Medical network - April 19 pharmaceutical circulation enterprises GPO (hospital pharmaceutical group procurement) is China's drug prices after let go of the government pricing, discusses drug prices reasonable formation of a new attempt. However, recently shenzhen GPO by the national development and reform commission, caused a sensation in the industry. 

 

GPO in some countries and regions is a useful method of drug purchase of medical institutions, is proved to be a good way to control drug costs. The GPO of medicine circulation enterprises in China how to walk well, go far, is a subject worth exploring. 

 

Control cost as its core value 

 

GPO or call GPOs, the full name of Group Purchasing Organizations, called "centralized Purchasing organization" in Chinese. GPOs and upstream supplier (drug firms or circulation) negotiations, to focus on a large scale purchase way, get a lower purchase price, help the downstream (hospital clinics, family, etc.) cost savings, improve efficiency, to achieve the effect of charged fees. 

 

The United States GPOs control ability is very surprising. According to related statistics, GPOs in 2009 to the American health care system to save the spending more than $36 billion (source: Report from Dr. Eugene Schneler.). Also have a scientific research shows that 2012 GPOs save health care costs between $25 billion to $55.2 billion, GPOs permeability in 71.7% ~ 80% (source: Healthcare Supply Chain Association, HSCA). 

 

Medicine circulation has been under government control in our country, even as the medicine circulation system of big changes of drug centralized bid procurement system is also thought to be the government's new control performance. Because the drug centralized bid procurement system is the government leading, in the province of online drug centralized procurement and decentralized procurement model of a single hospital. The GPO in Shanghai and shenzhen as a representative of the China GPO GPO is thought to be beneficial attempt to improve the drug centralized bid procurement system. 

 

Shanghai GPO in the original bid at the provincial level drugs for selection scope, require a declaration GPO settlement price (lower than the bidding price, and make a public announcement in the selected directory) and willing to accept the supply chain cost allocation, through expert voting form directory GPO drugs. Actual drug deal still by manufacturers, distributors and medical institutions in Shanghai sunlight procurement platform. 

 

With the Shanghai medical insurance with the amount actually listed in the contract the annual purchase amount compared to Shanghai GPO no direct commitment manufacturers actual purchases of medical institutions, but requires members to participate in the procurement and use medical institutions GPO list drugs amount not less than 90%. 

 

At the beginning of 2016, shenzhen haiwang group subsidiary "all medicine net" promise "drug cost than purchasing the same amount in 2015 in guangdong province platform product gauge drugs decreased by more than 30% of the total cost", marked the public medical institutions and drug procurement into GPO mode in shenzhen city. 

 

GPO GPO in Shanghai and shenzhen, are trying to through the medicine circulation system reform, to realize the core value of drug control charge this. 

 

The price should be fair competition 

 

GPO to negotiate the price is the result of fair competition, rather than the result of administrative power intervention. In our country, in view of the medicine circulation system reform measures emerge in endlessly, from the drug centralized bid procurement to the "two votes", is trying to circulation system reform to lower drug prices and form a more reasonable price. Especially in 2015, the national development and reform commission announced on the opinion "to push forward the reform of drug prices, emphasized according to the market plays a decisive role in the allocation of resources and better play to the role of government requirements, gradually establish take the market as the leading drug price forming mechanism, maximum limit reduces the government's direct intervention of drug prices. 

 

Practice proves that the mature market economy countries GPO mode can effectively reduce the drug purchase price, save medical expense, easing the burden on patients, and the fair competition between the GPO is one of the keys to achieve the above goals. This kind of fair competition is embodied in three points: one is the access of fairness, eligible GPO can decide whether to participate in the competition. 2 it is to have the normal order of market competition, the government cannot specify only through a GPO to participate in the purchase, or via a platform to purchase. Three is the free drug distribution, GPO purchasing medicines, pharmaceutical production enterprises to choose its own distribution enterprises. In this fair, on the basis of drug prices is the result of the GPO and drug supplier negotiations. Generally speaking, the GPO negotiating prices was mainly affected by the purchase quantity, the more purchase quantity, the lower the price. 

 

The shenzhen GPO problem, in fact is the monopoly limit competition. Since August 2016, according to the relevant medicine network all the winning shenzhen since the GPO, using its cooperation with government background, to participate in the GPO procurement of domestic drug taking merciless bargain and purchase price which is lower than the normal market price, in order to realize the whole medicine net cost for the centralized purchasing drugs than in 2015 in guangdong province "drug electronic trading platform" on purchasing cost for the same product gauge drug fell more than 30% of the target. The price of this formed by administrative power, which not only violates the dominated by market of drug policy for the price formation mechanism, but also our country anti-monopoly law does not allow. 

 

Right marketization GPO 

 

Drug centralized bid procurement system is government-led procurement mode, GPO mode is based on the market as the guidance of purchasing mode. Drug centralized bid procurement system is still a basic system of the medicine circulation system in our country, but it must be the introduction of the role of market mechanism. At the same time, introduced in 2015 in China is decided by the market mechanism reform policy of drug prices. So, market-oriented GPO in our country. 

 

GPO road all the way walk good, go away, you must "separation simultaneously. "Separation" of public hospital drug procurement autonomy, and the choice of drug distribution enterprises autonomy, pharmaceutical production enterprise autonomy. "And" means "separation" be short of one cannot, less any rights are not real GPO. The shenzhen city planning commission's approach is typical of the "power" behavior, is not allowed by law. 

 

Road of the GPO to really go far, go well, also must do the following two points: one is to be truly scale procurement. Scale procurement is the inherent requirement of GPO, drug centralized bid procurement system is the most reviled without quantity procurement, make centralized bid procurement lost its meaning. If the GPO is carried out on the drug centralized bid procurement system is perfect, it must be purchase. 

 

Second, must perfect the laws and regulations, coordinate the interests of all parties. Although the core value of the GPO is charged fees, but it must be in accordance with the law to coordinate the benefit of the parties involved. In particular, the relationship between medical institutions and GPO, vendors and the relationship between the GPO, at the expense of one party interests to ensure that the other party is not the essential requirement of GPO, win-win is the purpose of the GPO. 

 

(the writer is guangzhou university of Chinese medicine, professor, vice President of the institute of economics and management)