In order to implement the "Guiding Opinions on Carrying out the Centralized Procurement and Use of High-value Medical Consumables by National Organizations" (Yibaofa [2021] No. 31), to promote the centralized procurement of medical consumables system in Hebei Province In order to improve the price formation mechanism of medical consumables, address the problem of inflated prices, and further significantly reduce the burden of patients’ medicines, with the consent of the Hebei Provincial Government, the Hebei Provincial Medical Security Bureau and other eight departments jointly formulated the Implementation Plan for Purchasing and Use", the specific content of the plan is as follows:

　　About the development of the centralized supply of medical consumables in Hebei Province

　　Purchase and use implementation plan

In order to implement the "Guiding Opinions on the Centralized Purchase and Use of High-Value Medical Consumables by National Organizations" (Yibaofa [2021] No. 31) and the Hebei Provincial Committee of the Communist Party of China and the People's Government of Hebei Province Deepen the implementation of the reform of the medical security system" (Ji Fa [2020] No. 13) and other documents, improve the price formation mechanism of medical consumables, tackle the problem of inflated prices, and further significantly reduce the burden of patients on medicine. This implementation plan is formulated in accordance with the actual situation in Hebei .

　　 1. General requirements

　　 (1) Guiding ideology. Guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, implement the spirit of the 19th National Congress of the Communist Party of China and the 2nd, 3rd, 4th, and 5th Plenary Sessions of the 19th National Congress of the Communist Party of China, fully implement the decisions and deployments of the Provincial Party Committee and the Provincial Government, and adhere to the people-centered approach The development thinking of the company follows the general ideas of national organization, alliance procurement, and platform operation. In accordance with relevant national and provincial policy requirements, public medical institutions are the main executive body to carry out centralized procurement of medical consumables, explore and improve centralized procurement policies, and gradually expand coverage Scope, promote the return of the price of medical consumables to a reasonable level, reduce the burden on patients, reduce corporate transaction costs, purify the circulation environment, guide medical institutions to use them in a standardized manner, and better ensure that the people have medical treatment.

　　 (2) Basic principles. The first is demand-oriented and quality assurance. According to clinical needs, following the law of medical technology development, reasonably determine the range of medical consumables purchased in a centralized manner to ensure quality and supply, and meet the basic medical needs of the people. The second is the integration of recruitment and procurement, and the linkage of volume and price. Clarify the purchase quantity, exchange the quantity for the price, ensure the use, smooth the links of purchase, use, settlement, etc., reform the unreasonable factors in the procurement and use of medical consumables, and solve the problem of inflated prices. The third is to implement policies in accordance with their aptitude and compete fairly. Considering the characteristics of the clinical use of different medical consumables, the differences in functions, technologies, use, and production and supply capabilities, etc., a specific procurement plan is formed to guide fair competition. The fourth is departmental coordination and interaction between top and bottom. Strengthen the departmental cooperation mechanism, strengthen the supervision and monitoring of the production, supply, procurement, and use of selected products, improve the incentive and restraint mechanism, and coordinately promote the centralized procurement of medical consumables at the national, provincial, and municipal levels.

　　 2. Carry out the centralized procurement of medical consumables in different grades, and gradually achieve the best use of it

　　 (1) Timely implement the results of the national organization's centralized procurement with a large amount of selection. In the centralized procurement of medical consumables organized by the state, the Provincial Medical Security Bureau, in accordance with the time node required by the National Medical Security Bureau, will meticulously do a good job in reporting the amount of medical institutions, signing contracts, and selecting distribution companies to ensure that the national concentration is implemented as soon as possible. The results of the selection with quantity procurement will allow the masses of our province to use the selected products with high quality and reasonable price as soon as possible. (The Provincial Medical Security Bureau is responsible)

　　 (2) Orderly carry out centralized procurement of medical consumables in our province. For medical consumables outside the scope of centralized procurement by the national organization, our province independently develops or participates in cross-regional procurement alliances such as the "Beijing-Tianjin-Hebei" procurement alliance to carry out centralized procurement. Prioritize the selection of medical consumables with a large amount, high purchase amount, mature clinical use, sufficient market competition, and high level of homogeneity in the province to organize centralized procurement of medical consumables in batches, and according to market sales and clinical use needs And medical technology progress and other factors to determine the shortlisting criteria. (The Provincial Medical Security Bureau is responsible)

　　 (3) Encourage city-level coordination districts to form alliances to carry out centralized procurement. The Provincial Medical Security Bureau strengthened the overall planning of the province's centralized procurement work. City-level coordination areas (including Dingzhou City, Xinji City, and Xiongan New District) can form a procurement alliance according to the unified arrangement of the Provincial Medical Security Bureau to purchase medical consumables outside the scope of centralized procurement by the national and provincial organizations. In principle, the city and county (city, district) levels do not carry out centralized procurement. For medical consumables that have not been included in the scope of centralized procurement by government organizations, medical institutions independently carry out procurement on the provincial-level centralized procurement platform for medical consumables. (The Provincial Medical Security Bureau is responsible)

　　 3. Improve procurement rules and promote fair competition

　　 (1) Agreed purchase quantity. All public medical institutions (including military medical institutions, the same below) shall participate in the centralized procurement of medical consumables in quantities according to regulations, and medical insurance designated social medical institutions shall voluntarily participate in accordance with the provisions of the agreement. The procurement base is determined based on the demand reported by medical institutions, combined with the previous year's use, clinical use status, and medical technology progress. The agreed procurement ratio is reasonably determined according to the market competition pattern and the number of selected companies. The agreed purchase amount is determined according to the purchase amount base and the agreed purchase ratio, and is disclosed in the purchase document. Encourage public medical institutions to purchase the selected products with priority for the parts whose actual demand exceeds the agreed purchase amount, and they can also purchase other online products with suitable prices through the provincial centralized pharmaceutical procurement platform. (The Provincial Medical Security Bureau is responsible)

　　 (2) Bidding and winning rules. Consolidate the procurement volume of similar medical consumables with similar treatment purposes, clinical efficacy, and product quality, and uniformly bid for fair competition; encourage mergers and groups to promote competition. A variety of medical consumables that need to be used in combination can be integrated into a system and be purchased as one variety. According to the characteristics of the clinical use of medical consumables, the degree of standardization, the number of participating companies and other factors, the procurement can be carried out by means of bidding, competitive negotiation, and inquiries, etc., according to their aptitude. Enterprises voluntarily participate and offer independent quotations, and the selected prices and selected enterprises are generated through quality and price competition. If multiple companies are selected, the price difference between different companies should be controlled reasonably. In accordance with the principle of quantity-price linkage, clarify the agreed purchase quantity of each selected company and reasonably determine the purchase agreement period. (The Provincial Medical Security Bureau is responsible)

　　4. Strengthen measures to guarantee and pay attention to the reform of system integration

　　 (1) Ensure quality. Scientifically and rigorously formulate the quality and technical standards for the procurement of medical consumables. Strengthen the quality supervision of the entire chain of production, circulation, and use of selected products, improve the handling mechanism for quality problems of selected products, and urge enterprises to implement their main responsibilities. If adverse events and quality problems occur during the use of the selected products, the medical institution shall report in a timely manner according to the procedures, and take emergency measures. Deal with quality problems of medical consumables in accordance with laws and regulations. (The Provincial Drug Administration, the Provincial Medical Security Bureau, and the Provincial Health and Health Commission are in charge, and the first one is the lead unit, the same below)

　　 (2) Ensure supply and distribution. The selected companies should do a good job of predicting and preventing market risks, strengthen production arrangements, report production capacity, inventory and supply as required, and ensure that the procurement needs of the selected products of medical institutions are met in a timely manner during the procurement cycle. The selected products shall be distributed by the selected company independently or by the distribution company, and the accompanying services shall be provided by the selected company or a third party, and the related costs shall be borne by the selected company. The delivery of selected products and their accompanying service provision capabilities shall cover the agreed supply area, and the delivery party and accompanying service provider shall respond to the procurement and use needs of medical institutions in a timely manner. In the event of inability to supply in time, in addition to force majeure factors, the selected enterprise shall bear the corresponding responsibilities and all the expenses incurred, otherwise it will be regarded as a breach of trust and be included in the list of pharmaceutical prices and untrustworthy items in our province. (The Provincial Medical Security Bureau is responsible)

　　 (3) Ensure priority use. The medical institution is the main body responsible for the equipment and use of the selected products. Medical institutions should give priority to purchasing the selected products in centralized procurement, formulate in-hospital diagnosis and treatment routes for preferential use of the selected products, and complete the agreed procurement volume in accordance with the procurement contract. Medical staff should give priority to using the selected products under the principle of reasonable diagnosis and treatment. Medical institutions that do not purchase and use the selected products in accordance with the regulations shall be punished in the performance evaluation of public hospitals, the formulation of total medical insurance indicators, the management and evaluation of designated agreements, and the evaluation of the target responsibility of the person in charge of the medical institution. (The Provincial Health Commission and the Provincial Medical Security Bureau are responsible respectively)

　　5. Improve supporting policies and coordinate the interests of all parties

　　 (1) Ensure payment back. Settlement is carried out on the basis of the total budget management of the medical insurance fund, and a centralized purchase prepayment mechanism is established. After the contract is signed, the medical insurance fund prepays the medical institution at 50% of the annual agreed purchase amount, as a working capital for the medical institution to pay the company’s product purchases. Special funds are dedicated to reduce the transaction costs of selected companies. According to the procurement progress of the medical institution, the prepayment shall be offset quarterly from the medical expenses applied for by the medical institution until it is fully recovered. The medical institution shall settle the payment with the enterprise in a timely manner in accordance with the purchase contract, and the settlement time shall not exceed the end of the next month after the delivery is qualified. For medical institutions that fail to pay for products on time without proper reason, an early warning will be given in accordance with the policy. If the payment is still not returned within 5 working days after the early warning, the payment of the medical insurance expenses of the designated medical institution will be postponed. Promote direct settlement between medical insurance funds and enterprises. (The Provincial Medical Security Bureau, the Provincial Department of Finance, and the Provincial Health Commission are responsible)

　　 (2) Explore the coordination of medical insurance payment standards. For the centralized procurement of medical consumables within the scope of medical insurance payment, the limit price in the "Management Catalogue of Disposable Items for Additional Charges in Hebei Province" shall be used as the limit price of medical insurance payment. When the prices of selected products are lower than the price limit for medical insurance, the selected price will be used as the medical insurance payment standard, and the medical insurance payment standard of non-selected products shall not be higher than the highest selected price of the selected products of the same category and similar functions. When the price of the selected product is lower than or higher than the medical insurance payment limit, the selected product whose price is lower than the medical insurance payment limit shall be the selected price as the medical insurance payment standard; the non-selected product whose price is lower than the medical insurance payment limit shall be taken as the actual price Medical insurance payment standards; selected and non-selected products whose prices are higher than the medical insurance payment limit, all use the medical insurance payment limit as the medical insurance payment standard. (The Provincial Medical Security Bureau and the Provincial Department of Finance are responsible)

　　 (3) Improve the incentive mechanism of medical institutions. During the procurement cycle, the total amount of medical insurance will not be reduced due to the decline in the price of the purchased products. For the medical insurance funds saved due to centralized procurement, medical institutions can be motivated in a certain way on the basis of assessment. For specific measures, refer to the relevant provisions of the state and the province for the retention of the balance of centralized drug procurement. If the agreed purchase amount is completed and the assessment is passed, it shall be returned to the designated medical institution in a proportion not higher than 50% of the estimated base of the balance. Among them, 60%-70% is used for the salary payment of medical staff, and 30%-40% is used for the development of medical institutions. The system encourages medical institutions and medical staff to give priority to the use of selected products in centralized procurement, and eliminate sales with gold. Medical institutions should improve internal assessment methods, transmit incentive policies to medical staff, and encourage reasonable and prioritized use of selected products. (The Provincial Medical Security Bureau, the Provincial Department of Finance, and the Provincial Health Commission are responsible)

　　 VI. Strengthen the organization and implementation to ensure the orderly progress of the centralized procurement of consumables

　　 (1) Establish a working mechanism and strengthen departmental coordination. Departments such as medical security, finance, health, market supervision, drug supervision and management, and industry and information technology should improve the centralized procurement work mechanism, strengthen policy coordination and work cooperation, and form a joint force. As the lead unit, the Provincial Medical Security Bureau must strengthen overall coordination and comprehensive services, implement the relevant policies for centralized procurement of medical consumables, supervise the implementation of the results, and guide the provincial centralized procurement platform for medical consumables to carry out centralized procurement of varieties in accordance with laws and regulations. , Accelerate the use of uniform codes for medical security medical consumables, and link them with the unique identification of medical devices, do a good job of prepayment and settlement of medical insurance funds, adjustment of medical service prices, assessment of designated medical institutions, etc., implement a medical price and recruitment credit evaluation system, Intensify the handling of companies that violate regulations, and guide and promote the centralized procurement of medical consumables in various coordinating districts. The Provincial Health Commission is responsible for guiding and supervising the use of selected products by medical institutions, and standardizing and rational use. The Provincial Drug Administration shall further accelerate the full-chain application of the unique identification of medical devices in the production and operation of medical consumables, strengthen the quality supervision of selected medical device products, carry out adverse event monitoring, and urge enterprises to implement the main responsibility for quality and safety. The Provincial Department of Industry and Information Technology is responsible for supervising and urging selected production enterprises in the province to implement production and supply responsibilities in accordance with the agreed purchase volume of the selected products, supporting enterprises to carry out production technology transformation, and improving the supply guarantee capacity of the selected products. The Provincial Market Supervision Administration must severely investigate and punish various price violations, and resolutely crack down on behaviors that disrupt fair market competition. The Provincial Development and Reform Commission, the Provincial Department of Finance, and the army's logistics departments must actively cooperate with the procurement of medical consumables. (The Provincial Medical Security Bureau, the Provincial Department of Finance, the Provincial Health Commission, the Provincial Market Supervision Administration, the Provincial Drug Administration, the Provincial Development and Reform Commission, the Provincial Department of Industry and Information Technology, and the Provincial Military Security Bureau are responsible respectively)

　　 (2) Standardize platform construction. All public medical institutions in the province need to purchase medical consumables on the provincial centralized procurement platform for medical consumables. The Provincial Medical Security Bureau relies on the provincial centralized procurement platform for medical consumables, and on the basis of medical insurance payment, manages the bidding, procurement, transaction, and settlement of medical consumables to improve transparency. Strengthen the standardized construction of the provincial centralized procurement platform for medical consumables, unify basic operating rules, work procedures, and standards for medical consumables to be connected and removed from the network, unify the classification and code of medical insurance consumables, unify standards for consumable procurement information, and accelerate the formation of a unified and open centralized procurement of medical consumables across the province market. (The Provincial Medical Security Bureau and the Provincial Health Commission are responsible)

　　 (3) Do a good job in policy interpretation and publicity guidance. All regions and relevant departments should strengthen policy interpretation, strengthen positive publicity on the effectiveness of centralized procurement of medical consumables, increase policy awareness, and rationally guide social expectations. It is necessary to strengthen the monitoring of public opinion, promptly and proactively respond to social concerns, and strive to create a good atmosphere for reform. It is necessary to carry out in-depth policy interpretation and training for medical staff, give full play to its important role in clinical treatment, and guide patients to rationally choose products from centralized procurement. (The Provincial Medical Security Bureau and the Provincial Health Commission are responsible)