Policy Effect of the Medicines Procurement Based on Health Insurance Reimbursement Standards in Fujian Province
LI Ming-shuang1, YE Jian-chun2, DIAO Yi-fan1, LIU Mei-cen1, ZHANG Jie2, JIANG Mei-ying3, QIAN Jie1, FU Hong-yu1, GENG Shuai4, SUN Jing1*
1. School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730,China; 2. Fujian Pharmaceutical Machinery Joint Purchasing Center, Fuzhou 350011, China; 3. Fujian Cancer Hospital, Affiliated Tumor Hospital, Fujian Medical University, Fuzhou 350014, China; 4. Beijing 306 Hospital, Beijing 100083, China
Abstract：OBJECTIVE To analyze the effects of "adjusting structure and vacating space" of the transparent medicines procurement basing health insurance reimbursement standards, through comparing medicines consumption structure of health insurance designated health facilities of Fujian province. And to generate evidence as well as to propose recommendations for policy improvement and experience promotion. METHODS Based on the 2016 and 2017 provincial medicines pooled procurement database, adopting the pivot table statistical functions of EXCEL software, the consumption value and value in proportion of Class Ⅰ and Ⅱ chemical products (Fujian provincial medicines procurement list therapeutic classification for chemical products), as well as active pharmaceutical ingredients, consumption value and volume (standardized units in tablet/bottle/vial) of originator and generics were analyzed and compared. The consumption value of Class Ⅰ formulations of traditional Chinese medicines (Fujian provincial medicines procurement list therapeutic classification for formulations of traditional Chinese medicines) was also analyzed and compared. RESULTS Nearly 2.38 billion yuan procurement budget was saved in 2017 through adjustment of the medicines procurement list in Fujian province. There were a certain changes of the consumption structure of medicines. The procurement value of adjuvant and nutraceutical medicines dramatically reduced. The procurement value of medicines for treatment of chronic diseases like hypertension and cancers significantly increased. The procurement volume of generics started to surpass that of the originator, and showed potential competitiveness of generic substitution. However, the originator still dominated the market of quite a number of medicines. Prices of both generics and originators decreased. CONCLUSION The effect of “adjusting structure and vacating space” has been demonstrated. Fully implementation of the health insurance reimbursement standards will make the above effect more apparent. To promote effective generic competition, Fujian should set the same health insurance reimbursement standard for originator and its generics (quality and efficacy validated) to promote generics substitution.
李明爽, 叶建春, 刁一凡, 刘美岑, 张杰, 江梅英, 钱捷, 富宏羽, 耿帅, 孙静. 福建省基于医保支付结算标准的药品采购政策“调结构,腾空间”效果分析[J]. 中国药学杂志, 2019, 54(13): 1114-1120.
LI Ming-shuang, YE Jian-chun, DIAO Yi-fan, LIU Mei-cen, ZHANG Jie, JIANG Mei-ying, QIAN Jie, FU Hong-yu, GENG Shuai, SUN Jing. Policy Effect of the Medicines Procurement Based on Health Insurance Reimbursement Standards in Fujian Province. Chinese Pharmaceutical Journal, 2019, 54(13): 1114-1120.
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2019, Vol. 54 
