiation to determine the lowest decline in bargaining negotiation.

　　It is reported that if you don’t participate in or accept the bargaining negotiation, the variety will be treated as a poor standard, which will affect the centralized procurement of drugs involved in the pilot area.

　　Analysts of Guojin Securities pointed out that the bidding process was stricter than expected, which avoided the "bad money driving out good money" caused by the low price in the past. At the same time, the advantages of drugs with better competitive pattern were weakened to some extent through the setting of bidding process.

　　Regarding the quality of drugs purchased with quantity, Gong Bo said that quality is the bottom line of national procurement with quantity, because they are all varieties that have been consistently evaluated and can be replaced by the original drugs. Take the purchase of kelp as an example, the varieties that won the bid should be detected by near infrared spectroscopy to ensure the stability of drug quality.

　　In addition, according to Gong Bo, after the centralized procurement is completed, the medical insurance department will cooperate with the health department to strengthen the supervision of medical institutions from the aspects of ethics construction, rational drug use and comprehensive evaluation of clinical drug use, so as to ensure that the agreed procurement volume is implemented. At the same time, a series of medical insurance support policies will be issued to pay the purchase price in time, protect the legitimate rights and interests of pharmaceutical companies and enhance their enthusiasm.

　　Do not drop out, the advantages of the original drug are no longer

　　It is clear in the document that the original drug and the reference preparation for the consistency evaluation of generic drug quality and efficacy released by National Medical Products Administration, the generic drug that passed the consistency evaluation of generic drug quality and efficacy, and the generic drug approved according to the new registration classification of chemical drugs can all be declared.

　　Some insiders said that in addition to effectively promoting the decline of drug prices, the method of purchasing with quantity will also replace the original research drugs with high-quality generic drugs and change the phenomenon of super-national treatment of expired patented drugs in the past. Under the same purchasing conditions, generic drugs that have passed the consistency evaluation will have great advantages.

　　According to the report of Guojin Securities, many varieties are dominated by foreign pharmaceutical companies, such as rosuvastatin, atorvastatin, clopidogrel, irbesartan and other varieties, and the market share of the original pharmaceutical companies is above 60%.

　　An industry insider admits that generic drugs with the same effect as the original drug will reduce the market share of the original drug, which means that the original drug will either reduce its price or lose a large number of markets.

　　Because the varieties that do not participate in or accept the bargaining negotiation will be treated as substandard, and it will affect the centralized procurement of drugs involved in the pilot area of the enterprise. "In theory, it only lost part of the market of 11 cities with quantity procurement. However, according to the requirements of the procurement documents, abandoning the procurement in 11 cities may affect all hospital markets in 11 cities. " The above person said.

　　However, the report of Ping An Securities also pointed out that the purchase with quantity will lead to the price reduction of drugs, which will reduce the profits of enterprises in the upper and middle reaches of the relevant industrial chain. However, for a single company, it is of great significance for the company to consolidate its market position in the industry if it wins a large increase in sales volume in the purchase with quantity, thus offsetting the impact of price reduction.

　　In terms of medical insurance payment, relevant persons said that purchasing with quantity is conducive to the formation of medical insurance payment standards. The traditional bidding system has brought about the problem of high drug prices, and it is difficult to take the bidding price of drugs as a reference for the medical insurance payment price. The purchase price of 4+7 cities will become the prototype of the medical insurance payment standard.

　　Zhao Heng, founder of Latitude Health, said that the purchase of medical insurance with quantity means combining the formulation of medical insurance drug list, the determination of medical insurance payment price and the negotiation of drug purchase price. On the surface, it obviously reduces the drug price, but forming a relatively reasonable medical insurance payment price is the ultimate goal that this round of medical insurance with quantity purchase and its follow-up measures hope to achieve.