news

한어Русский языкEnglishFrançaisIndonesianSanskrit日本語DeutschPortuguêsΕλληνικάespañolItalianoSuomalainenLatina

01

high-priced drugs account for nearly 70% of the total purchase amount

30 hospitals were named

recently, the hebei provincial medical insurance bureau issued a number of documents to its subordinate units and provincial medical institutions. one of them was a report on the procurement of traditional chinese medicines by various cities and medical institutions (hereinafter referred to as the "report"), and 30 hospitals were named.

according to the "notice", the second cycle of the first batch of hubei traditional chinese medicine alliance centralized procurement expires on june 30 this year. during this cycle,there are 2,447 medical institutions in hebei that purchased more than three times the high-priced or second-highest-priced drugs (hereinafter referred to as "high-priced drugs"), with a purchase amount of more than three times the amount of drugs of 227 million yuan, accounting for 69.83% of the total purchase amount.(the total purchase amount is rmb 325 million).

the hebei provincial medical insurance bureau pointed out that even though the provincial medical insurance bureau has color-coded high-priced drugs on the platform and made restrictive reminders, some medical institutions still signed tripartite agreements with the highest-priced drug companies.

when faced with multiple options for drugs with the same generic name and dosage form, some medical institutions do not choose products with lower daily cost but choose products with higher daily cost.taking danshen as an example, the highest daily usage amount of this drug is 110 times the lowest daily usage amount.some medical institutions only choose drugs with the highest or second highest daily cost.

the "notice" is divided into two dimensions: coordinated areas and medical institutions. it ranks the total amount of high-priced drug purchases from high to low, announces the procurement situation of each coordinated area, and names the hospitals with the highest total procurement amount.

in terms of the overall planning area, langfang is the city with the highest purchase volume and amount of high-priced drugs in hebei (see the end of the article for the complete ranking).the purchase volume of high-priced drugs exceeded 44% of its total purchase amount, and the purchase amount of high-priced drugs accounted for nearly 86% of the total amount.; the north china oilfield, which has the lowest proportion of high-priced drug purchases (3.77%), and its high-priced drug purchases also accounted formore than 34% of the total purchase amount。

by medical institution, the 20 hospitals with the highest amount of high-priced drug purchases and the 10 hospitals that only purchased high-priced drugs and had the highest purchase amounts were all named (see the end of the article for the specific list).

the amount of high-priced drugs received by 20 medical institutions ranged from 1.83 million to more than 6.6 million yuan.the two highest-ranked hospitals received more than 6 million yuan in high-priced drugs during this period.; the top six hospitals received more than 4 million yuan in high-priced drugs.

02

suspension and rectification, self-inspection and self-correction

or introduce audit, discipline inspection and supervision departments

according to the requirements, each coordinated district in hebei will rely on the provincial procurement system to conduct monthly inspections on the purchase and use of higher-priced chinese patent medicines by medical institutions instead of using lower-priced ones, with a focus on taking restrictive measures against medical institutions that purchase drugs with a price difference of 3 times (inclusive) or more of the minimum daily usage amount.tripartite agreements with enterprises are not permitted.

medical institutions that really need to purchase more than three times the amount of drugs must explain the reasons.andmake a commitment not to accept drug kickbacks.if the reasons are insufficient, the medical institution must immediately stop using the product and make corrections;if the circumstances are serious, the medical insurance department will not allocate the surplus retained funds and will hand them over to the discipline inspection and supervision department for handling.

the notice also requires all medical institutions to use the second cycle data announced this time as a reference, and conduct self-inspection and self-correction in comparison with the procurement situation of the third cycle. medical institutions that take the initiative to correct the situation can adjust the reported quantity and re-sign the tripartite agreement to ensure that the centralized procurement policy of purchasing low rather than high is implemented, "and it must withstand the review of audit, discipline inspection and supervision and other departments."each city’s rectification report must be submitted to the provincial bureau before september 10.

in another notice issued during the same period, hebei also stated that it will carry out monitoring of abnormal situations such as medical institutions purchasing high-priced drugs instead of low-priced drugs, and purchasing non-selected drugs instead of selected drugs.

“mining high, not low”the monitoring scope covers unit price, that is, the lowest price of the smallest dosage unit (tablet/grain/tube) of drugs is higher than 10 yuan.procurement of drugs by medical institutions at a price 20 yuan higher or 1.5 times higher than the lowest listed price is considered an abnormal purchase.

“don’t purchase selected drugs if they are not selected” covers all centralized purchased drugs, and medical institutions that engage in related behaviors will be subject to key monitoring and supervision.

in june this year, the general office of the state council proposed in the "key tasks for deepening medical and health system reform in 2024" to promote the quality and expansion of centralized procurement of drugs and medical consumables. this also includes further strengthening the implementation of centralized procurement, implementing the policy of retaining surplus medical insurance funds from centralized procurement, improving the incentive and constraint mechanism, promoting medical institutions to truthfully report the procurement volume and reasonably give priority to the use of selected products; improving and enhancing the functions of the centralized procurement platform for medicines, strengthening online procurement supervision, and increasing the online procurement rate of drugs and medical consumables.

03

drug price monitoring systems upgraded in many places

at present, provinces are constantly improving their monitoring methods for online drug prices and abnormal procurement situations in medical institutions.

at the end of august this year, the "sichuan province drug and medical equipment centralized procurement and medical price supervision platform online drug price monitoring management measures" (hereinafter referred to as the "monitoring measures") was officially implemented.

all drugs listed on the provincial platform will be included in the monitoring scope. sichuan will monitor the prices of the drugs listed on the platform.the three colors of marking are green, yellow and red according to the ratio.

the procurement situation of medical institutions will be counted on a quarterly and annual basis.10%, or the purchase amount of yellow drugs exceeds40%, or the combined proportion of red and yellow drugs exceeds40%when the medical institution is located, the provincial drug recruitment center will prepare a report and inform the medical insurance bureau of the city (state) where the medical institution is located.

sichuan has adopted both vertical and horizontal monitoring and price comparison mechanisms.

looking vertically, the drugs listed on the internet with the same manufacturer, the same drug name, and the same dosage form,compared with its base pricewhen the increase exceeds 80%, the product will be marked yellow; when the increase exceeds 200%, it will be marked red.

looking horizontally,same quality levelchemicals and biologicalscomparable price ratio exceeds1.8 timesof,chinese patent medicineratio exceed3xthe ones are marked in yellow; the comparable price ratios of chemical drugs and biological drugs are3xand abovethe ratio of traditional chinese medicine is5 times and aboveif the generic drug that has not passed the review is compared with the original drug, reference preparation, or reviewed drug with the same generic name,the price is inverted and is directly marked in red.

jiangsu, which also adopts red and yellow warnings, also proposed earlier that the provincial platform will dynamically monitor and compare the negotiated purchase prices and quantities of the same drug in different public medical institutions, and issue "red, yellow, and blue" price reminders, warnings, and controls on the bargaining results.

medical institutions that refuse to bargain for a long time, have a large proportion of red areas in bargaining results, or have abnormal procurement will be summoned by the relevant provincial authorities, urged to make rectifications, and reported to the relevant supervisory departments depending on the circumstances.

in shanghai, the 10 drugs with the largest purchase amounts among those that exceed the yellow price line each month will also be included in the key monitoring list; medical institutions that rank high in the amount of drugs with large purchase increases will also be named.

nowadays, the procurement system with gradually increasing degree of informatization, as well as the joint supervision of medical insurance, health care and even audit, discipline inspection and supervision departments, have put forward higher requirements on the compliance of medical institutions' procurement processes and internal risk management. the impact will be transmitted upward along the industrial chain, and pharmaceutical companies with high prices and want to raise prices will also face greater pressure.

attachment: