Research On The Legal Issues Of Centralized Procurement Of Medical Insurance Drugs

Centralized procurement of medical insurance drugs has played an important role in reducing inflated prices and promoting better allocation of medical insurance capital resources.In 2021,the "Medical Security Law(Draft)"(hereinafter referred to as "draft")was released,marking that the construction of the legal system of centralized drug procurement was finally put forward to the legislative level.However,in terms of the normative content of the "draft for comments",the legal attribute of centralized procurement of medical insurance drugs with quantity is still not clear,and the legal relationship between the rights and responsibilities of the subject is unclear.Based on literature research and empirical analysis,this paper,starting from the legal attributes of centralized procurement of medical insurance drugs with quantity,conducted a comprehensive review of the legal issues of centralized procurement of medical insurance drugs with quantity.The main research contents are as follows:The first part is the overview of centralized procurement of medical insurance drugs.In combination with the policy documents issued by the central and local governments and the commonness of the three major modes of centralized procurement of medical insurance drugs with quantity,the basic process of centralized procurement of medical insurance drugs with quantity was clarified as follows: the medical insurance department formulated the policy documents,clarified the general principles and implementation ideas,and determined the contractor of centralized procurement of medical insurance drugs with quantity through administrative delegation or administrative selection,which carried out the specific procurement matters;After successful procurement,public medical institutions,pharmaceutical production enterprises and pharmaceutical distribution enterprises shall sign purchase and sales contracts to clarify their rights and responsibilities;The medical insurance department shall supervise the implementation of the contract after it is signed to ensure that the purchase and sales contract is performed according to the contract.The second part,the legal examination and verification of the centralized procurement of medical insurance drugs.This paper mainly compares the centralized procurement of medical insurance drugs with public resource trading and government procurement system,analyzes the differences between the three concepts,and defines the centralized procurement of medical insurance drugs as an independent strategic procurement mechanism of medical insurance drugs from the perspectives of procurement subject,procurement method and institutional purpose.The third part,the multiple legal relations of the centralized procurement of medical insurance drugs.According to the centralized procurement process of medical insurance drugs,the participants and their legal relations were defined.The medical insurance Bureau,as the leading organization department,assumed the role of administrative regulator in the procurement process and had an administrative entrusting relationship with the drug procurement contractor.Public medical institutions,as joint purchasers,have civil principal-agent relationship with drug procurement agencies.Public medical institutions,drug production enterprises and distribution enterprises,as the participants in the civil legal act of drug procurement,have contractual relations with each other.The fourth part is the legal responsibility of breach of contract of centralized procurement of medical insurance drugs.Select and analyze typical cases that have occurred since the implementation of "4+7" centralized procurement of medical insurance drugs,and make it clear that after the supplier breaches the contract,it shall bear the legal liability for punishment of breach of trust based on the credit supervision system,as well as the liability for damages and liquidated damages based on the contract agreement.After breach of contract,the purchaser shall bear the administrative legal liability from the Medical Insurance Bureau,as well as the liability for damages and liquidated damages from the contract.The fifth part,the supervision law system of centralized procurement of medical insurance drugs.This paper puts forward suggestions on the improvement of the legal system of centralized procurement with quantity of medical insurance drugs,analyzes the existing problems in the legal system of centralized procurement with quantity of medical insurance drugs from three aspects: level of legal effect,monopoly risk control and liability for breach of contract,and puts forward suggestions to improve the top-level system design of centralized procurement with quantity of medical insurance drugs.