After the price of drugs hanging on the net refers to the lowest price in the country, IVD reagents, consumables and other medical devices have also begun to link the national price.
On May 7, the Sichuan Provincial Centralized Procurement and Pharmaceutical Price Supervision Platform released the news that the first batch of medical consumables products that "illegally hung on the net" this year, a total of 21 testing reagents and consumables will withdraw from the procurement of public hospitals in Sichuan Province.
And according to the regulations, Sichuan Province will no longer accept applications for these products within two years.
Source: Centralized procurement of pharmaceutical equipment and pharmaceutical price supervision platform in Sichuan Province
Sichuan reported that some of these products concealed the lowest price in the country, and some did not complete the coding mapping of the original Sichuan and national consumables in accordance with the regulations. These are considered violations.
Drugs must currently be linked to the lowest price in the country, and the price is not cheap enough to be refunded. In terms of consumables, not every province has a network procurement of IVD reagents, etc., so the outside world's feelings about "price linkage" are not very obvious.
The Health Bureau found that in fact, since the beginning of this year, Jiangsu, Hubei, Shaanxi and other provinces have begun to link the price of consumables.
Rather withdraw the net, not reduce the price
Sichuan did not remove these consumables from the beginning. After thoroughly verifying the quotation of consumables, Sichuan requires these companies: as long as the lowest purchase price in the history of the platform is reduced by 10%, they can continue to hang the net.
However, most companies refuse to reduce prices, preferring to withdraw from the hanging net.
The products involved in the removal of the net include disposable vacuum blood collection vessels, glaucoma drainage valves, disposable dispensing syringes, human chorionic gonadotropin (HCG) detection reagents, treponemal specific antibody detection reagents, etc.
Consumables for net removal
Because the national hanging net needs price linkage, this year's active and passive price reduction of consumables has become a trend, and refusal to adjust the price will lose the qualification of hanging the net.
In March 2022, the Hubei Provincial Public Resources Trading Center issued the "Notice on Announcing the Adjustment of the Hanging Net Price of Intraocular Lens and Coronary Drug-Coated Balloons with Concentrated Quantity procurement of Hubei Non-selected Products and suspending the hanging net", which punished the suspension of the hanging net for 4260 kinds of high-value consumables of 27 enterprises that refused to reduce the net price.
Liaoning has the most frequent price cuts for consumables. Since the beginning of this year, Liaoning has issued dozens of active price reduction notices for medical consumables, including Medtronic, Johnson & Johnson, Lepu and other machinery companies are on the list.
Detection reagents for net removal
The price reduction method adopted by Nanjing has also attracted attention in the industry. The Nanjing Municipal Medical Insurance Bureau's "Implementation Opinions on Deepening the Reform of Medical Consumables Governance" proposes that it will promote various forms of consumables with quantity procurement and price reduction negotiations, establish a gradient price reduction and linkage price reduction mechanism for products related to volume procurement, and no less than 1,000 medical consumables price reduction products will be reduced each year. Nanjing has suspended the hanging net of 11,278 consumable reagents in December 2021.
In provinces that have not yet fully implemented the hanging net of consumables, large hospitals have become the main force of bargaining.
In March 2022, the First Affiliated Hospital of Xiamen University issued the "Circular of the Committee of the First Affiliated Hospital of Xiamen University of the Communist Party of China on Inspecting and "Looking Back" at the Progress of Rectification", announcing that the consumables that do not reduce the price will be discontinued, and 4 batches of high-value consumables have been discontinued.
Xiangya Hospital is even more ruthless. Also in March, Xiangya Hospital released the "Announcement of Public Bidding for a Batch of Reagents in the Department of Anesthesiology and Laboratory Of Xiangya Hospital of Central South University", showing that the bidding price of many consumable varieties was as low as 20%.
Various cases are in front of us, and medical device companies have to take the initiative to reduce prices to exchange for the market.
IVD price limits, collection and other policies have struck
Low-value medical consumables, IVD reagents, etc. are more special.
For a long time, these products were procured by the hospital itself. Because of the low price and the variety involved, it is difficult to unify coding, unified procurement, and timely delivery. Hospitals often choose long-term suppliers to deliver goods in one phone call.
However, under the general trend of cost control, these consumables with low unit price, miscellaneous types, large dosage and fast update have gradually been paid attention to. Because in some large hospitals, these consumables are an important source of income generation, and some hospitals alone can bring about 10% of the income generated by the whole hospital every year. Not only that, because of the self-organization of procurement, it is very easy to generate rent-seeking space.
In this way, consumables once became a paradise for corruption.
Around 2016, Guangdong and other provinces began to start the net of consumables to make the prices of consumables and IVD reagents transparent. However, just by announcing the price, it is the same as the purchase of drugs on the net, and it is impossible to squeeze the moisture in it.
Du Xuepeng of Guangxi Zhuang Autonomous Region People's Hospital once said in the survey that the professionalism of high-value consumables management is very high, and the DRG/DIP model is still exploring, and the lack of a unified coding system and information platform makes it difficult for hospitals to supervise.
In Sichuan, it is not only price and medicare codes that limit the use of consumables in hospitals. West China Hospital of Sichuan University, West China Second Hospital, etc. have adopted the "evidence-based consumables use management", strictly manage the use of consumables in hospitals, the selection of consumable brands according to data evidence, decoupled from the doctor's independent decision, strictly monitored the proportion of consumption, and immediately suspended supply beyond the warning line.
Nationwide, in the face of high-value consumables collection and key monitoring has begun, artificial joints, orthopedics and other consumables have been collected, oral implants, electrophysiology and endoscopic staplers are the key tasks of this year's collection.
For low-value consumables, the state has also begun to start collecting, and the breakthrough may be easier to standardize IVD reagents. This year, the collection of new crown-related testing reagents and consumables has been organized, and it will be led by Jiangxi to organize the liver function biochemical reagent alliance.
With the opening of the new crown antigen reagent market, in just two months, more than 30 products have been approved, but centralized procurement has quickly reduced the price to a minimum of less than 4 yuan.
With the ensuing collection, DRG/DIP, and key monitoring, consumables and reagents are not only facing the problem of reducing prices, but also the threshold for entering the procurement list of medical institutions is getting higher and higher.
The era of lying and making money is over, and the big changes have come.
Text | Zhang Ling operates | Twenty-thirteen