Evaluation Of Drug "Trinity" Reform Policy In Ningxia

Background: Drug procurement reform is an important part of China’s medical reform. Inorder to reduce the consumer’s burden of medical expenses, the Drug"Trinity" policy reformhas been implemented in Ningxia Hui Autonomous Region since Jan2006, which meansreform in unifying tender operation, price, and distribution. During the policy implemented inthese more5years, whether the policy objectives have reached? How the effect of policyimplementation?To be answer this questions,we need to integrated analysis and evaluationthe Drug"Trinity" policy from all links,it has great significance to promote the policyimplementation in further.Research objectives: This study aims to systematically evaluate the drug“Trinity” policyusing indicators based on investigation of the current status of tender drug use and distribution,as well as responses collecting from doctors and patients. The underlying problems related tothis policy will be analyzed based on the evaluation and possible solutions andrecommendations will be made.Research Methods: Collect the relevant information from medical institutions, healthmanagement departments and residents in sampled region through quantitative survey,personal in-depth interviews and focus group interviews. Evaluation system is set up throughindicators screening and determination through expert consultation. Using the Kruskal Wallistest, Correlation analysis for quantitative data；using the system analysis, comparative analysisconstitute ratio and some qualitative descriptive methods to analysis qualitative data.Results: The Ningxia Drug"Trinity" policy has been put forward based on evidence-basedresearch in the policy making process, the policy has been successfully implemented. The expected effect of the policy implementation achieved as follows: Drug price has beenreduced and regulated the conduct of doctors through unified bidding; Tender led by thegovernment has to protect benefits of patients. The unified drug distribution has regulated thepharmaceutical distribution market, reduced counterfeit drug circulation; promote thedevelopment of local distribution enterprises3.The unified drug price, in primary health caresector has decreased significantly. And the salaries of health worker who work in the primaryhealth care sector has improve. However, the defects of the policy implementation what theproject researched as follows:1. Lack of "Open, Just and Fair " in the complicated tenderprocedures; views from grass roots have been neglected in the formulation of drug bidding list;the quality and effectiveness of the tender drugs has been questioned.; low contractperformance rate of the pharmaceutical manufacturers. Low distribution rate and quantity oftender drugs; the delivery time is longer, especially in remote mountainous areas; thedistribution costs can not meet the running costs of the distribution companies. The medicalservices enthusiasm of primary health care sector has decline; the drug cost in county andabove level medical institutions is still more expensive.Recommendations: In the unifying tender: Improve the bidding system, and enhance thetransparency of the tendering procedure; implement the principle of "quality first withreasonable price" tender score; increase punishment for random raise tender drug price andprevent underperformance of contracts; simplify the tender link and reduce the tender costs.In the unifying distribution: Introduce a new mechanism to improve the distribution effect,and to establish flexible delivery service costs. In the unifying price: To improve theperformance appraisal mechanisms of medical institutions and strengthen health workersprofessionalism education, reduce per-capita health care costs.