Source of this article: Times Finance Author: Zhang Yuqi
As the first continuous procurement initiated by the National Drug Joint Procurement Office, on April 23, the bid for the special centralized procurement of insulin was opened in Shanghai.
According to the official WeChat platform of the National Health Insurance Administration, a total of 53 products from 13 companies participated in the continuous procurement, and 49 products were qualified for selection, with a winning rate of 92%, and the winning price was stable and decreased, which was reduced by 3.8 percentage points on the basis of the first round of centralized procurement price reduction. At the same time, the price difference of the third-generation premixed group, which had the largest price difference in the first round of centralized procurement, narrowed from 2.3 times to 1.6 times, and the proportion of Class A products with lower quotations increased from 40% in the previous round to 71%.
According to the national centralized drug procurement document (special continuation of insulin), the selected products in this round of continuous procurement are divided into three groups (categories) of A, B and C according to the declared price from low to high. Among them, the proportion of the basic quantity of the selected products in class A to the purchase demand of the corresponding products in the first year is 80%~100%, the proportion of the selected products in A1 is 100%, and the proportion of the remaining selected products in class A is 80%.
Jiang Bin, deputy director of the Public Policy Research Center of Peking University, told Times Finance and other media at the site of the insulin procurement that judging from the results of the selection, the price of the winning selection is reasonable and the price difference is small, which further reflects the fairness of the market.
"First of all, from the price level, the characteristics of the procurement is the grasp of the price data and the setting of the price line, this time the renewal of the bid will be the last round of the bottom price as the highest effective declaration price, in terms of price management effect is better; Finally, the classification component is optimized, the proportion of A1 selected products is 100%, the proportion of the remaining A-class products is 80%, B-class 55%, and C-class is 45%, which reflects the principle of linking quantity and price, and also encourages enterprises to exchange for the market through price reduction. Jiangbin analysis said.
According to the National Health Insurance Administration, the results of this continuous procurement will be implemented nationwide in May, which will be smoothly and orderly connected with the previous round of centralized procurement.
At the end of 2021, three years after the implementation of the national centralized procurement, it was officially expanded to the field of chronic diseases, that is, the first round of special centralized procurement of insulin was launched. This is the first time that biologics varieties have entered the national centralized procurement, and the average price reduction of the selected products is 48%. This round of centralized procurement began to be implemented in May 2022, and it has been nearly 2 years so far.
With the centralized procurement into the deep water area, how to implement it after landing has attracted much attention, especially this kind of special and special drugs. According to the news released by the National Health Insurance Administration on its official website, before the special centralized procurement of insulin, the annual insulin consumption of public medical institutions across the country was about 250 million, and after the centralized procurement, the 22-month dosage of selected insulin reached 650 million, with an average annual dosage of about 350 million. In addition, after centralized procurement, the proportion of third-generation insulin use increased from 58% to 70%.
In terms of regional volume and implementation, many experts and business people at the scene told many media such as Times Finance that grassroots community hospitals have a higher acceptance of insulin centralized procurement, while the acceptance of tertiary hospitals is relatively low. Some people on the scene also told Times Finance that for enterprises, the amount of weight they receive after winning the bid is still limited, and if the implementation of some provinces is not in place, it may also have an impact on the volume of enterprises. At the same time, the person pointed out that there are still restrictions on the implementation of centralized procurement, and according to their observations, the implementation of the second and third-tier cities is slightly worse.
Jiangbin told Times Finance and other media, "First of all, the quality of the product is undoubted, the registration and approval rules and quality standards of domestic varieties have tended to be internationalized, the review and approval effect and efficiency of the State Food and Drug Administration can be guaranteed, many domestic varieties are also applying for overseas registration, and the quality and management level of enterprises and products have also reached the international level." Quantity procurement is a training opportunity for domestic drugs, which can help cost-effective varieties better go abroad and enter the international track. In addition, the State Food and Drug Administration adopts quality inspection and supervision and inspection of the whole life cycle of the selected varieties, and the quality awareness of the enterprise is also very strong. The first nine batches of 374 varieties and 932 enterprises were purchased in volume, of which only 5 were unqualified varieties, all because the production process did not meet the regulations, and the quality was directly judged to be unqualified. The selected varieties are guaranteed based on quality and efficacy, and the price has dropped again, so that patients can ensure their health output when using the selected drugs, and at the same time, the economic burden is reduced. For example, most of the selected insulin products are low-cost Class A products, and less than 30% of Class B and C products are selected, and the overall cost will definitely decrease. ”
Jiang Changsong, assistant to the dean of the National Medical Insurance Research Institute and director of the Price Procurement Office of Capital Medical University, pointed out in an interview with Times Finance and other media that insulin has certain differences with other drugs, and patients' compliance and drug changes have attracted special attention. "Some patients pointed out that the patient is accustomed to a certain brand and a certain product, and the effect is good, and he/she is reluctant to change the dressing. Although the price of the medicine is an important consideration, patients are still more concerned about their recovery. Jiang Changsong said.
In addition, it will not be too difficult for hospitals to report and use the amount of medical institutions. A total of 13 companies participated in the quotation for this insulin succession, including 3 new companies, and all 13 companies were selected. Jiang Bin explained that all 10 old varieties have been purchased and used in the first round of special centralized procurement of insulin, and the hospital has accumulated corresponding experience. Secondly, the continuous procurement gives medical institutions a lot of autonomy, that is, in the allocation of surplus, hospitals are allowed to independently classify the surplus into Class A varieties and choose the varieties they are familiar with and trust. The scale of use of the selected varieties in category C will be adjusted, but the overall quality level of the product will not change.
In order to ensure that the centralized procurement of products completes the agreed procurement volume, the latest national centralized drug procurement document (insulin special continuation) also pointed out that "during the procurement cycle, medical institutions will give priority to the use of the selected products in this centralized drug procurement and ensure the completion of the agreed procurement volume." Among them, on the basis of giving priority to the use of the selected products in this centralized drug procurement, the remaining dosage can be in accordance with the relevant provisions of the local centralized drug procurement management, and the appropriate amount of other products with appropriate prices can be purchased. During the procurement cycle, if there is an unsuccessful product or a newly approved product that accepts the highest winning price of the relevant procurement group, the enterprise shall apply to the Drug Joint Procurement Office, which can be regarded as the winning product, but there is no agreed purchase volume in the procurement year in which the application is made. ”