Source: Qu Xueshu
Recently, Jiangsu Province Pharmaceutical and Medical Consumables Sunshine Procurement Service Network released the August 2022 price warning variety catalog. Some varieties were suspended due to price differences of more than 10 times.
Its basis is the "Implementation Opinions on Deeply Promoting Sunshine Procurement of Drugs" issued by the Jiangsu Provincial Medical Insurance Bureau in 2021. The implementation opinions propose that if the price is 10 times (inclusive) or more than the highest price of the same variety that has been listed (hereinafter referred to as the highest price of the listed product) when the Sunshine Procurement System is implemented, it will be marked as a red warning★★★, and the transaction qualification of this product is suspended. In principle, medical institutions are not allowed to purchase.
Jiangsu Province Pharmaceutical and Medical Consumables Sunshine Procurement Service Network also released red warning varieties and yellow warning varieties. Although these varieties can be temporarily listed on the Internet, their procurement will also be subject to certain restrictions.
According to the above implementation opinions, if the price is 2 times (inclusive) -5 times, 5 times (inclusive) -10 times higher than the highest price on the Internet, it will be marked as red warning★ and red warning★★ respectively. We will interview relevant companies and remind medical institutions to be cautious in purchasing; if the price is higher than the highest price on the Internet, it will be marked as yellow warning to remind medical institutions.
In short, any price higher than the highest price on the Internet will be marked with color and will be reminded extra. What is more serious is that according to the implementation opinions, focuses on strengthening bargaining and procurement monitoring for drugs included in the price warning scope; for medical institutions with the highest number and amount of early warning drugs, the medical security department will summon and supervise rectification, and if the circumstances are serious, the discipline inspection and supervision department at the same level will be reported to the discipline inspection and supervision department at the same level. directly links the amount of the drug with the supervision of the Commission for Discipline Inspection, which shows the deterrent effect of red card warnings and yellow card warnings.
online price has been fully regulated
Previously, drug online had to go through rounds of bidding, drug price pricing reform, pharmaceutical companies can independently price and directly purchase online instead of bidding. At first, as long as they meet the online conditions, they can go online in real time. In recent years, setting thresholds for new online products has become a common choice for all provinces. All provinces have issued rules for drug listing, and on the basis of linking the lowest prices in the country, they have begun to control the drug listing price.
industry insiders said that medical insurance negotiations, national volume-based procurement and provincial volume-based procurement respectively effectively control the procurement prices of high-priced drugs and drugs with higher sales, while provinces have begun to sort out the prices of other drugs listed online, limiting the prices of drugs according to historical prices, filling in the price management loopholes of non-national negotiations and non-centralized procurement drugs.
Hebei Province issued the "Implementation Plan for Chemical Drugs Online", which pointed out that except for the state negotiated drugs, selected drugs organized by the state and Hebei Province, as well as drugs such as semen, shortage, etc., all chemical drugs applied for online registration must be selected according to the regulations. The drug price must be kept within the 1.8 times price difference. All varieties with prices within 1.8 times the lowest price can be listed online, and are not subject to the number of entrepreneurs; varieties with prices exceeding 1.8 times the lowest price cannot be listed online; for some drugs with good quality, different indications, and specialty for children, such as drugs with prices exceeding 1.8 times the lowest price, they are allowed to be listed online after expert demonstration. The 1.8-fold rule of
has also been learned by Shanxi. The online listing rules in Shanxi Province also clearly state that the lowest price calculated by the reference price difference ratio of the same group of online listing products is used as the benchmark price. The benchmark price is not higher than 1.8 times the benchmark price can be shortlisted for the direct online listing directory. Companies that exceed the price can be requoted and the price limit is not higher than 1.8 times the benchmark price.
In addition, many places have also established early warning mechanisms to warn drugs with excessive purchase prices. Hainan will push a red light warning if the declared price is higher than the lowest online price of this product on the national provincial platform. The green line is the lowest price of the bargaining result for medical institutions and the lowest online price of the national provincial platform on the national provincial platform. The yellow line is the original winning price of the drug (medical consumables) or online price of the drug (medical consumables) in Hainan. The bargaining result is higher than the yellow line, and the system will automatically remind you.Pharmaceutical companies that receive red and yellow light warnings will be suspended from being listed on the Internet if they do not take corresponding corrective measures.
medical insurance payment standards will also be a big move
Industry insiders said that with the upgrade of the cost control policy in the future, the online price limit policies of various provinces may be further upgraded, especially the linkage of medical insurance payment standards and price limits will have a greater impact on the drug market.
This point is also reflected in the implementation opinions issued by Jiangsu Province. After clarifying the red and yellow warning rules, the implementation opinions also urge hospitals and enterprises to conduct substantial and active bargaining and reduce prices from the clinical use end.
If the hospital does not bargain with pharmaceutical companies, then information disclosure and reminders will be made to hospitals of the same level that have not negotiated the total number or amount of drug purchases in hospitals of the same level; hospitals that have not effectively corrected the procurement behavior after the reminder will be conducted with letter of inquiries and interviews and public notices. If the circumstances are serious, points will be deducted in the medical insurance designated performance appraisal, and relevant information will be reported simultaneously to the relevant supervision departments.
implementation opinions also require that the bargaining results must be uploaded to the procurement platform in real time. If a hospital and a company are not bargaining offline but fail to upload the real bargaining results within 7 working days, or conceal, conceal or falsely report the bargaining results in various forms, once discovered, they will be reminded and warned, etc., and if they are not corrected, they will be reported to the relevant supervision department. At the same time, Jiangsu also prohibits hospitals and medical personnel from accepting or requesting rebates, rebates, kickbacks, sponsorship support from enterprises in any form. If the above behavior occurs, it will be reported to the relevant supervision department once it is discovered.
After urging hospitals to bargain on a large scale, Jiangsu Province stated that for drugs within the medical insurance catalog, the actual procurement results of hospitals within the provincial hospitals should be reasonably formulated for medical insurance payment standards for drugs purchased on sunny, and prompted hospitals to actively negotiate and enterprises to actively reduce prices. In this way, price limits are required on the online price, hospitals are urged to bargain, and on this basis, a reasonable medical insurance payment standard is formed, and the prices are promoted to the whole province, thereby better filling in price loopholes.
Attachment: List of other alert varieties in Jiangsu Province
