Medical network - April 28 April 19, to accelerate the public medical institutions of drug purchase two votes, held a special work forum in Beijing national health and family planning commission (hereinafter referred to as the "health development planning commission project work forum"). Around the meeting stressed that to promote the establishment of norms and orderly, harmony, guarantee the supply of drugs circulation policy environment, positive innovation approach, using the information, such as convenient means to promote the implementation of the "two votes", to guide the public hospitals to do specific item of the "two votes". 

 

This is national health development planning commission on January 19, after by press conference interpretation of purchasing drug purchase in public medical institutions in the implementation of the implementation of the two votes opinion (try out) "[countries health hair (2016) 4], after another to make a feature on drug procurement" two votes "interpretation. 

 

Focus 1 place "two-ticket" schedule 

 

The pilot provinces and regions of the reform plan have a two-ticket plan by the end of June 

 

"Who planning commission project work symposium", points out that comprehensive reform pilot provinces and public hospital reform pilot areas to take the lead to implement the "two votes" in 2017, before the end of June to formulate the specific measures for the region's implementation of the "two votes", encouraging other areas implement the "two votes", for the 2018 fully implemented throughout the country. 

 

This timetable is consistent with the "two-ticket" time window set up by the national health reform television conference on March 28. The health care reform conference has also made clear that the state council reform office will receive and receive regular notification of the reform, and conduct a review of the "two-ticket" situation in the provinces before the end of the year. 

 

In fact, in view of the assessment, the health star anhui province will be the first time response, clear will soon to the region and the implementation of the "two votes" for special inspection. The author prejudge, the special inspection of anhui this special examination or will be in the supervision mainly, the examination is auxiliary. Main reason is that the anhui province "two votes" policies issued earlier than the country, and since October last year the province since the implementation opinion "two votes", the province's health development planning commission two joint mandate and drug safety agency has been assembled for industrial and commercial enterprises and medical institutions are "two votes" advance work arrangement and refinement. As the definition of "two votes" votes "in national level, implementation rules, such as gradually clear, the anhui province special inspection of the" two votes "is more like a" two votes "system construction should be issued. 

 

The "two fare" timetable is also the supervision of the health line's key work on health reform. From 11 "two votes" to promote reform pilot provinces, as of April 27, has been in fujian, anhui, shaanxi, chongqing, qinghai, sichuan, hunan, a total of seven provinces and cities issued a formal implementation plan, ningxia is still within the network transfer edition discussion stage, jiangsu has not released the "two votes" official documents, but did not stop related reform in pharmaceutical circulation field. It is understood that a number of hospitals in Shanghai have started to comb and filter their own "two-ticket" and "non-two-ticket" varieties in order to carry on the "two-ticket" policy. In addition, the "two-ticket" scheme has been officially announced in liaoning, gansu and hainan provinces. 

 

From the implementation rules recently released the provinces "two votes" policy, general version to the national opinion, give enterprise buffer, to some extent to digest in circulation "two votes" inventory, such as sichuan and hunan version policy. In addition, all release of official documents of the provinces, anhui, hunan, chongqing will only medicine in licensor as a production enterprise, also only for "total domestic drug generation" of chongqing as a production enterprise. 

 

The latest development of the two-ticket system in the pilot province of health reform 

 

 

Focus 2 on cheap, short supply of medicines 

 

We will encourage innovative ways to implement the "two-ticket system" to ensure sustainable supply 

 

"Who planning commission project work forum" at the same time, points out that public medical institutions to implement the "two votes" is a new work, around should notice to strengthen the construction of clinical pharmacy services and compensation mechanism of hospital pharmacy, actively encourage market main body with innovative and efficient way to carry out the "two votes", pay special attention to guard against the enterprise differentiation combined with market uncertainty and the risk of drug supply to ensure sustainable. 

 

The primary responsibility of the medical establishment is to save the lives of those who are dying, and the medicines are for the livelihood of the people. From anhui, in fact, the "two votes" advance experience, since last October in anhui province after the release of the "two votes" policy, the province's more than one city and county hospital is the responses of the "two votes" is: increase or adjust the distribution requirements, or with the existing commercial insurance for agreement, or require distributors YaoPinLiang reserves months to ensure the hospital drug use. In 2017, during the Spring Festival, with millions of migrant workers returning home in anhui province for medical treatment, medical institutions in the province is also only can do it well under the premise to ensure the supply of medicines "two votes". 

 

, anhui province, the author thinks that this is not the case, due to the different insurance reimbursement system has not yet been fully established in our country, the less developed areas in the Spring Festival is very common for medical personnel in the short term. In anhui province in its policy of "two votes" patch gives legal space, to the pharmaceutical distribution by requirements can not make out an invoice, not buying and selling behavior, is in response to the "two votes" under the guarantee one of the prescription drug supply. But it is worth noting that, in view of the shortage of cheap drugs, medicines, from an economic point of view, the "two votes" itself increased industrial chain costs, no matter from the Angle of the supplier enthusiasm, or "two votes" as a point of view of the impact of market rules, will most likely result in a certain range of cheap foreclosures, shortage of medicine. 

 

Focus 3 medical establishment how to check the ticket? 

 

The key to the two-ticket system is how do public health clinics check their tickets 

 

, according to the theory of "two votes" promote the review of the notes, "who planning commission project work symposium" requirements, the public medical institutions at various levels shall strictly implement the bill management regulation, active to the relevant distribution enterprises taking notes, a clear corporate compliance real responsibility for the content of invoice, and check the bill information, retained for future reference, concrete shall be clear in the drug centralized purchasing contract. 

 

According to the author, in "two votes" to promote the medical establishment itself to examine whether the drug is no enthusiasm "two votes", especially in the public hospital drug common zero rate of big background, the drug for medical institutions from profits into a cost center, the vast majority of medical institutions is not willing to spend the cost and effort to examine whether the two votes. 

 

But that does not mean that "two-ticket" regulations cannot fall. The author thinks that, with the development of the informationization construction of the pharmaceutical administration, the information supervision and the platform of "two tickets" will be the trend. But before that, the medical institution or the upstream regulatory responsibilities to commercial enterprises, such as distribution agreement clause form requires the upstream business enterprise the good "first ticket" level, ensure warehouse drugs all medical institutions to realize "two votes", from this perspective, compliance, integrity, large pharmaceutical commercial enterprises will be more get the favour of upstream and downstream. 

 

To sum up, 2017 will be the year of the "two-ticket system", with more non-reform than the pilot provinces of health reform. From the implementation rules, under the framework of the national version, the rules of the "two-ticket" system will have different characteristics. In "two votes" to promote, medicine channel reconstruction and security supplies, paper inspection are likely to experience the reform of the short-term pain, medicine, industry and commerce enterprise should improve efficiency under the framework of compliance, optimize the layout, work together to eliminate pharmaceutical circulation augean stables, in "two votes" environment realize multi-win-win situation. "(author mou qiong is a researcher at the institute of strategic development in Shanghai.)