On May 23, the Sanming City Deepening Medical Reform Leading Group Office, the Municipal Health Planning Commission, and the Municipal Finance Bureau jointly issued the “Notice on Encouraging Medical Institutions to Actively Carry out Bargaining and Related Account Processing of Pharmaceutical Consumables†(Ming Medical Reform Office [2016] 〕number 20).
According to the "Notice", after more than four years of medical reform in Sanming City, the operational efficiency of medical institutions has been greatly improved, and the cost of pharmaceutical consumables has dropped from 61% (excluding non-billed income) to the current 33.63%. Although there has been a significant decline in joint limit purchases, there is still room for further decline, especially for high-value consumables and imported drugs. The payment of the whole disease is to further promote the medical institutions to strengthen management, full participation in management, process management, block waste, reduce operating costs, improve efficiency and quality of medical care. In order to cooperate with the implementation of the reform of the whole disease payment, all medical institutions are encouraged to actively carry out bargaining work on the basis of the joint price limit purchase of the whole city.
The Notice puts forward four requirements for how to carry out bargaining work:
First, it is necessary to encourage all medical institutions to carry out bargaining work with existing drug consumable suppliers on the basis of joint price limit purchases in the city (not subject to 10% of the price below the limit price), or purchase 10 below the limit price. In the case of %, choose other manufacturers to negotiate purchases;
Second, the accounting treatment. In order to maintain the national market price (the purchase amount of drug consumables in Sanming City is less than one thousandth of the country), the manufacturer refuses to invoice according to the actual price, and the price of the rebate is reduced by the medical institution. To reduce the expenditure on pharmaceutical consumables, the rebate portion shall be calculated to 50% of the nursing expenses and treatment fees respectively, and shall not be used as other income;
Third, in order to prevent the flow of counterfeit and inferior drug supplies into medical institutions, the "two-vote system" must be strictly implemented;
4. The medical management center shall conduct tripartite settlement with the distribution enterprise and medical institution according to the actual purchase price.
When the "Notice" came out, it immediately triggered a netizen dispute. However, the point of controversy is no longer the “two-vote systemâ€, but allows the hospital to purchase medicines and consumables at its own bargaining price, and allows medical institutions to collect rebate discounts for manufacturers who do not invoice at actual prices.
Some voices said that Sanming allowed the hospital to negotiate its own price before returning to the new medical reform, and it blatantly violated and disrupted the provincial standard practice; there were also voices that government documents openly encouraged the use of kickbacks, contrary to anti-corruption. Of course, it is also a bit like, saying that Sanming is giving benefits to enterprises. In short, Sanming’s behavior is very “daringâ€.
But, however, they are all excited. . . .
It’s really not new to look at the article “Allowing medical institutions to negotiate their own pricesâ€. Sanming City has always done this in the procurement of its medicines and consumables, and it has long been written.
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