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Critical Policy Turning Point of Centralized Drug Purchase

2018-12-29 17:07:31
"Time seems to suggest that every five years, China's centralized drug procurement policy will undergo a major change, a major turning point. In 2014, this turning point is likely to come.

It has been nearly 15 years since the implementation of centralized drug procurement. No. 308, which marked the establishment of centralized drug procurement system in 2001, and No. 320, 2004, further improved the policy of centralized drug procurement. In these years, the policy framework of centralized drug procurement has been initially established and the national unified model of drug bidding has been implemented.

In 2005, Sichuan's trial of hanging up the Internet triggered a wave of thousands of stories. Hundreds of flowers blossomed everywhere to explore the pilot projects. Ningxia's "three unification" and Guangdong's sunshine procurement policies emerged one after another. The author summarized the bidding at this stage into 18 modes. It was five years since the release of the new medical reform plan.

In the past five years, No. 64 was promulgated for centralized purchasing of non-basic drugs in medical institutions at county level and above, and No. 56 for centralized purchasing of basic drugs in primary medical institutions. Although both documents were drafted by the former Ministry of Health, they came from different departments, so they adopted totally different centralized procurement methods.

The biggest difference is that No. 64 is a comprehensive evaluation method, with the highest score ranking and multi-product bidding, while No. 56 is a "double envelope bidding" with low price ranking, the lowest price winning bidding and single source commitment.

Time seems to remind us that every five years, China's centralized drug procurement policy will undergo a major change, and there will be a major turning point in policy. By 2014, documents 64 and 56 have been implemented for five years in a twinkling of an eye. Does that mean that there will be another major adjustment this year?

The facts may confirm that conjecture again.

According to the timetable stipulated in the Notice of the General Office of the State Council on the Issue of Key Tasks for Deepening the Reform of the Medical and Health System in 2014, the Guiding Opinions on Improving the Centralized Procurement of Drugs in Public Hospitals (hereinafter referred to as "Guiding Opinions") of the Health Planning Commission (hereinafter referred to as "Guiding Opinions") could not be issued before 30 June, and is now in the process of intensive discussion and revision. Based on the analysis of the two versions that have been published and the recent implementation plans or draft solicitation issued by Zhejiang, Sichuan, Fujian, Hebei, Hubei and Shaanxi provinces (cities), the author predicts that 2014 will be the turning point of the policy of centralized drug procurement in China. It is embodied in twelve aspects.

1. A document governs bidding for essential and non-essential drugs

Previous documents 64 and 56 have their respective functions, one is to manage the bidding of non-essential drugs, and the other is to control the bidding of essential drugs. With the continuous exploration of various places, the two modes have gradually emerged as a trend of integration, reference and reference. The two documents belong to different departments, with different requirements and even inconsistent concepts. They are far from meeting the current demand for centralized drug procurement. The Guiding Opinion synthesizes the reasonable contents of the two documents. With its formal introduction in 2014, it will become a programmatic document for unified centralized drug procurement in the future.

2. Classified Purchase as Future Direction

Classified procurement has been described in previous documents. In 2014, it seems that tender offices around the country have reached a high consensus under the guidance of the policy of the Health Planning Commission. This principle has been embodied in the centralized procurement schemes of many provinces.

For example, Hebei Province divides basic drugs into two categories: non-bid evaluation drugs and bid evaluation drugs for bidding; Hubei Province divides the bidding catalogue into four categories: commonly used low-price drugs, shortage drugs, basic infusion drugs and bid/bargain drugs, and adopts different bidding methods; Sichuan Province divides the centralized procurement into four categories: self-procurement drugs by medical institutions, commonly used low-price drugs, and bargaining drugs. Pharmaceuticals in Zhejiang are also classified into four categories: basic drugs, low-cost drugs, medicines with tight supply and non-mainstream drugs, which are evaluated, announced in stages and implemented step by step.

The Guiding Opinions also make it clear that the following products can be purchased separately, such as some patented drugs, exclusively manufactured drugs, non-patented drugs for gynecology and pediatrics, emergency (rescue) drugs, drugs with small clinical dosage, commonly used low-cost drugs, medicines that are clinically necessary, in small dosage and in short supply in the market, ethnic drugs, narcotic drugs, psychotropic drugs, medicines for free treatment of infectious and parasitic diseases. Vaccines, family planning drugs and Chinese Herbal Pieces for the National Immunization Program, etc.

3. Double envelope review no longer distinguishes between basic and non-basic drugs

Double envelopes, originally stipulated in document 56 for centralized procurement of essential drugs, have been widely used in bidding for non-essential drugs and medical consumables in recent years. Various signs indicate that double envelopes will become the future direction of centralized procurement. Sichuan Province, which has been in operation for ten years, began to implement this method in 2014. Zhejiang, Hebei, Shaanxi, Gansu and other provinces that have issued centralized procurement plans or solicited opinions have adopted this method (except Jiangxi and Guangdong).

However, this double envelope is not the other two envelopes. In the past, double envelopes were the first to evaluate technical bids, with a certain proportion of entries. Those with low commercial bids won the bid, just like the preliminaries before the finals, the preliminary results were not brought into the finals and won the first place. Now it has been improved as follows: after entering the technical tender, comprehensive evaluation in the commercial tender takes up 60% and 40% of the total technology and price, respectively; taking the high or low comprehensive score, or taking one of them, or taking two high comprehensive and one low comprehensive tender, as in the preliminary and final competitions, the preliminary results are brought into the final competitions, and the first place is no longer one with multiple criteria.

4. Loose Policy of Single Source Commitment and Lowest Price Winner

No. 56 Advocates Single Source of Goods