Medical network - on March 27, is apart from the national health development planning commission on January 19th press conference interpretation of purchasing drug purchase in public medical institutions in the implementation of the implementation of the "two votes" opinion (try out) "(the reform do hair (2016) 4, hereinafter referred to as" the health "4) has passed two months. 

 

Across the globe, except a few provinces action is unknown, most of the provinces with a formal or informal (web version) policy document conveys the region drug distribution scope of the implementation of the "two votes", to promote the progress and execution, etc. 

 

The overview 

 

Policy to escort 

 

Under the state council on February 9, issued "on further reform and improve the pharmaceutical production circulation use policy several opinions (countries do hair (2017) 13), involved in three areas, a total of 17, a drug annual focus. Among them, in the field of drug circulation, article 13 for the "two votes" overweight, made clear that "the implementation of drug purchase and sale of two votes, in the national push for 2018". 

 

Since last April, in fact, article 26 of the state council put forward the "comprehensive reform pilot provinces throughout the province to carry out" two votes ", since the top of its mood is clear. In early 2017, CCTV firing again, with three special news focus on drug prices and health care, from the high commission under high drug prices to to say no to higher medical consumable materials, and then to the "3 d linkage" to medical disease operation ", CCTV exploration for people to propaganda the fujian sanming mode "two votes", "two votes" for 2017 the full implementation of. 

 

Will elongate the time line is easy to find, from 2006, guangdong medicine for files in the flash in the pan, to reform star following the success of the province of fujian province for many years practice, in the present reform into the deep water area, the "two votes" has not only is a measure to improve the drug procurement system, also is not limited to some current mess of the regulatory approach, but three important breakthrough of the reform of medical linkage, might be expected. 

 

Pilot provinces bask in progress 

 

Reform on the national version of the implementation opinions (countries do no. 4) before, many provinces began the exploration of the "two votes". Healthcare benchmarking anhui province governs incorruptibly, since November 2016 on all public medical institutions in the province of two votes. Now, the "two votes" has been largely into the rest of the health reform pilot provinces advance schedule. 

 

11 health of the provinces, in addition to the fujian, anhui, shaanxi, qinghai, chongqing are released the official version of the "two votes" implementation opinion. 

 

Health reform pilot provinces "two votes" process (by 2017.3.15) 

 

 

Overall, the provinces have different schedule, promote the scale also has certain elasticity, but the basic principle and the national version consistent opinion. 

 

, for example, most of the provinces to pharmaceutical production enterprise (group) set up the only sales of the enterprises wholly owned or holding (group) pharmaceutical trading enterprises shall be regarded as production enterprises, and mostly stressed the "national only 1", but is no uniqueness in anhui, the implementation of the qinghai's instructions. 

 

In addition, the provinces are more or less give medical institutions and industrial and commercial enterprises transition. Such as western provinces tend to implement the "two votes" step by step, first by the urban tertiary public hospital, and then spread to the secondary and primary care institutions; And hunan provinces such as giving the transformation of enterprise marketing, financial processing, channel merging buffer time. 

 

Focusing on the 

 

Jiangsu slower 

 

From the current health care reform pilot provinces of the progress of the "two votes", jiangsu, zhejiang, Shanghai "two votes" lag is especially noteworthy. The author analyze reasons are as follows: 

 

Jiangsu: pharmaceutical province decision prudently 

 

Jiangsu drug itself is a big province, according to the data of China health statistics yearbook, jiangsu in 2015 hospital drug cost ranked second with 67.82 billion yuan. At the same time, the big pharmaceutical province of jiangsu is well-deserved, the pharmaceutical industry in jiangsu province in 2015 output value exceeding RMB 400 billion, 417.02 billion yuan, which accounts for nearly 1/7, the second in the country, including chemicals, medical equipment size has grown into the domestic first. Jiangsu province not only has the Yangtze, hengrui, zhengda shine, he markets such as the optimization performance and innovative strength pharmaceutical backbone enterprises in, to be nearly 350 growth drug firms to GMP 100% pass rate, the number of new drug applications, the clinical batch number, listed on the approved number ranked the top honors as a strong backup in the country. 

 

"Big pharmaceutical province" and "drug province" the dual role of also determines the province on the medicine policy, consultation, or scope of implementation and the way the determination of all face a more complicated interests balance. Many large taxpayer "two votes", the province's marketing transformation, financial capacity are facing the challenge, therefore, jiangsu province in "two votes" policy the first response, positive remarks, but when push to err on the side of caution is understandable. 

 

Zhejiang: "third-rate unity" procurement platform 

 

Zhejiang as early as 2015 set off a "votes" relevant policies. On May 8, 2015 in zhejiang province who planning commission announced on the innovation mechanism of the provincial drug centralized purchasing opinion (draft) ", file it as it comes to cause an industry outcry. 

 

In addition to the drug price is the lowest price linkage, bring the purchasing negotiation bargain hard efforts, also made clear since July 2015, formally launched drug centralized purchasing related reform, reform core is through the construction of information flow, business flow, cash flow "the unity of" third-rate drug centralized purchasing online trading platform, so as to regulate the behavior of drug purchase, government and society to YaoXie procurement process monitoring. Platform at the same time, "third-rate unity" to "two votes" or "votes" provides a strong support on the level of technical operations, and a "votes" direct threat to the pharmaceutical commercial enterprises of living space, about survival is also released the file at the beginning of the dispute. 

 

From the bidding level, zhejiang confirmed by drug prices since January 2015 after the second batch of drug purchase in the form of no large scale, and the 10% price reduction as the threshold, and according to the sales ranking JieTiXing price only for the second batch of bidding in the province has a distribution record of drugs, does not give new drugs for chance. According to the report, zhejiang are poised for new drugs and the third batch of tender, no trading record drugs and the recruit mining will be implemented with "two votes" company. 

 

Above all, adopt policies of zhejiang in recent years, the drug action and practice can be seen that zhejiang government to regulate the behavior of drug procurement and reduce YaoXie purchase price determination is very obvious. In this sense, the "third-rate unity" of the platform structures, as the important content of the reform of the drug purchase in the province, the first in the "two votes" policy that is should be. 

 

Shanghai: the GPO and "two votes" both 

 

Compared with a number of health care reform pilot provinces, the reform measures is to err on the side of the industry in Shanghai. To cancel the medicine and become a public hospital patients, Shanghai three stages canceled, respectively in December 2015 and September 2015, in February 2017, the cancellation 5%, along with all kinds of health service fees during the period of ascension. In respect of drug supply security reform, Shanghai pharmaceutical group purchasing (GPO) as the gripper, price oriented, squeeze out the moisture in pharmaceutical circulation by reducing prices, both at a disadvantage to the people, and to arouse the enthusiasm of members to the hospital. 

 

In terms of "two votes" advance, although no formal document issued in Shanghai, but the government, industry associations, enterprises have held a seminar for many times. It is worth mentioning, 122 Shanghai pharmaceutical commercial enterprises, the prescription with state-controlled occupy about 80% market share, coverage at the grass-roots level are more perfect, therefore, even if the rules of Shanghai "two votes" supply distribution can be an additional tickets, but under the state-controlled entrenched prescription, many small and medium-sized business survival predicament facing particularly remarkable. In advance schedule, according to industry insiders, Shanghai "two votes" file will be announced in April 2017, introduced the implementation, the state-controlled leading prescription with sunshine do information docking platform, before the end of 2017 the city of full implementation of two votes. 

 

We can say that 2017 is the year of Shanghai pharmaceutical sales reform measures be born, along with the GPO member unit gradually get VAT general taxpayer qualification, GPO will accompany with "two votes", also will improve pharmaceutical commercial enterprise concentration.