Research On Centralized Government Procurement Of Medical Insurance Drugs With Volume

Since the 19 th session of the national congress of the communist party of China,healthcare system reform has been continued in-depth advancement as a livelihood project.General Secretary Xi Jinping pointed out at the conference that people's health is an important symbol of national prosperity and the government shall improve the national health policy and provide a comprehensive health service of the life cycle for the people.He also pointed that we should deepen the reform of medical and health system,comprehensively establish basic medical and health system,medical security system,and high-quality and efficient medical and health service system with Chinese characteristics,perfect modern hospital management system,abolish the “supporting medicine with drugs” policy,and improve the drug supply guarantee system.Medicine reform is an important part of “Three medical linkages”(the joint reform of medical service,medication,and medical assurance).As the current medical market in China is still not standardized enough,there are a lot of problems existing,such as virtual low and high drug prices,low capacity and repeated production,shortage of supply,disorderly competition,serious problems of“with the gold takes on a sales mode” in the field of medicine purchase and sale,insufficient regulation of medical service industry,etc.It is very urgent to explore a new mechanism for drug price formation in medicine reform to standardize the order of drug circulation and reduce the burden of drug use.Purchase with target quantity is a common practice in international drug purchasing which has been applicated in Hong Kong for many years and is still in the early stage in the Mainland.In recent years,drug purchasing with quantity has been explored Shanghai,Fujian,Wuhan and other places and has played a positive role in promoting the drug prices back to a reasonable level.The following benefits can be achieved through purchase with target quantity.Firstly,encouraging enterprises to improve the quality of medicines to ensure that patients can use medicines with high quality and reliability;secondly,lowering the price by quantity,squeezing out thevirtual part of drug price,reshaping the market discovery mechanism of drug price,lowering the false high price,and reducing the unreasonable expenses of medical insurance fund;thirdly,eliminating “supporting medicine with drugs” situation,putting an end to drug sales promotion and drug rebates by pharmaceutical enterprises from the perspective of mechanism,purifying the medical staff and promoting the healthy development of the pharmaceutical industry.Since 2010,in responding to the requirements of the government in Shanghai,Shanghai took the lead in implementing the drug bidding and purchasing work led by the medical insurance department in the whole country.From 2015 to 2018,Shanghai has conducted three times of purchase with target quantity on common medical insurance drugs.It has created a model for the integration of drug recruitment and acquisition and plays a positive role in promoting the optimization and upgrading of the pharmaceutical industry.In 2018,the institutional environment of drug centralized purchase has undertaken a positive change.Based on previous experience of purchase with target quantity in Shanghai and other regions,according to the general idea of "national organization,alliance procurement,and platform operation",the newly established National Healthcare Security Administration organized eleven cities to form a purchasing alliance of experimental units of purchase with target quantity and further promote the joint reform of medical service,medication and medical assurance.This is a strategic institutional arrangement that is of help to the broad masses of the people.It has far-reaching practical and historical significance for dealing with difficulties of medicine reform,improving the industry ecology,and constructing strategic institutional arrangements for constructing market order of fair competition.This paper is divided into five chapters.In the first chapter,by using the method of literature analysis,starting from the development process of centralized drug procurement mode in China and the current research situation at home and abroad,the significance of the research on centralized government purchasing of medicines for medical insurance is extended,and the research ideas and methods,possible innovations and shortcomings are put forward.The second chapter is the definition and theoretical basis of the relevant concepts.Based on the perspective ofgovernment procurement,the necessity of centralized government procurement of medical insurance drugs as quasi-public goods is analyzed.The third chapter focuses on the documents and data of three batches of drug purchasing in Shanghai,and analyses the data from the scope and varieties of drugs,bid evaluation rules,winning results,policy implementation effect and so on.Chapter IV briefly introduces the basic situation of the pilot project of China's belt purchasing based on Shanghai's belt purchasing model(i.e.4+7 City drug centralized purchasing),and analyses the difficulties of carrying out belt purchasing for medical insurance drugs and the factors that may affect the implementation of belt purchasing.This paper compares the centralized purchasing mode of national pilot drug with that of Shanghai drug quantity purchasing mode,describes the specific methods and supporting measures of centralized purchasing of national pilot drug,analyses the characteristics and difficulties of centralized purchasing of drug quantity,finally puts forward my own conclusions and policy suggestions,makes feasibility analysis on promoting the mode of centralized purchasing of drug quantity in an all-round way,and perfects the mode of centralized purchasing of drug quantity in the future.The direction of purchasing mode is put forward.