In 4 aspects, ensure the smooth landing of medicines in the collection of collection

Since the establishment of the State Medical Insurance Administration in May 2018, seven batches of eight batches of eight batches of nationally organized pharmaceutical band -volume procurement work have been carried out. Essence

Pharmaceutical concentration and quantity procurement work related to the entire process of drug production, transactions, circulation, and use. Therefore, it is both a systematic project and a large article. If it is said that the completion of bidding and determining the selected medicine is the first half of this article, then the implementation of the selected drugs is the second half of this article. The quality of the second half of the article will directly affect the success or failure of the procurement of the concentrated drugs. The medical institutions that have been repeatedly exposed by the media have not completed the agreed purchase volume. Reality necessity and urgency. From August 11th to 12th, 2022, Chen Jinfu, a member of the Party Group and Deputy Director of the National Medical Insurance Bureau, went to Weihai, Shandong to investigate the use of products to choose from, which fully illustrates the importance and concern of the National Medical Insurance Bureau.

Doctors are specific prescriptions for medicines. Therefore, the author believes that whether the selection of medicines in the collection is to be used smoothly. Use, use first, and willing to use "" collection in "collection of products. Of course, it is also necessary to ensure that the selection of medicines in the collection of collection is "enough".

1. Strengthen supervision, ensure the quality, and ensure that the drug doctors are used to use

Only the quality of medicines can be rest assured that the doctor can rest assured. This is the basis and premise of ensuring that the selection of drugs in the collection in the collection. Although it is said that in the concentrated volume of drugs organized by the state organization, the consistency evaluation of quality and efficacy is the prefix conditions for the shortcut bidding for generic drugs, but how to ensure the selection of drugs and the decline in prices, the quality of drugs produced and supplied by enterprises remain unchanged. Stability of quality is a special issue that needs to be paid attention to and attaches great importance. It must be strengthened. It must be strengthened. The key is to grasp the following four aspects:

The first is to clarify the responsibilities of all parties. For the selected enterprises, it is mainly to organize production in strict accordance with the quality standards and production processes approved by the drug regulatory department. For the government, it is mainly to implement the responsibility of the local government's drug regulatory authorities. The selected drugs are included in the key regulatory varieties, and the "one enterprise, one file" management is implemented in accordance with the "most rigorous standards, the most stringent regulatory supervision, , The most severe punishment and the most serious accountability "requirement to achieve full -process, full chain, and comprehensive quality supervision for pharmaceutical production, circulation, and use; for medical institutions The reaction monitoring, found suspected adverse reactions to report in time according to the procedure.

The second is to achieve information sharing. Mainly two aspects of information sharing: vertical speaking, the country, provinces (municipalities, autonomous regions), regions (districts, cities, autonomous prefectures), counties (cities, districts) drug supervision departments must realize drug production technology and quality standards Wait for the sharing of basic information of supervision, thereby enhancing the timeliness, targetedness and accuracy of supervision and inspection; in horizontal speaking, accelerate the realization of medical insurance information platforms, comprehensive management information platforms, regional national health information platforms, and national credit information Share platform information sharing.

The third is to establish a traceability system. Accelerate the construction of pharmaceutical production, circulation, and use of the entire process traceability system, strictly require the drug listing license holder, pharmaceutical manufacturer, pharmaceutical business enterprises and medical institutions to provide traceability information in accordance with regulations. Tour.

The fourth is to strengthen supervision and inspection. Comprehensively implement "two full coverage, one key concern", continuously strengthen quality supervision, and effectively ensure the quality of drugs. "Two full coverage" refers to: full coverage supervision and inspection of the selected enterprises, and conduct a full -coverage inspection inspection of the selected products; The variety of changes in production technology and batches will effectively strengthen supervision and management and risk prevention.

2. Clear requirements, strengthen assessment, and ensure that selected medicines are preferred

The government's organization of the procurement of concentrated drugs is an important measure to reduce the people's medication and the burden of medication, purify the ecology of the pharmaceutical industry, improve the efficiency of medical insurance funds, and promote the further development of medical improvement. In a sense, it is also a re -adjustment and a large reshuffle of the vested interests that have been formed and solidified in the past. Therefore, in the process of promoting, the resistance and difficulties encountered can be imagined. If the necessary administrative means are not supplemented, the application of drugs in the collection may become an empty words. The damage also infringed the vital interests of the people. Therefore, it is obviously necessary to make clear requirements for medical institutions and doctors on the clinical prescriptions of drugs to strengthen management and assessment to ensure that selection of drugs in collective mining is obviously necessary.

The first is clear requirements. Judging from the current situation of our country, medical institutions play a very unique role in the use of medicines, play a very important role, and are also large households for drug use. Therefore, in order to ensure the implementation of drugs in the collection, the medical institutions must be clearly stipulated in the use of the selection of drugs in the collection. Specifically, the medical institution is required Complete the agreed purchase volume. The second is to strengthen management. Specific measures include: 1. Incorporate selected medicines in the collection of collection into clinical path management, formulate medical guidelines to ensure standardized drugs; Reminder beforehand; 3. In the hospital's prescription specification, the clinician is required to prescribe prescriptions according to the general name. Except for special circumstances, the name of the prescription shall not appear in the prescription; Optimized use of drugs in the adoption.

The third is to strengthen assessment. Incorporate the selection of drugs in the collection of collection into the performance assessment system of public medical institutions, including: 1. Incorporate the procurement and use of medical institutions into the performance assessment of public medical institutions, the scope of the target responsibility assessment of the person in charge of the medical institution; 2. The medical institution will be The procurement and use of the selection of drugs are important basis for medical insurance assessment and evaluation, and link with the settlement of medical insurance funds; 3. Special interviews with doctors with a significant decline in the prescriptions of the selected varieties.

3. Establish a mechanism, incentive constraints, and ensure that the drug doctor is willing to use

Stimulating the endogenous motivation of medical institutions and their prescription doctors to choose drugs in the collection of drugs is the foundation for ensuring the implementation of drugs in the collection. Therefore, the establishment and improvement of the incentive restraint mechanism for the use of drugs to be used in the collection of drugs is a long -term strategy. Sustainable way. The key is the following three aspects:

The first is to stimulate the endogenous motivation of the selection of drugs in the collection. Mainly include: 1. For medical insurance funds saved in the selection of drugs in the concentrated volume procurement, in accordance with the regulations of the balance retention policy, incentives to medical institutions in the settlement of medical insurance funds; 2. 2. The selection of varieties procurement during the implementation cycle of the procurement results is not completed normally Medical institutions deduct the corresponding scores in the evaluation and evaluation of medical insurance; 3. Support and encourage medical institutions to improve the internal assessment measures and salary mechanisms, promote the reasonable medication of clinicians and pharmacists, and give priority to the use of secondary products; 4. Increase policies Publicity, improve the policy awareness of medical personnel, and strive to create a good public opinion atmosphere and working environment that given priority to the use of drugs in the collection.

The second is to clarify the payment standards for the selection of drugs and medical insurance. According to the provisions of the General Office of the State Council in the "Opinions on Promoting the normalization and Institutionalization of Purchasing Purchase Purchase Works" (Guoqi Fa [2021] No. 2), specifically: 1. Drugs, determine the medical insurance payment standards on the basis of the selected price; 2. The same medical insurance payment standard is implemented for the original research drugs, reference preparations, and generic evaluation of the same name under the general name; 3. Those who have not passed consistency evaluations Imitation drugs and medical insurance payment standards must not be higher than the medicines that have passed consistency under the same name.

The third is to select medicines in incentives in medical insurance paid. With the reform of the DRG/DIP payment method comprehensive and in -depth, the use of drugs and medical consumables has changed from a source of revenue to the current cost item. The biggest change brought about by the government -organized drugs and medical consumables is the biggest change. A significant reduction of the procurement price of drugs and medical consumables. In the case of determining the medical insurance payment standards according to the medical insurance payment standard, the decrease in the price of drugs and medical consumables also means that the cost of medical services is reduced. Procurement costs saved for medical institutions are in a sense, this is the income brought to medical institutions. If it is said that the selection of drug balance in the collection is a prominent incentive for the use of pharmaceuticals in the collection; then the in -depth advancement and comprehensive implementation of the DRG/DIP medical insurance payment method reform is a hidden incentive.

4. Strengthen the supply and prevent shortage, ensure that the selection of drugs in China is enough

On August 20, 2021, the National Organization Pharmaceutical Co -Purchasing Office (hereinafter referred to as the "Liancai Office") issued an announcement stating that the third batch of national organizational procurement varieties of Buruffen Capsules North China Pharmaceutical Co., Ltd. (here below Abbreviation: North China Pharmaceutical) Failure to procure the agreed in Shandong Province in accordance with the agreement. Based on this, the "Liancai Office" incorporated North China Pharmaceuticals into the "illegal list" and canceled its qualification to participate in the national organizational drug centralized procurement activities from August 11, 2021 to May 10, 2022. The occurrence of this incident undoubtedly sounded the alarm for the guarantee of the protection of drugs in the collection, and effective countermeasures must be formulated in time to prevent similar incidents from happening again. Judging from the current relevant policy documents, it mainly includes:

The first is to clarify the responsibility of the selection of corporate. Clear requirements: 1. Elected companies should make market risks prediction and prevention, and organize drug production in accordance with the requirements of the procurement contract in a timely and in accordance with the purchase contract, and send drugs to the distribution enterprise Demand; 2. If there is no timely supply, in addition to the non -resistant and resistant factors, the selected enterprises shall bear the corresponding responsibilities and all the costs generated, otherwise it will be regarded as a breach of trustworthiness. 3. , Give full play to the role of the market, make full use of and integrate third -party logistics resources, improve the efficiency of distribution and reduce delivery costs to solve the "pain point" of distribution. The second is to establish an emergency deployment mechanism. In order to ensure the supply of drugs in the drug, the specific measures mainly include: 1. When the drug shortage occurs due to special reasons, the temporary adjustment of various medical and health institutions is allowed to be opened, and the interoperability of the provincial pharmaceutical mining center and the drug production and operation enterprises will be negotiated with the adjustment of the drug production and operation enterprises. Methods to maximize the supply of clinical and pharmacies; 2. In order to avoid the risk of confession risks that may exist in the past "one pharmaceutical in one province", a provincial "dual supply" model is implemented to ensure the selection of product supply, that is,: The proposed enterprises are uniformly confirmed by the main supply area and the preparation area. After the proposed enterprise is confirmed, it becomes a candidate enterprise in the preparation area, and the selected enterprise will directly supply the network in the preparatory area according to the selected price. When the main supply enterprise cannot meet the market demand of the selected areas, the preparation enterprise can obtain the owner's identity in accordance with the relevant procedures, ensure the supply of drugs in a timely manner to ensure the continuity of the patient's medication.

The third is to play the role of credit evaluation. On the guarantee of the guarantee supply of drugs in the collection, the following measures can be taken: 1. Timely, comprehensive, complete and standardized to collect pharmaceutical enterprises (including drug production license holders, drugs and medical consumables, and production enterprises with commissioning agency relationship The distribution companies, as well as distribution companies) 's behavioral information in pharmaceutical supply, and conduct corresponding credit grades management of pharmaceutical companies; 2. According to the credit rating of pharmaceutical companies, take written reminders and warnings, relying on centralized procurement platforms to remind the purchaser's risk to the purchaser's risk Information, restrictions or suspension of related drugs or medical consumables, restrictions or suspension of procurement of related drugs or medical consumables, disclosure information such as dishonesty information; if the number of dishonesty involves the provincial number meets the prescribed conditions, the medical prices and bidding procurement of the State Medical Security Bureau The guidance center starts a nationwide joint treatment; if the supply structure of the drug or medical consumables involved is a single supply structure, and the supply and demand situation is tight, it takes graded disposal measures on the basis of ensuring supply; The nature of the problem and the severity of the circumstances are treated differently, and it is announced to the society in a timely manner.

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