| Objective:The establishment of a third-party drug trading platform in Guangdong Province in 2013 marked a new era of centralized drug bidding and procurement in Guangdong Province,which has been developed for nearly ten years since.This study provides a reference basis for further improving centralized drug bidding and procurement in Guangdong Province by analyzing the main modes of centralized drug bidding and procurement in Guangdong Province and their winning bid data.Methods:Firstly,through literature research method,various relevant journals,papers,documents and implementation plans of centralized drug procurement in various provinces were reviewed to analyze the development history,bidding schemes and advantages and disadvantages of various centralized drug bidding and procurement models.Secondly,the three procurement models of the centralised procurement of drugs at provincial level from the procurement of essential drugs for medical institutions in Guangdong Province in 2013 to the latest centralised procurement of drugs at provincial level in 2022 were collected through the three drug procurement platforms in Guangdong Province respectively,including data on the procurement rules,drug specifications of the winning catalogue,manufacturers and winning prices.The data on the procurement rules and the winning drug categories of the three procurement models were analysed using the descriptive analysis method.price reasonableness.Results:(1)In procurement modes I and II,the Guangdong provincial platform and Guangzhou GPO gradually covered the full range of products,while the Shenzhen GPO was a key price reduction drug that guaranteed the supply of drugs and a large sales amount.Commonly used low-priced drugs,specialist drugs for women and children,emergency rescue drugs,clinically necessary and difficult to procure as well as drugs with short supply in the market are procured through bargaining and negotiation;exclusive varieties with insufficient competition are procured through negotiation.After 2021,the provincial platform will take the lead in gradually transforming into a centralized bidding and procurement process for drugs with large amounts and usage,while the rest of the products will be procured at prices not higher than The remaining products will be procured by bargaining at prices no higher than the listed prices.(2)The Guangdong Provincial Platform and Shenzhen GPO products can only be procured for record after they have been unsuccessful,and the provincial platform will implement a strict price difference conversion.The Guangzhou GPO products with unsuccessful bids can continue to be procured on the grid after accepting the adjustment factor of the grid.(3)The three types of drugs with the highest number of winning bids were systemic anti-infective drugs,drugs for digestive tract and metabolism,and drugs for cardiovascular system.The winning bidders were mainly domestic manufacturers,but the number of foreign companies gradually increased over time.The concentration of the top 4 winning bidders increased from 5.30% to 6.33%,a slight increase but all less than30%,with too many winning bidders and the overall level of market concentration in the industry still low.(4)From the perspective of the winning price,the average price of basic drugs was lower,the lowest being RMB8.7482±356.2;the average price of the full variety of procurement catalogue was higher,the highest being RMB72.139±9177.941.The highest quadratic spacing was 37.3947 and the lowest was 4.3053;the highest coefficient of variation CV was 23.6 and the lowest was 1.89,indicating that there were too many drug winning specifications and the prices were more dispersed.Compared with the international reference price,the average percentage of products with MPR less than 1 is 31.89%,and the MPR of individual products is greater than 10,which may be related to the increased focus on drug quality in tender procurement,but also reminds us that we can pay attention to the price reduction space of such products.(5)Since the centralized bidding and procurement of drugs was launched in Guangdong Province,the ratio of drug costs to total pharmaceutical costs(i.e.drug cost ratio)has been decreasing year by year,reaching 22.64% as of 2020,and the centralized bidding and procurement policy for drugs has achieved certain results.Suggestions:Based on the existing problems of centralised bidding and procurement of drugs in Guangdong Province,it is recommended to try the "price correction" mechanism and explore the "medicine price calculator" in the next bidding documents to ensure the reasonableness of the winning price;the leading department of medical insurance to improve the policy supervision system and promote The leading department of health insurance will improve its policy and regulatory system to promote industry consolidation and industrial upgrading;it will also promote the three drug procurement platforms for quantity procurement on a regular basis to gradually increase the concentration of the pharmaceutical industry.In addition,pharmaceutical companies should also adjust their strategies at the right time to enhance their ability to adapt to market changes. |
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