Centralized procurement of drugs needs to be both "horizontal" and "vertical"

Autumn fruit

As another "main force" with volume procurement, the pace of local collection and procurement has accelerated, and a number of cross-regional drug procurement alliances have been launched recently. Industry insiders analyzed that the current normalization of drug centralized procurement has been basically clear, in 2021, the centralized procurement of drugs will be significantly upgraded, a number of super regional alliances, cross-regional alliances will successively test the water to carry out procurement, and the pace of collection and procurement will be further accelerated. (Economic Information Daily, May 24)

At present, regional alliances for the procurement of pharmaceutical products have sprung up in large numbers. For example, Guangdong Province recently plans to set up a regional group procurement alliance to unite 16 provinces and regions to jointly carry out provincial-level drug and consumables ultrasonic knife head procurement. The "Eight Provinces and Two Regions" Alliance, led by Heilongjiang, as well as the Beijing-Tianjin-Hebei "3+ N" Alliance, the Inner Mongolia 14 Provinces Alliance, and the Shaanxi 11 Provincial Alliance have also appeared. In addition, the cross-regional common drug alliance and the shortage drug alliance are mainly aimed at different drugs. The number of alliances is dizzying.

Regional alliance procurement is a powerful complement to national procurement. National collection should consider the universality of the policy, otherwise it will be difficult to promote it throughout the country, because there cannot be too many types of drugs and the adjustment is not flexible. Regional alliances can quickly include drugs of common concern in the region into the procurement catalogue with quantities. And all parts of the region are often distributed by the same company, and the negotiated drugs are more convenient to distribute. The same price of the same drug in the region can also avoid undesirable phenomena such as the purchase of drugs across provinces due to the excessive price difference in the region.

Whether it is a regional alliance or a national collection, it belongs to the "continuous horizontal" method of drug procurement. At present, cross-regional horizontal "group buying" has become the norm, but there are still some shortcomings in the vertical "group buying" of provinces, cities, counties and townships. Due to the difference between the commonly used drugs in large hospitals and grass-roots medical institutions, the purchased drugs are mostly suitable for large hospitals, but the grass-roots medical institutions are facing problems such as insufficient applicability. For example, most primary medical institutions do not carry out anti-cancer treatment, and although anti-cancer drugs have a "diving price", the allocation rate of primary medical institutions is extremely low. And because the grass-roots medical institutions are located in remote areas, enterprises are unwilling to distribute drugs on time and in full, and if centralized procurement does not pay attention to "combination and vertical", the lack of drugs at the grass-roots level is difficult to resolve.

Cross-regional "continuous horizontal", drug catalogue and price coordination, cross-medical institutions "vertical", due to different scope of diagnosis and treatment, drug list and medication habits are different, policy coordination is more difficult. It can be seen that the difficulty of drug procurement is greater, and more effort is needed. With the medical federation as the procurement unit and the distribution of drugs as the key content of the "joint vertical" negotiations, these methods are worth trying. This kind of bargaining method is a powerful supplement to the national collection and regional alliance bargaining, and it is also a powerful measure to open up the "last mile" of drug supply. Therefore, after the popularization of national collection and regional alliance procurement, the regional "vertical" alliance procurement should also be put on the agenda as soon as possible.

"Continuous horizontal" can make the actions of different regions coordinated, and "vertical" can make the actions of medical institutions coordinated. The two measures can complement each other, and as two lines of longitude and latitude, jointly weave a complete network of drug procurement, form a more sound system, so that the scope of benefits of this model can be both horizontal to the edge and vertical to the end, creating a better market environment for the continuous decline in drug prices and the continuous improvement of drug quality.