Jiangsu publicizes 1642 kinds of base medicines to win the retail price, and the community buys medicine at a cost

Starting from December 2, the Jiangsu Provincial Price Bureau conducted a one-week online publicity campaign on the procurement of 1,642 basic medicines for the procurement of bids for essential drugs. In the current situation where the procurement of pharmaceuticals has been criticized and the drug price is so high that it is called "drug life", can these 1,642 kinds of drugs be purchased at low prices?

In the past two days, with the price list of these 1642 drugs, they visited a number of pharmacies and hospitals in Nanjing and found that the prices advertised were indeed low. According to the regulations, community hospitals must all implement zero sales for essential drugs. So, can these drugs be bought in community hospitals, and can the benefits be truly enjoyed by consumers? In this investigation.


Some drug retail prices are twice the retail price of the successful bid

There are two kinds of prices for this publicity. One is the bid price and the other is the winning retail price. The bid price is the price executed by the community hospital. It is sold at a zero rate by the community hospital, which is how much the purchase price is. The winning bid price is the price after the price increase of 15% of the bid price, which is the so-called maximum retail price. The price of a large hospital cannot be higher than this.

The highest retail price of the 10 drug varieties was selected for comparison. It was found that the price of the 5 drugs in pharmacies was double or nearly twice the retail price of the successful bid.

They are: 6g×10 bags of cold heat granules produced by Shenwei Pharmaceutical Co., Ltd. sell for 16.8 yuan, which is more than double the retail price of 7.9 yuan for winning the bid; Niuhuang Detoxification, 20 tablets of Nanjing Tongrentang Pharmaceutical Co., Ltd. The price of the film is 3.7 yuan, which is higher by 1.5 yuan than the retail price of 2.2 yuan; Shaanxi Hanwang Pharmaceuticals produces 10ml x 18 sticks of the powerful price of 14.4 yuan, which is nearly twice the retail price of 8.1 yuan; The Group's Sanjing Pharmaceutical Co., Ltd. sells 10ml×10 Shuanghuanglian oral liquids for 18 to 19.8 yuan, a retail price of over 7 yuan more than 11.4 yuan; and Sichuan Haobang Sun Pharmaceutical 10g×10 bags of Xiaochaihu granules sells for 9.8 yuan. , 4 yuan higher than the retail price of 5.8 yuan.

The other 5 kinds of drugs and the successful retail price of the bid are relatively close: the price of compound Danshen Dripping Pills is 27.6 yuan, which is lower than the retail price of the successful bid of 1.2 yuan; Guilin Sanjin Pharmaceutical Co., Ltd.'s 2.5g of Guilin Watermelon Frost Spray is priced at 8.5 yuan. The retail price of RMB 7.8 was RMB 0.7. The price of 200ml emergency syrup produced by Taiji Group Chongqing Liling Pharmaceutical Factory Co., Ltd. was between RMB 13.2 and RMB 18.2. The high price was RMB 3.6 yuan higher than the successful bidding retail price. Henan Wanxi Pharmaceutical Co., Ltd. produced The 0.5g x 44 tablets of each box of Jianwei Xiaoshi tablets is priced at 6.5 yuan, which is 2 yuan higher than the successful bid retail price; Nanjing Tong Rentang Pharmaceutical 36g packs Wuji Baifeng Pills at 9.8 yuan, which is 1.2 yuan higher than the successful bid retail price.

Big hospitals: half of the drugs are only expensive one yuan

In the two major tertiary hospitals in Nanjing, basic medicines are small but not expensive. Randomly found 20 kinds of drugs sold, 10 kinds of drugs prices only higher than the retail price of around 1 yuan, 6 kinds of drugs consistent with the retail price of the successful bid, 3 kinds of drugs are lower than the retail price, there is a kind of drugs, expensive 4.6 yuan.

The medicines costing 1 yuan are as follows: 10 ml×10 sticks of Anshen Bunao Liquid produced by Guangzhou Xingqun (Pharmaceutical) Co., Ltd. sell for 12 yuan, a retail price of 1.2 yuan higher than 10.8 yuan; Zhuzhou Qianjin The 0.4g x 24 capsules of gynecological daughters' capsules produced by the Pharmaceutical Co., Ltd. sell for $27.3 per box, which is $0.6 higher than the retail price of the winning bids. The price of compound Danshen Dripping Pills, which is 27mg x 180 for Tianjin Tasly Pharmaceuticals Co., Ltd., is $29.8. , higher than the winning retail price of 1 yuan; Guilin Sanjin Pharmaceutical's 72 pieces of three gold film, priced at 25.5 yuan; Henan Wanxi Pharmaceutical 200 pieces of Xiaoyao pills, priced at 10 yuan.

Cheap drugs include: Tai Chi Group Chongqing Liling Pharmaceutical Factory Co., Ltd. 200ml emergency branch syrup price 11.3 yuan, lower than the successful retail price of 3.3 yuan; Henan Wanxi Pharmaceutical Co., Ltd. 200 capsules Liu Wei Di Huang Wan Price 11.6 Yuan, lower than the retail price of 0.2 yuan.

Slightly expensive drugs are: 0.25g x 48 capsules of Huoxue Zhitong Capsule produced by Jiangxi Changnuo Pharmaceutical Co., Ltd. sell for RMB 24.3, which is RMB 4.6 more than the retail price of RMB 19.7.

Where to buy medicine is more cost-effective?

Buy basic drugs, it is best to go to the community

Pharmacies, large hospitals, and communities are three different channels of medicines, each with its own strengths and weaknesses, and you can use it for reference.

One is a pharmacy. Diversification of drug access channels, there are specialized pharmaceutical companies, but also have their own exclusive "cheats." In terms of price, as long as it is not higher than the national maximum retail price, it is not illegal. The advantages are more varieties, more commonly used drugs, shorter distances, and no need for registration when buying medicines. In terms of essential drugs, there is not much advantage compared to the community, but pharmacies are now “misaligned” with the community. Although they are the same chemical name, sometimes the manufacturers are not the same. Citizens can refer to the purchase.

The second is a large hospital. A single purchase channel, mainly a pharmaceutical company, can increase sales by 15%. If it is to use common drugs or basic drugs, it is recommended not to go to large hospitals. However, the advantages of large hospitals are irreplaceable. The variety of drugs is abundant, and some hospitals have certain drugs.

The third is a community hospital. A single purchase channel, zero sales, there are 599 kinds of basic drugs, the community generally have 300 to 400 kinds to choose from, the vast majority of the price is cheaper than the pharmacy, just need to register to buy medicine.

Drug tender

This year, there are a lot of "cheaper" prices for bidding drug prices.

According to the relevant personage of the Price Bureau of the Jiangsu Provincial Price Bureau, there are a total of 599 varieties of basic medicines catalogued according to Jiangsu Province in 2009. So many drugs are divided into more than 1800 categories according to different dosage forms. For example, Buzhong Yiqi Pill is divided into granules, condensate pills and water pills according to the dosage form, plus different specifications of each dosage form. There are 6 kinds.

"As early as 2009, Jiangsu conducted the first centralized procurement tender. This year is the second tender." The maximum retail price of Chinese medicines for centralized procurement is publicized and divided into two groups. At present, the first batch of 1642 kinds of drugs of different specifications are publicized on the Internet. There are less than 200 different specifications of medicines left, which will be announced in the second batch. However, since the final review has not yet been completed, the second batch of drug prices will be released later and publicized.

Compared with the tender in 2009, the responsible person stated that from the variety point of view, there are fine-tuning of certain drug formulations. From the price point of view, the overall price level is lower than in the past, and some drugs have become lower in price. Some drugs have been awarded a very low retail price, why manufacturers are willing to offer such a low price? In this regard, the relevant person in the price department believes that one of the key reasons is that several companies are producing certain drugs, and competition is fierce. Some manufacturers trade away long-term brand effects at the expense of profits.

In the nuclear price process, the vast majority of drug prices meet the requirements

After the price of all successful bids for the bidding office is released, the highest retail price of all winning bids will be reviewed by the Price Bureau of the Jiangsu Provincial Price Bureau. The price department will pay attention to whether the price difference between the bid price of the medicine and the retail price of the bid is in compliance with the regulations. In addition, the price department must also check whether there is an “upside-down” bid between the manufacturer and the generic name and the same type of medicine. According to reports, the price of 1642 kinds of drugs during the nuclear price process, the vast majority of prices are in line with the provisions, only a very small number of violations of the policy have been corrected.

The relevant person of the Department of Health of Jiangsu Province introduced that this time the goal of basic drug bidding is to enable consumers in the province to use safe, effective, and cheap basic drugs. The vast majority of these drugs are used in grassroots community hospitals and can be easily purchased.

The tendering system is a "double envelope system", that is, a system of two rounds of bidding. In the first round of bidding, we examined the economic level of these drugs and pharmaceutical companies, such as specifications, quality, and services. If this barrier can be passed, then it will enter the second round of bidding. This round takes different measures for different drugs. "The medicines are divided into competitive products and bargaining products. There are about 90% or more of the so-called competitive products. This means that at least two manufacturers produce the same medicine. In this round, the lowest price is included. In addition, there is still 10%. Bargaining drugs refer to medicines that are produced by only one company. In order to prevent drug prices from spreading all over the world, mandatory negotiations are adopted to minimize prices.

After the implementation of the basic drug system, the goal is to centralize purchases and payments to give profits to the people. “It can be said that in auction medicines, it is difficult for the market to find prices lower than this. In bargaining medicines, there may be lower prices on the market. , but not too much, and the small number of drugs in this part will not have too much impact on us." The provincial Health Department said.


Medicines needed by community hospitals are not available on some

Lu Ying, chief of the Hospital of Nanjing, Baixia District, said that 599 kinds of drugs are only chemical names of medicines, and that the real categories add up to more than 1800 kinds. For community hospitals, the main job is to select medicines suitable for the needs of the community from the Zhongzheng because all It is very unrealistic for medicines to enter the community.

“Our hospital now purchases more than 370 essential drugs. There are more than 700 kinds of essential medicines in the community plus proprietary Chinese medicines. There is no need for thousands of essential drugs, such as felodipine, a commonly used drug for hypertension. Under the district, four species were purchased, both domestically produced drugs and joint ventures, both 2.5 mg and 5 mg, to meet the needs of different groups of people. After each dosage form, there are others. There is no need to purchase the product specifications," said Lu Kechang.

A person in charge of a community hospital in Nanjing said that sometimes it will be based on the characteristics of the community to purchase, for example, some children in the community see more patients, and they will enter more children's dosage forms. "Each community hospital has different characteristics, and the basic drug types will also be omitted. Differences."

On the other hand, the supply of medicines is a bit difficult. A pharmacy department official at a community hospital said that at present, there are 15 types of species that are needed in community hospitals, but they are often not even available. Even more than 10 yuan can basically ensure supply, but within 10 yuan, especially It is very difficult for drugs below 1 yuan. For example, norfloxacin, which has a price of 0.45 yuan, is often unavailable for purchase. This year it was even out of stock for four months and has not been supplied until now. "Though these drugs do not sell well, they are always so out of order. It is indeed a bit worrying."

"Our hospital's drug sales are 2.7 million yuan a year. If there was a price increase before, there would be 400,000 yuan of income. Now that this money is gone, the relevant reform compensation measures have not yet been fully implemented. The pressure on community hospitals is not small." The head of the community hospital revealed.


The basic drug system is expected to “stretch” upwards from community health service organizations

The sharp drop in drug prices was due to the fact that the government-run community health service agencies fully implemented the basic drug system. However, the “big head” of medication—the proportion of basic medicines used in large tertiary hospitals is not high. At present, there is no hard regulation for the use of essential medicines in tertiary hospitals by the competent authorities, and basic medicines only account for more than 10% of the total sales of medicines. According to the person in charge of the Provincial Health Department, Jiangsu will “extend” the base medicine system on the basis of the full implementation of the base medicine system in community health service agencies. At present, the provincial health department is investigating and setting a minimum ratio for the use of essential drugs for the second and third-tier hospitals.

It is understood that the drug-based system is not merely a drug problem, but also involves a series of supporting reforms. Since the hospital's reliance on drug profits is still relatively large, the hospital may face difficulties in survival and development if it increases the amount of “zero difference” essential drugs without resolving the compensation issue. The person concerned believes that the key is to form a mechanism that allows the hospital to motivate the use of cheap essential drugs: "The payment method is very important, and we must gradually explore various payment methods such as payment by case basis and total advance payment."

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