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11城用上“团购”药:中选药品质优价廉 平均降价52%

2019-04-23 22:30:19

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     国家组织药品集中采购试点实施
  11城用上“团购”药 中选药品平均降价52%
  眼下,国家组织药品集中采购和使用正在试点实施。
  3月18日,厦门大学附属中山医院开出了国家“4+7”城市集采中选药品的第一张处方。处方中的乙肝用药恩替卡韦为“4+7”中选品种之一。该药新售价为17.36元/盒(28片/盒)。而在这一新政实施之前,恩替卡韦的原研药品价格为175.68元/盒(7片/盒)。
  这张处方的诞生标志着“4+7”城市药品带量采购和使用试点落地,进入了临床使用阶段。这次带量采购以4个直辖市和包括西安、厦门、沈阳在内的7个城市的公立医疗机构作为集中采购主体,它们在药品集中采购招投标或谈判议价时,明确采购数量,让企业针对具体的药品数量报价。其目的是以量换价、降低药价和医保控费。
  记者从国家医保局获悉,4月1日,11个试点城市已经全面启动。截至4月14日,25个中选品种在11个试点地区采购总量达到了4.38亿片支,总金额为5.33亿元,完成约定采购总量的27.31%。
  药品质优价廉
  4.38亿片、5.33亿元……谈到带量采购试点以来的情况,国家医保局副局长陈金甫表示,这些数字超出了预期,中标药品的质量和供应都得到了保障,使用量超出了预期,有关政策基本上全面落实,如医保的预付、医院使用及回款等。
  从试点效果来看,试点地区肿瘤、乙肝、高血压、精神病等重大疾病的患者用药获得了质优价廉的药品,医疗费用显著下降。
  “4+7”中标地区用的中标药品总体平均降幅52%,单个药品有些降幅达到96%。试点前,不少人担心医院会不会用这些中标药品。陈金甫认为,现有的试点情况消除了大家的担心。在他看来,“4+7”试点的完整解释是招标采购和使用试点,就是说采购后临床得用,也确实能适用于医院的临床使用。
  根据国家癌症中心发布的最新数据,我国每年因恶性肿瘤导致的医疗花费超过2200亿元,其中肺癌病例最多。此次集中采购试点中,肺癌靶向药吉非替尼降价幅度达到76%,首次出现“专利悬崖”现象。该药进入医院后,不少患者发现药价“跳水”,还能医保报销,经济负担大大减轻。
  这一方面是改革的成效,另一方面也说明确实存在着药价虚高。记者了解到,目前有患者因降价后的药价便宜怀疑是假药。对此,陈金甫表示,药价低不是因为质量问题,是因为新的改革措施把价格虚高的水分挤掉了。伟德1949后的药通过了质量一致性评价,质量是可控的。
  不能急功近利
  不过,11个城市之外的地区还没有享受到政策的红利。
  “这既反映了改革取得了成效,也反映了改革还在路上,这是局部地区试点产生的必然现象。”陈金甫认为。
  这次“4+7”伟德1949不是政府定价,不是国家谈判,是企业之间按照市场规则,针对不同的情况产生的自我价格竞争。陈金甫表示,这一新的伟德1949机制切中了药价虚高的核心问题、关键问题,取得了改革成效。毫无疑问,11个试点地区的患者首先享受到了改革的红利。
  4月3日召开的国务院常务会议,要求完善集中招标采购制度,加强中标药品的质量监管和供应保障,认真总结试点经验,及时全面推开。
  但如果要扩大试点,也不能一蹴而就、急功近利。陈金甫表示,要考虑价格对供应的影响。如果价格过低了,对企业来说,没有积极性,就造成短缺;如果价格不能合理地体现竞争性,就产生虚高,对患者就会产生费用负担。
  “因此要充分听取各方面意见,总结各地区试点的经验,来检验各项试点政策配套措施一些持续性的效果。”陈金甫举例,如解决了药价虚高的问题,医生的医疗服务价格能否进行正向的调整;价格达到合理水平后,能不能有利于促进医药企业的质量发展、创新发展,有利于培植中国的企业规模的集中等。在此基础上,国家医保局将完善政策,进一步扩大试点。


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