High Price Of In-Vitro Diagnostic Reagents Under Centralized Procurement And Competition Policy

In vitro diagnostics refers to a diagnostic method that obtains clinical diagnostic information by detecting samples of human body fluids,cells,and tissues in vitro,and then determines the disease or body function.More than half of global medical decisions are made based on in vitro diagnostics.With the continuous improvement of medical health,the average growth rate of China's in vitro diagnostic industry in recent years is about 20%,far exceeding the global average compound growth rate of 4.8%.In vitro diagnostic reagents play an important role in medical services.In order to gradually promote the rationalization of purchase prices and effectively reduce the inflated price of in vitro diagnostic reagents,since the implementation of centralized procurement of in vitro diagnostic reagents in Sichuan Province in 2017,Anhui Province,Shanxi Province,Hainan Province,Nei Monggol Autonomous Region,and Gansu Province have successively implemented in vitro diagnostic reagents purchase.Centralized procurement requires medical institutions and in vitro diagnostic reagent production and operation enterprises to conduct procurement through a centralized procurement work platform established in each province,and implement unified organization,unified platform and unified supervision.According to the experience of centralized procurement of medicines and high-value medical consumables,under the provisions of the maximum price limit and the dynamic adjustment of prices,the prices of medicines and high-value medical consumables have fallen.In 2018,the gross profit of in vitro diagnostic reagents rose without decline compared with 2015.The gross profit margin of the main business of listed companies for in vitro diagnostic reagents in 2018 is much higher than that of industrial enterprises above designated size and listed companies in the pharmaceutical industry.The high price of in vitro diagnostic reagents has increased the cost of inspections in hospitals,resulting in high inspection costs and increased medical expenses.The impact of centralized procurement on the price of in vitro diagnostic reagents is lacking academic research.This article believes that the lack of bargaining for exclusive product regulations and the conspiracy of non-exclusive product regulations are the main reasons for the insufficient price reduction of in vitro diagnostic reagents under centralized procurement.Due to the inconsistent common names of in vitro diagnostic reagents and the disordered product specifications,it is difficult to divide the bidding group into centralized procurement.In addition,the proportion of blocked in vitro diagnostic reagents is increasing.In the case of a large proportion of exclusive product regulations and an increasing trend,the lack of a reasonable control mechanism for exclusive product regulations in the centralized procurement policy is one of the main reasons for the insufficient price reduction of in vitro diagnostic reagents.In addition,this article combines the provinces(autonomous regions)with the implementation plan for centralized procurement of in vitro diagnostic reagents,and studies the formation mechanism of collusion under centralized procurement.It was found that the regulations on the maximum price limit and dynamic price adjustment in centralized procurement,the lack of provisions on the existence of common shareholders in competing companies,and the lack of punishment for conspiracy will promote collusion among enterprises,making the motivation for companies to deviate from collusion smaller and conspiracy It is easier to maintain,which results in the centralized procurement of in vitro diagnostic reagents can not achieve the desired price reduction effect,and the above view is supported by examples.In this article,the proportion of inspection costs to pharmaceutical costs is used as an indicator to measure the effectiveness of centralized procurement of in vitro diagnostic reagents.The reason is that the purpose of the centralized procurement policy is to reduce the price of in vitro diagnostic reagents,and the price of in vitro diagnostic reagents is an important part of inspection costs.The cost of inspection can be seen in the price reduction effect of in vitro diagnostic test reagents.In this paper,the provinces that implement centralized procurement of in vitro diagnostic reagents are used as experimental groups,and the provinces that have not implemented centralized procurement of in vitro diagnostic reagents are used as control groups.By constructing a double difference model,it is concluded that the centralized procurement policy has not achieved the result of reducing inspection costs.The last part of this article makes policy recommendations.Relevant departments should unify the coding standards for in vitro diagnostic reagents to promote competition for similar reagents,make it easier to compare the prices of similar products,and reduce the price of reagents.Establish an open and transparent price negotiation mechanism for exclusive in vitro diagnostic reagents.In addition,in view of collusion in centralized procurement,collusion control mechanisms should be established and improved as soon as possible.First,the information of stakeholders involved in centralized procurement companies should be disclosed before quoting.The second is to strengthen the ability to identify collusion.Third,economic and criminal penalties are imposed on corporate collusion.The fourth is to reduce the government's regulatory cost of corporate collusion.Fifth,the use of leniency policies can exempt or reduce penalties for surrendered member companies.