Drug bidding hot debate was accused of fighting prices

On the 4th of the two sessions, 25 pharmaceutical industry associations such as the China Pharmaceutical Enterprise Management Association organized dozens of representatives of the two associations to communicate with government officials. During the communication, representatives from the pharmaceutical industry began to discuss the tendering of pharmaceuticals. Officials from the State Food and Drug Administration and the Health and Development Planning Commission stated that after years of trials, the tendering of medicines is currently used to classify tenders in the form of a combination of methods of discharge and management. Pilot cities can give greater flexibility.

Not long ago, the State Council issued the "Guideline for the General Office of the State Council on Improving the Centralized Purchasing of Drugs in Public Hospitals" (Guobanfa [2015] No.7). This "Document No. 7" serves as a guideline for the authorities in charge of drug bidding at the current stage. The documents have caused great attention in the industry. At the symposium, officials of the competent department also explained the document.

Drug tenders accused of major fight prices

A number of representatives from the two associations' medicine industry stated that at the current stage, drug bidding was carried out in different provinces, and that many provinces did not rely mainly on quality and innovation in drug bidding, but merely stuck to the price.

Ding Liming, deputy chairman of the National People's Congress and chairman of Zhejiang Beida Pharmaceutical Co., Ltd., said recently that the State Council has issued opinions on public hospitals for tenders, giving negotiation mechanisms and bargaining opportunities for national varieties and innovative drugs, but many tenders are simply bargaining. For example, the recent tendering time in Hunan was very short, but the evaluation was based on the percentage of cuts.

“I also mentioned last year that the issue of bidding for innovative drugs has not been able to find a clear answer. The country itself is pricing its innovative drugs autonomously. In the pricing process, we automatically reduce the price of new drugs of innovative drugs, which is 30 percent cheaper than similar foreign drugs. % ~ 40%. If you can set a higher price for the purpose of tendering, and leave this space for bargaining, we should say that the price has been properly set out before. Why is this procedure passed through the tender?"

The deputies to the National People's Congress and the chairman of Yabao Pharmaceuticals proposed that the practice of providing drug inspection reports in the sale of drugs for tender should be eliminated. He believes that the current drug inspection report must be provided in the tender, which results in the longest one or two monthly review reports of the provincial drug administration department, and basically only five months to seven months in Shanxi Province to get the application proposal report. single. In fact, pharmaceutical companies do not submit unqualified products for inspection. Otherwise, unqualified companies have already closed down. The burden of drug testing institutes is very heavy. According to preliminary statistics, the basic drug testing institutes have submitted 30% to 40% of the entire inspection report of the drug testing institutes. He suggested that in the future drug tenders do not need to provide drug inspection reports every year, but should increase drug supervision and random checks to ensure the safety and effectiveness of people's medication.

“Look at how Europe is bidding? Even how do Brazilians in developing countries bid? How can Mexico bid? How can hospitals directly bid for drugs directly? How can one rely on small pharmacies to solve the problem?” Li Ling said, actually there was no Which country is so loose and so free from drug control in China as it is that it actually harms the pharmaceutical industry in China.

Representatives of pharmaceutical companies should have been concerned about drug bidding and reform of drug prices. However, most of them believe that the success or failure of the “pharmaceutical reform” actually depends on “medical reform”. If there is no progress in the reform of the hospital, the drug reform cannot actually solve the problem of expensive medical treatment.

Liu Qun, deputy to the National People's Congress and chairman of the Tiansheng Pharmaceutical Group, believes that in terms of progress, doctors can practice more. He believes that doctors practicing more than one is not a reform of the hospital, but actually the reform of the pharmaceutical industry, the doctor came out, in order to ease the contradiction between the supply and demand of the medical industry. The second is the opening up of social doctors, and the second is the liberalization of online drug sales. Liu Qun believes that the State Council's latest document on centralized bidding for drugs has many highlights, including the resumption of the use of cheap drugs and the resumption of the use of gynecological and paediatric drugs. This is a big step forward, and it is a correction to the problem of procurement of drugs for the past decade. . In addition, the documents require hospitals to pay in a timely manner within 30 days, and all pharmaceutical companies in the past are deeply affected by the hospital's failure to pay in time, and all the funds are trapped inside, affecting the development of the industry.

“Do not take medicine reform as a medical reform. Our core is to carry out medical reforms, and we must liberate the vitality of doctors. First, let the doctors have dignity, and second, let the doctors have income. The medical reforms will also enable the hospital to have vitality and allow the hospital to manage from a long-term imprisonment. As the system emerges, as long as the vitality of the hospital is resolved and the vitality of the doctor is resolved, medical reforms may be completed. Otherwise, the medical reform will be empty talk, said Liu Qun.

He suggested that the Health and Planning Commission should quickly push physicians to practice freely and practice more. Physicians are free to practise, and more practitioners are required to first request the hospital to disregard the doctor's files and submit the doctor’s files to the doctor’s association. The tune out, the doctor's more practice to get out.

Promotion of classified tendering measures

Regarding the large number of different opinions expressed by representatives of drug companies in drug bidding, Zheng Hong, Director of the Department of Drug Policy and Essential Drugs of the National Health and Family Planning Commission, expressed his views.

Recently, the 2015 State Council issued document No. 7 was issued. This is the current guidance on standardizing the centralized procurement of drugs in public hospitals. Zheng Hong believes that this document summarizes some of the past experience of centralized drug procurement.

“Objectively speaking, the centralized procurement of medicines has taken more than ten years. How was this before? It was previously used in a decentralized manner. That is, after the 1990s, there was a development process from decentralized procurement to centralized procurement. Now there are some Experts and scholars also hope that this power will simply be handed over to hospitals for hospitals to handle. Now that they are handed over to the market, in fact, if the market manages this matter properly, I fear that as government departments have more responsibilities, they should turn their energies into supervision. In the century to the present, medicines have gone from decentralized procurement to centralized procurement. Why did we come to this day? There are actually laws to follow and lessons learned. Today we pointed out that the great highlight of the document is the decentralization of procurement and it also reflects the The spirit of the Third Plenary Session of the Eighth National Party Congress played a decisive role in the market, and at the same time better utilized the role of the government."

Zheng Hong believes that not all drugs are subject to tender in classified procurement. After several years of investigation and research, the long-term exploration by the hospital, and the implementation of classified procurement, are basically three major methods: bid procurement, direct procurement, and negotiation procurement. “Everybody feels that our document is integrated, and some of them should be placed directly on the network. Some may even want to give fuller play to the market mechanism. Through competition, drugs can guarantee quality assurance. In areas where public hospitals are reformed, we Give more flexibility."

Another focus of the problem of pharmaceutical company representatives is the slow approval of drugs, which seriously hinders the development of the pharmaceutical industry. In response, Wang Lifeng, Director of the Department of Drug Cosmetics Registration of the State Food and Drug Administration, admitted frustratingly: “The most prominent contradiction is that our reviewers are too few, the amount reported is too large, and the amount of annual declarations is average. In 9,000 cases, we have only 120 personnel. We have recently expanded recruitment to prepare to spend money to buy services. We will not expand the review team to meet the limitation of establishment. Basically, we will target ourselves for three years, and three years. It can be dynamically reviewed later."

Wu Xi, director of the State Food and Drug Administration, stated that there is a timetable for accelerating the assessment: “We plan to use three years. If we are not satisfied, we will accelerate again.” He believes that for the approval of drugs in three years, the stock should be digested, and the incremental increase should be balanced. Completed by time limit.

Wu Yan emphasized that reducing drug costs largely depends on generic drugs. "Don't underestimate generic drugs. Who does a drug do? The more drugs that are sold, the better the drug must be, and it must be recognized by the society. It must be internationally recognized. We hope that everyone will actively follow international standards. Doing and actively participating, I hope that our generic drugs are competing in domestic and some multinational companies. At the same time, we must go abroad to participate in international competition.”

Fang Zhiwu, an expert from the leading group of the National Medical Reform Office, believes that compared with developed countries, China’s medical reforms have solved more contradictions than foreign ones with less money. He cited several data: The cost of medicine for medical expenses in the United States is three trillion US dollars, China is three trillion yuan, and the United States is six times our country's rate of exchange. In addition, there are 300 million people in the United States and 1.4 billion people in China, which are multiplied by 6 and 5 times respectively, a difference of 30 times. That is, China’s per capita medical cost is 1/30 of that of the United States.