On June 9, 2007, the joint conference on comprehensive health reform in the four provinces of fujian, zhejiang and anhui province was held in Shanghai. This is the last November reform do four provinces and one city signed the "Shanghai neighboring fujian" system of joint conference for comprehensive reform in four provinces and one city agreement, a joint meeting for the first time. 

 

It is worth noting that the meeting made clear the division of labor in the work of health reform in the four provinces. In terms of drug purchase, will be led by fujian province, several kinds of large dosage, high price of the original, joint procurement of four provinces and one city of exclusive varieties and price negotiations. In addition, a city in four provinces has also decided to share information about the purchase price of drug consumables. 

 

The four provinces and a city jointly procured 

 

It is understood that the meeting of the joint meeting of comprehensive health care reform in four provinces and one city 2017 annual work arrangements drug joint procurement work plan of the four provinces and one city "the high value medical consumables in four provinces and one city joint procurement work plan" Chinese medicine "four provinces and one city supply reform pilot scheme" and so on four schemes are discussed. 

 

For the specific work of division of labor, four provinces and one city of Shanghai will take 3 armour hospital as the bibcock, medical institutions associated with the four "min" neighboring provinces of 1 ~ 2 medical association, by the high quality output and radiation of medical resources, in the subject, talent, technology, management and other aspects to carry out close cooperation, promote regional health service ability. Anhui province should play the important role in deepening the reform of traditional Chinese medicine, reform on the supply side, expand the services of traditional Chinese medicine effective supply, to speed up the construction of whole life cycle, connotation is rich, reasonable structure of the traditional Chinese medicine health service system. 

 

On medical consumables procurement, the promotion of ningbo city, zhejiang province medical consumables quantity procurement experience, choose 1 ~ 2 kind of big dosage, high price of medical consumables, joint procurement, the four provinces and one city of procurement concentration, compression inflated prices. On drug purchase, led by fujian province choose several large dosage, high price of the original and exclusive varieties, joint procurement and price negotiation practice the four provinces and one city, giving full play to the advantages of scale, compression inflated prices. In jiangsu province, the price of medical services is Shared by a city in four provinces, and the purchasing price information of drug consumables is carried out regularly in the form of information gathering and exchange. 

 

For joint procurement, four provinces and one city in suzhou pharmaceutical industry association, jiangsu wuzhong medicine group co., LTD., vice chairman of Yan Zheng opinion, "after the tender is all provinces as, joint procurement is a kind of four provinces and one city. East China area due to the location, economic situation, the structure is close to, so relatively easy together. Plus recruit mining does not coordinate between the provinces in the past, although will collect and consult the price of other provinces, but the information may not be comprehensive. At present, according to the results of the bidding purchase price have high low, because of this, might want to do some correction and coordination in east China." 

 

"But, in fact, close to jiangsu market, with anhui and fujian were not very close, like many expensive medicine sales in east China's anhui province, fujian is limit to the implementation of the procurement under sunshine, a lot of imported drugs, branded foreclosures or limit for, came under pressure in hospital use, fujian may also want to do some remedy." Yan zheng added. 

 

Price negotiations are difficult 

 

At the moment, the industry is most concerned about the price negotiations that a city in the four provinces will be able to negotiate with the original drugs, the exclusive variety, and how the negotiations will be. Indeed, on the scale of the use of drugs, Shanghai, zhejiang, jiangsu and anhui are important drug circulation provinces and cities in China. Issued by the ministry of commerce of the medicine circulation industry to run statistical analysis report (2015) show that in 2015, Shanghai, zhejiang, jiangsu, anhui seven class pharmaceutical sales ranked the third to the sixth respectively, and fujian, the four provinces and one city medicine more than 500 billion yuan, total sales of the commodity of one-third of the total amount of the national drug market. As a result, the four provinces and cities combined together, their purchases will be substantial. 

 

In addition, joint procurement negotiations led by fujian province, has long been in fujian in price-cutting and strength reduction is known for his "fierce", released this from fujian province in February this year, the implementation of medical insurance payment settlement price based medicine joint limit sunlight procurement notice can see, in the imported drugs, large dosage of auxiliary drug prices aggressively. In the case of imported medicines, fujian was the first to introduce the price of foreign countries and the price of customs ports as the price limit measures. And the dosage of big (sales amount more than $5 million a month) of monitored drugs, quarterly sales amount of the top 10 auxiliary medication and nutritional medicine introduced ladder price mechanism. 

 

In the eyes of the industry, the pressure to reduce prices of these products will be high if the four provinces are engaged in joint negotiations with the original and exclusive varieties. For companies, the trade-off between economies of scale and economies of scale is the need to change prices. 

 

"For a long time, because the market demand, the original drug and exclusive varieties have the advantage in price negotiations. And, given these drugs a certain market monopoly, make its profit also can encourage drug firms r&d enthusiasm." Yan Zheng thinks, "if you want to really reduce the price of these products, or want to speed up domestic generics market, form the price competition. And from the viewpoint of the doctor to treat economics as evaluation, to consider the price whether can benefit patients, whether can reduce health care costs." 

 

In addition, the industry expects the substantial joint procurement of a city in four provinces to be implemented this year. In the industry, however, there are still some practical problems. For example, how do you deal with the results of this round? Moreover, fujian, anhui and jiangsu price to pull together also not too realistic, price is so low, especially in fujian is used as a reference, will enforce the price, it is difficult now. The personage inside course of study points out: "it depends on the coordination between government, also want to see whether can and enterprise settled price. Estimate of four provinces and one city joint price negotiations more difficult. However, bargaining is easier to form an alliance between operating around the hospital."