Medical network - on December 16, in view of the current public hospital clinical drug use, "adjuvant" is undoubtedly one of the most popular words, but so far, not yet, about "adjuvant" relatively comprehensive and objective summary and analysis. In this paper, based on the relevant policies and regulations of the state and local stage, combined with the market conditions, comprehensive analysis, in view of the current adjuvant coping strategies to give Suggestions, hope to inspire staff.
[summary] provinces
Different policies
Released on September 8, 2015 in yunnan province, the directory is not released, but issued directly to the hospital.
[reading] a total of 122 varieties, including traditional Chinese medicine injections, vitamins injection and other auxiliary medicine 3 products. Products found and auxiliary drug catalogue, some not in social security and is rarely used in the market of products is also within the directory, dosage of some great product was not in the directory. The personage inside course of study to the relevant departments to consulting directory selection criteria or principles, has not been exactly reply. This directory before, without any information about auxiliary drug selection, not to mention the organization experts demonstrated that directory is "sky".
[measures for the management of clinical medication] file after the release, yunnan who planning commission requires medical institutions, led by the medical department, monitored the adjuvant of drug utilization of the directory and all medical institutions on a monthly basis to ranking and special prescription medication reviews, 20 products for three months ago and prescription inappropriate rate more than 10% of drug withdrawal immediately.
Released on December 19, 2015 in anhui province, directory for the anhui province at the county level public hospital clinical pathway management advancement work plan "part of it.
[reading] a total of 21 varieties, the products that are attached to the "adjuvant" is not in social security directory is almost not selling products, such as spleen peptide oral producing ammonia. There are rumours, refer to the catalog Beijing unpublished adjuvant directory.
[measures for the management of clinical medication] specify adjuvant cannot be included in clinical pathway, although the range is not very big, but the varieties that are attached to the directory expectations of future. The scheme make clear a regulation, before the end of 2017 county-level hospitals implement clinical pathway management, more than 70% of the discharged patients medicine of slope to 30%. Before the auxiliary drug release, 2015 issued by the government in October 4 to the hospital at or above the county level and the grassroots of the monitored directory, a total of 50 product rules. Among them, 10 county-level hospitals are divided into antibiotic, the antibiotic 20, are bigger hospital sales products.
On February 2, 2016 in sichuan province, sichuan who planning commission issued "on the drug management system set up medical institutions monitored notice, notify the sort, according to the sales of medicine called platform developed monitored the first drug directory.
[reading] a total of 25 rules, including proton pump inhibitors, TCM injections, auxiliary medicine 3 kinds big. Notice only stipulate measures for the monitoring of the drugs for clinical use and no clear quantitative indicators that may influence degree of the market is not so fierce management quantitative target province!
Released bidding in 2015 in fujian province, the specific price drugs and blood products negotiation procurement implementation plan ", the scheme to determine the specific price negotiations negotiation of purchasing drugs and blood products, the former consists of two batches of directory, a total of 41 product rules, the latter 21 product rules. Fujian as health reform pilot provinces, decisive launch negotiations specific product catalog including exclusive varieties, and dare to harsh and bargain price fixing, the end result is a lot of products in order to maintain the price system and give up the market.
Beijing in September 2015, medical institutions have received the Beijing hospital authority to develop auxiliary medication directory, directory has 27 varieties, are larger injection products sales. But there has been no official directory officially announced, but directly issued by medical institutions, and specific measures for the management of clinical application and management are more fuzzy quantitative targets.
In hebei province on December 14, 2015, joint administration of traditional Chinese medicine health development planning commission issued the notice on further strengthening of clinical rational drug use.
[reading] notification does not release specific what products, medical institutions according to their own medications in drug monitoring.
Clinical drug use measures for the administration of the notice provisions, each month to enter the medical institutions and drug sales amount, the use of the top 20 drugs special review, and, according to the results of the review to the public department and physician, extraordinary use of drugs for early warning, there is a problem of processing as stipulated in the hospital management department and doctors. Extraordinary use for 3 months in a row, to stop the drug use in hospitals, and may not recover within the year.
In jiangxi province in February 2016, the health development planning commission issued "on further strengthening YaoXie management, promote the rational use of medicinal machinery work notice.
Measures for the management of clinical drug use the notice provisions, all medical institutions to reasonably determine the auxiliary medicine department directory and auxiliary drug use scope, product gauge, quantity, amount, scale, the implementation of procurement, usage monitoring and early warning, minimize the number and proportion of auxiliary medication, and at the end of march this year to determine the auxiliary medicine directory of this unit, submit it to the family planning administrative department of public health at the same level for the record.
In May 2016, hubei province, hubei province health and family planning commission issued by the "on further strengthening the guidance on rational drug use management of medical institution", the medicine proportion of medical institutions and drug use proportion set specific goals, and for clinical rational use of drugs to give guidance, also has not specific varieties.
In May 2016, Shanxi Province, Shanxi Province health and family planning commission issued "on further strengthening the management of the medical institutions auxiliary class medication notice, aims to further implement the" about printing control public hospital medical expense unreasonable growth of several opinions of notice, normalizing the medical institutions auxiliary class management, build system of auxiliary class medicine directory report, and build auxiliary class public notification system.
The Inner Mongolia autonomous region in July 2016, Inner Mongolia autonomous region issued "about further standard adjuvant management of medical institutions notice.
[reading], the clear definition of auxiliary medication for the first time in the properties of adjuvant, and made the clinical use of adjuvant management approach. The notice will be the first 50 varieties into the auxiliary medicine catalogue, including clinical monitoring class 38, restricted class 12.
Measures for the management of clinical medication notice requirements, the medical institution for the auxiliary medication consumption amount before 20 special prescription reviews, disagrees with auxiliary medication rate more than 10% of the prescription or hospitalization orders implementation of early warning. For three consecutive months after entering this institution, the consumption amount of the top 20 drugs and 3 months still not appropriate rate more than 10% of the auxiliary medicine, belongs to the monitored, it shall timely adjust to restrict the use of class; Belong to restrict the use of class, should immediately stop using, and may not recover to use this year.
In June 2016, liaoning province, liaoning province who planning commission issued "on the strengthening public hospital auxiliary medication guidance of early warning and monitoring work.
[measures for the management of clinical medication] the opinion regulation, all medical institutions according to the agency the drug preparation auxiliary medication monitored directory and implement dynamic management, establish auxiliary purchase use alert system, the focus on monitoring the kinds through clinical path, the prescription review, improve the purchasing auxiliary medication monitored varieties used controls. The opinion does not have specific varieties directory, only gives the measures for the administration, no specific quantitative management target, and performed by the medical institutions, is relatively moderate.
Suzhou in October 2015, as jiangsu provincial health reform pilot city, suzhou city health group released the 60 adjuvant directory, strengthen the supervision of clinical use for catalogue, through prescription reviews, early warning, strive to medicine proportion fell to 45% from 45% now.
[policy analysis]
On abuse prevention, control of social security fee
So far, "adjuvant", there is no clear standards and definition in pharmacopoeia and related policy documents did not explicitly define "adjuvant", even in a foreign country is just a relative concept. The definition of "adjuvant" is complex, the root cause lies in the various drugs under different conditions of use, its function and meaning are not the same. Some products in some departments or disease treatment is auxiliary, in other disease treatment is required. It has also led to some directory of chaos, dosage of some products is very big, some products are not yet in clinical use.
At present, the national level released documents are not clear "adjuvant" as clear statement of product categories, countries also never asked around formulate the policy of "adjuvant" directory. But for the several ministries and commissions of the state of clinical drug release on the control of public hospital medical expense unreasonable growth several opinions, the specific measures of control of social security fee gives clear guidance. The provincial policies, opinion is also important basis, also the release of these directories to promote compliance, prevent abuse.
From the current 12 provinces and cities, has introduced policies abuse prevention and control of social security fee is true intention of the auxiliary medication management. In the provincial policy, there is a clear varieties directory has seven provinces or regions, released the related policy but there is no clear species there are five of the directory.
Analysis provinces a directory, can not deny the fact that there is a clinical abuse, also caused a certain social resources waste, but into the directory of many species also has an irreplaceable advantage in clinical use. For example, in the field of heart failure treatment, the western medicine treatment is limited and it is easy to produce drug resistance, lead to therapeutic effect, and gas injection for reasons after pulse has very good treatment effect. So, we should dialectically and objectively treat the clinical use of these products. Countries for clinical rational drug use control this strategy is right, related products manufacturers should keep pace with The Times, promote the healthy development of the industry.
Come around to monitor the clinical rational drug use for the purpose of related policies and directory, to clear the influence of some products, but the concrete strength of the execution of the policy and different provinces, the market have different influence degree, to clear about the product catalog and quantify the specific management objectives, relatively speaking, a greater impact.
[strategy]
To drive the market
Under the circumstances of national standards of clinical medicine, take up a lot of social resources of injection products, especially in the related policy have released product, should be prepared:
1. For province introduced relevant policies and directory, should be paid close attention to, the moment to grasp the trend, combined with clinical use of advantages and characteristics, from the academic point of view, ahead of some key experts and government departments communication work, try to reduce the possibility of were included in a directory.
2. Adjust the marketing strategy, from the terminal width to depth of the hospital, no longer blindly pursue single hospital sales, but pay more attention to hospital coverage, to drive the sales promotion, even focus on hospital, can consider to shrink the corresponding promotion department, focusing on promoting the key departments.
3. Under the background of hierarchical diagnosis and continue to advance, develop a new growth point of product, through multiple channels, multiple pattern, the development of multiple formats, improve product sales, enhance the risk resistance ability of the product. Where is the new growth point, will see the specific planning of marketing director.
4. In view of the long-term product development, and cannot be further pursuit of relationship marketing of soft power, more should pay attention to the product of hard power, increase the study of the product itself, such as product components, mechanism, etc. Products on the clinical use of a clear positioning, do have significant efficacy and safety, and can be recognized experts in the related field. In the specific product promotion measures, should become the most important means of promoting academic promotion. As a whole, this kind of product of rough gone growth phase, manufacturers need to intensive cultivation, to guarantee the vitality of the product. (the writer is tianjin tasly pharmaceutical marketing group powder injection branch deputy general manager) |
