National procurement speed expansion of high-value medical supplies focus on orthopaedic supplies, drug balloon, dental implants and other species

The next step is to consolidate the new normal, promote the speed and expansion of set mining, shape a new ecology and build a new pattern.

"Collective procurement is a big system innovation, system integration reform, this reform is not a single goal, it is a dynamic balance of multiple goals." On 11 February, at the State Council Information Office held a regular State Council policy briefing on the progress of the reform of deepening the centralised band purchasing of drugs and high-value medical consumables, Chen Jinfu, deputy director of the State Medical Security Bureau, said.

From the present point of view, the state organisation, alliance procurement has formed a regular pattern, centralised bidding regulation, quality, supply, distribution, use of the guarantee mechanism and supporting policies are also increasingly improved and optimised. At the same time, while participating in the national collective procurement, the local authorities have also carried out different forms of provincial and inter-provincial alliance collective procurement, and from the perspective of procurement varieties, the three major categories of drugs, namely, chemical drugs, proprietary Chinese medicines, and biological drugs, have been involved, and two varieties, namely, coronary artery balloon and ophthalmic IOLs, have been achieved to achieve the full coverage of the provinces.

From the perspective of the results achieved, the collection and procurement rules continue to optimise, quality supervision is more rigorous, the supply guarantee is more stable, the use of policy is more perfect, the overall presentation of the "price reduction, quantity rise, quality" trend. Chen Jinfu pointed out that the next step is to consolidate the new normal, promote the centralised purchasing to speed up and expand, shape a new ecology and build a new pattern.

Talking about the centralised band purchasing on the innovation of drug enterprises and the impact of production enthusiasm, Chen Jinfu pointed out that the promotion of the system from the collection and procurement, including the setting of specific operating rules, is always the healthy development of the pharmaceutical industry and the quality of clinical enhancement, the accessibility of the people (603883) access to medical treatment of the three objectives together with the overall balance of consideration. "China is building 'Healthy China', the development process will strongly improve the people's medical standards, as long as the immediate need for medication in, improve China's health and health level of investment in, there will be a market. Institutional promotion can truly enable Chinese pharmaceutical (600056) companies to move towards quality maintenance and innovation drive through fair competition." On 11 February 2022, China's State Council Information Office held a regular State Council policy briefing in Beijing to introduce the progress of deepening the reform of centralised band purchasing of medicines and high-value medical consumables, and to answer questions.

Centralised procurement speeds up and expands

Since 2018, the State Medical Insurance Bureau, together with relevant state departments, has taken banded procurement as the core to promote the reform of banded procurement of medicines and high-value medical consumables, and after three years of efforts, the reform of centralised banded procurement has entered a new stage of normalisation and institutionalisation, with six batches of banded procurement of medicines having been carried out so far, and a total of 234 types of medicines have been procured, with the amount involved accounting for 30 per cent of the total amount of the annual drug procurement of public medical institutions.

Chen Jinfu further introduced that the average reduction of the first six batches of centralised procurement of drugs was 53%, the average reduction of cardiac stents was 93%, and the average price reduction of artificial hip and knee joints was 82%, which has strongly squeezed out the space of inflated prices. From the cumulative results of three years of reform, the state organised centralised procurement to save more than 260 billion yuan. The overall drug price level is on a steady downward trend, and from the drug price monitoring data carried out by the Medical Insurance Bureau, the overall price level of drugs has continued to decline in the two years of 2019 and 2021, reaching an annual average of about 7%.

Statistically, the share of centrally procured varieties in which the masses use originator drugs and drugs that have passed the consistency evaluation of quality and efficacy has risen from 50 per cent before the centralised procurement to more than 90 per cent. Take cardiac stents as an example, originally among the stent products, 1/3 are stainless steel, now basically eliminated, the use of selected chromium alloy reached 95%; another example is imatinib in "I am not the God of Medicine", after going through the centralised purchasing, its use grew to 35%, so that patients in need of treatment are fully guaranteed medication."

Chen Jinfu called speeding up and expanding the surface of the normalisation and institutionalisation of the proper meaning, mainly reflected in the speeding up of varieties, the expansion of the area covered by the pooled collection, and sustained efficiency, expanding the benefit of the people in three aspects.

"What we are currently planning is the seventh batch of centralised band purchasing of medicines. From the situation over the past three years, including local collective procurement, the average number of collected varieties per province has reached a cumulative total of 50, and high-value medical consumables have reached three. This year, we will guide the local according to the clinical needs, around the big varieties and common diseases, check and fill in the gaps to promote, and strive to carry out in each province of the provincial collectively procured varieties can reach more than 100, high-value medical consumables can cover up to 5 varieties." Chen Jinfu pointed out.

Chen Jinfu said, the original collection mainly focused on chemical drugs, last year expanded to insulin, artificial joints. This year, in accordance with the principle of "one product, one policy" for the masses reflect more, the price adjustment space for large varieties of consumables to carry out centralised volume purchase of high-value medical consumables, this year, we are prepared to carry out centralised volume purchase of orthopaedic spinal consumables. At the local level, further exploration in other areas. Including proprietary Chinese medicines, in some provinces last year has been organised on the basis of alliance procurement, this year to further expand the scope in an orderly manner. In this way, the three major areas of full coverage, there is no room for the survival of fluke band gold sales.

Drug collection in the chemical drugs, pCms, biological drugs in all three major segments, high-value medical consumables focus on orthopaedic consumables, drug balloon, dental implants and other varieties, and strive to achieve an average of more than 350 drug varieties covered in each province by the end of 2022 through the national organisation and provincial alliance purchasing, and more than five varieties of high-value medical consumables, so as to make it the new collection norm, thus achieving the stabilisation of the social expectations and stabilise the industry ecology.

Promoting high-quality development of the pharmaceutical industry

For the production and supply guarantee of selected products, Zhou Jian, head of the Department of Consumer Goods Industry of the Ministry of Industry and Information Technology, said that the Ministry of Industry and Information Technology attaches great importance to the deepening of the reform of the centralised banded procurement of pharmaceuticals and high-value medical consumables, during which it has carried out the dynamic monitoring of the production of national centrally procured pharmaceuticals and coordinated the resolution of the practical difficulties faced by enterprises, as well as continued to enhance the ability of the national centrally procured pharmaceuticals to guarantee their production and supply.

"The next step, the Ministry of Industry and Information Technology will follow the deployment of the State Council executive meeting, continue to do a good job in the centralised procurement of the production and supply of selected products to ensure the work. First, continue to carry out dynamic monitoring of the national centralised procurement of drugs, timely detection and coordination to solve the incipient problems that may affect the production and supply, to ensure that our selected varieties can be a stable supply of the market. The second is to effectively supervise enterprises to do a good job in the production and supply of the selected varieties, support enterprises to carry out technological transformation, enhance the production and supply security capacity. Thirdly, we focus on the short-board problems of the pharmaceutical industry, support a number of high-quality projects to solve the key common technology, strong demonstration and drive the role of enterprises in the production process, high-end auxiliary materials, pharmaceutical equipment and other short-board gaps in the field to achieve new breakthroughs." Zhou Jian pointed out.

Centralised band purchasing can effectively reduce drug prices and save the health insurance fund and residents' medical expenses, but there are also voices pointing out that the reform may affect the innovation and production enthusiasm of pharmaceutical enterprises.

In this regard, Chen Jinfu pointed out that some enterprises are indeed still anxious. "Because it is true that in the middle of fierce competition mainly rely on cost and quality, of course, there is also the role of the baton of the rules. We from the collection and procurement system to promote, including the setting of specific operating rules, is always the healthy development of the pharmaceutical industry and clinical quality improvement, the accessibility of the people to medical treatment of these three goals in one piece to the overall balance of consideration."

Its introduction said that from the beginning of the design, this system is tightly focused on the problem of inflated prices of medicines orientated, tightly focused on the provision of high-quality medicines for the Chinese people, the use of pricing tools, and play the role of the market mechanism.

Chen Jinfu pointed out that the centralised band purchasing, that is, band purchasing, recruitment and procurement in one, is considered from the perspective of the enterprise. At the same time, the medical institutions to purchase drugs, must ensure that the return, but also to ensure that the bidding and purchasing as far as possible to reduce the administrative costs of enterprises, "the pharmaceutical industry, especially in the field of consumables, the backlog of payments is a big problem, more than half a year of drugs, consumables more than a year of non-recovery accounted for a large proportion of the set of procurement after its return to be strongly guaranteed".

“这些从集采规则本身，对医药企业产生的影响，从原来的带金销售公关，走向真正的质量和成本的竞争，真正促进它形成规模效应，真正推动中国仿制药进入头部企业。有些企业反映，想通过集采真正做大做强，走向国际，甚至成为国际仿制药大企业、头部企业，这都是有可能的，这是一个概念，制度性的影响。”陈金甫指出。