The Research On The Pricing Mechanism And Procurement Of The High-value Medical Devices In Shandong Province

BackgroundThe high-value medical devices refer to something that directly act on the human body,have strict requirements on safety,have large clinical usage,relatively high prices,and heavy burden on the masses.In recent years,high-value medical devices have attracted much attention because of their high prices and rapid cost increases,and the government also attaches great importance to the reform of high-value medical devices.From the deepening of the special discussion of the high-value medical devices of the Reform Commission to the promulgation of high-value medical devices governance programs,all of them explain the reform of high-value medical devices is imminent,but the research on high-value medical devices at home and abroad only stays at the theoretical research stage,and the empirical data is scarce.Based on this,this research is based on the procurement and use of high-value medical devices in Shandong Province,and provides a reference and basis for the future reform of high-value medical devices.ObjectiveThe main purpose of this study is to analyze the procurement data of high-value medical devices from 2015-2017 in Shandong Provincial Centralized Bidding and Purchasing Platform,to explore the price mechanism and demand changes of high-value medical devices,then we will provide a scientific basis for perfecting the centralized procurement of high-value medical devices under the zero-plus policy.MethodsThis research material mainly includes some policy documents on high-value medical devices collected from official websites of domestic and foreign governments and international organizations such as WHO and ISPOR,literature on high-value medical devices from key databases such as the core collection of Web of Science,PUBMED,Springer,and Elsevier.Science Direct,CNKI,VIP,Wanfang Data Knowledge Service Platform and CBM,the second-hand data collected in the China Health Statistics Yearbook,the 2015-2017 centralized procurement data of high-value medical devices obtained from the Shandong Central Purchasing Center,and qualitative information from the interviews with government managers,manufacturers,purchasers and users of medical institutions.We use the content analysis method and the literature analysis method to sort out and summarize the policies.We use the stakeholder analysis method to find the current price formation mechanism and use management problems and countermeasures of high-value medical devices.We use descriptive analysis to use high-value medical devices and summarize the current purchase situation,then we use time series analysis to predict and analyze the consumption of subsequent high-value medical devices.Data was processed and analyzed using Excel and stata15.0 throughout the process.ResultsThis research,through a combing analysis of the management policies in the field of high-value medical devices,found that for a long time,the country has not paid enough attention to the management of high-value medical devices,and there are few special documents.Efforts,and specifically promulgated a special treatment plan for high-value medical devices.Research on the price formation policy of high-value medical devices in Shandong Province can be found that after centralized bidding and procurement,three types of prices will be formed:quoted price,biding price,and trading price.The prices decreased in order,but when analyzing the price of the stent as an example,we found that the bid price decreased by about 4%relative to the quoted price,and the trading price was basically unchanged compared to the winning bid price.Analysis of the use and procurement of several types of high-value medical devices has found that their purchases are increasing rapidly.The consumption of coronary intervention supplies is increasing year by year,with an average annual growth rate of 54.25%and a total of 4.351 billion yuan in three years.Imported products account for the largest proportion and the fastest growth rate.The consumption of tertiary hospitals was 2.76 times to secondary hospital;the consumption of blood purification supplies also increased year by year,with an average annual growth rate of 32.07%,a total of 1.123 billion in three years,imported products accounted for 53.47%,the average annual growth rate was 30.78%,the consumption of the tertiary hospital accounted for 55.85%,the average annual growth rate was 36.13%;the consumption of ophthalmic devices was 540 million yuan,the average annual growth rate was 31.74%,and the imported products accounted for 97%,the third-tier The proportion of hospital purchases was 55.36%,but the average annual growth rate(29.36%)was slightly lower than the 34.85%of secondary hospitals.Conclusion and suggestionsThe study found that,first of all,there are many problems that need to be solved urgently.For example,the multi-sector and multi-rule naming method of product access makes it difficult to unify the coding of devices and increase the management difficulty.The "Administrative Measures on Centralized Procurement of High-Value Medical Devices" issued by the former Ministry of Health as a centralized procurement guidance document,but in the actual implementation process,the price of devices cannot be effectively reduced,and there is no uniform devices code and devices medical insurance catalogue.Secondly,through the analysis of the centralized procurement data of high-value medical devices in Shandong Province,it can be found that the centralized bidding and procurement mechanism cannot effectively reduce the price of high-value medical devices,and the procurement mechanism is too rigid,the adjustment period is too long,and the supplementary procedures and supplementary ports are incomplete.As a result,new products cannot be applied to the clinic,and the price remains unchanged after the price is formed.There is no dynamic adjustment mechanism.Finally,the analysis of the procurement of high-value medical devices found that in recent years,the consumption of high-value medical devices has increased rapidly,much higher than the growth rate of total health expenditure.Based on the above conclusions,in order to further improve the management of high-value medical devices,this study will propose the following:1.Speed up the establishment of a unified devices coding system2.Improve the price formation mechanism of high-value medical devices,and establish a dynamic price adjustment mechanism and monitoring mechanism.3.Exploring to introduce the health economic evaluation of high-value medical devices4.Exploring the procurement based on quantity of high-value medical devices...