Recently，China Affairs Office of the State Office of the State Office forwarded "Opinions"，It is required that drug procurement of public hospitals is gradually implemented & ldquo; two -vote & rdquo;，That is, the manufacturer will issue an invoice to a circulating enterprise，Circulating enterprises to issue an invoice at a medical institution。The key tasks of the medical reform issued by the State Council in 2016 were also proposed，Comprehensive medical reform pilot provinces must implement & ldquo; two votes & rdquo;。

 

  Drug prices have been criticized for a long time，What changes can it bring about & ldquo; two -vote & rdquo; Can it reduce the price of virtual high medicine?

 

  Compressed agent sales layer increase in price

 

  Recently，Notification of the Office of the Fujian Provincial Medical Security Management Committee，Clarify that drug consumables supply and manufacturers and distribution companies do not implement & ldquo; two votes & rdquo;，will enter & ldquo; blacklist & rdquo;，Dispertation of supply or distribution。Fujian can be regarded as the real implementation of & ldquo; two -vote & rdquo; the earliest province。

 

  So far，There have been 12 provinces to implement the relevant policies for implementing & ldquo; two -vote & rdquo;，Among stake betting appthem, Fujian、Anhui、Shaanxi has officially landed。

 

   & ldquo; Both votes & rdquo; Why are you so much attention? From the pharmaceutical company，& ldquo; Two votes & rdquo; changed the distribution of interests in circulation links。In our country，Drug sales mainly have two modes，1 is independent sales，First is agency sales。Some large pharmaceutical companies have their own sales channels，You can directly sell medicines to the hospital、Pharmacy and other terminals。Most manufacturers use agency sales models，After layer of agent，Finally sold to hospitals or retail pharmacies，Sold it to the patient's hands。

 

  In the agency sales mode，From production enterprises to hospitals or pharmacies，After layer of agent，Prices layer in layers，Three votes in the middle、Four votes or more votes，The difference between the factory price and the final sales price is huge，& ldquo;。

 

   & ldquo; Two votes & rdquo;，Multi -vote links in the middle，Let the manufacturer's independent distribution medicine，or only choose one distribution company，Direct supply to the hospital。Large circulation companies with powerful distribution capabilities will undoubtedly win，Most of the small and medium agent or elimination or transformation of beef hair。& ldquo; Two -vote & rdquo; Before implementation，channel、The terminal is controlled by the agent in one hand，Many pharmaceutical manufacturers do not master the terminal situation。& ldquo; Two votes & rdquo; post -，Drug production enterprises will be responsible for the delivery link。Zhejiang even requires the implementation of & ldquo; one vote & rdquo;，It is directly responsible for distribution from a pharmaceutical manufacturer。

 

  Allowing an additional invoice for some remote areas

 

  According to statistics from the State Food and Drug Administration，As of the end of November 2015，13508 pharmaceutical wholesale companies nationwide，Among them, the top 100 pharmaceutical wholesale business business income accounted for 68.9%of the total national pharmaceutical market during the same period。Small in the field of drug circulation、San、stake betting appChaos phenomenon can be seen。

 

   Analysis of Mao Zongfu, Dean of the School of Public Health, Wuhan University，& ldquo; Two -vote & rdquo;，Drug circulation industry will change greatly，It is likely that there are only some large circulation companies in the country，The concentration of circulation enterprises has greatly increased，& ldquo; Tickets for money laundering & rdquo; Phenomenon disappear，Drug virtual high price decrease，Circulation environment is purified。The entire circulation link becomes simple and transparent，Supervision is also more convenient。

 

  But，Director of the Department of Pharmacy Management and Clinical Pharmacy at the School of Pharmacy of Peking University、Director of Medical Management International Research Center Shi Luwen believes，& ldquo; Two -vote & rdquo; Although it can shorten the excess circulation chain，Eliminate excessive price increase factors，But can it be executed in place，Depending on the level of local economic development。Often more developed areas，The delivery company's outlets are relatively complete，Able to & ldquo; one vote & rdquo;。In areas with a lower level of economic development，Drug circulation companies often have more，Small scattered situation is even more serious，Drugs are difficult & ldquo; one vote & rdquo; distribution in place。For example, Xinjiang、Tibet、Qinghai and other places，Implement & ldquo; two -vote & rdquo; may be more difficult。

 

  Reports of the Ministry of Commerce，The industry only has 3 annual sales scale exceeding 100 billion yuan、1 national pharmaceutical circulation enterprise with an annual sales of more than 50 billion yuan，24 regional pharmaceutical circulation enterprises with annual sales of more than 10 billion yuan。and the delivery objects are many and scattered，Number of more than 1.2 million。If these large circulation companies want to build a perfect pharmaceutical distribution outlet，Including extending the outlets to a remote area，High cost，It also needs technical means、Innovation of the supply chain management method，Challenge corporate response ability。

 

  The reporter checked stake betting appthe relevant documents issued by the provinces，It is found that regional differences are considered in various places，For example, Anhui Clear，Drug operating enterprises sell drugs to the grass -roots public medical institutions of remote mountainous areas，Allows on & ldquo; two votes & rdquo;。

 

  Also need to adjust the medical service price simultaneously

 

   & ldquo; Two votes & rdquo; shorten the circulation link，The price of drugs dropped? Actually，The purchase price of the hospital has been determined in the government centralized bidding，Public hospitals that implement zero -rate rates are purchased at the winning bid price。In a new round of centralized bidding，Whether the bid price in the winning bid will be due to & ldquo; two votes & rdquo; decline，You need to see the policy and regulations in the next step。

 

  The country has been clear，All public hospitals must implement a zero -deviation rate，So some places will cooperate with the implementation of the medical insurance payment price，Will it play a role in reducing drug prices? Mao Zongfu thinks，Medical insurance payment is very good，But to reverse the strange circle of medicine with medicine，Only to implement the medical insurance payment price。

 

  In fact，A medicine supplementing medicine is still the leading mode in my country's public hospital。Statistics display，The proportion of hospital medicines is still around 40 %。In this case，Like & ldquo; Two -vote & rdquo;。​​& ldquo; It must be emphasized & lsquo;，In the promotion of & lsquo; two votes & rsquo; at the same time，Adjust medical service price synchronously，Reflecting the technical value of the labor service of medical staff，Value law of regression medical services。When a hospital does not need to obtain income from medicine，But there are reasonable income channels，The price of drugs naturally dropped in the competition。& rdquo; Mao Zongfu said，He goes to Sanjia Hospital to see orthopedic experts，Registration is only 30 yuan，The value of labor technology is distorted。

 

  Shi Luwen emphasized，Even if the two -vote system has reduced the price of the drug，But stake online sports bettingmedical expenses may not be reduced。If you cannot establish a system and mechanism that promotes hospitals and medical staff to return to medical laws，In order to develop the hospital，There will also be a way to get unreasonable income。So，It is still necessary to emphasize the scientific and reasonable fund income of public hospitals reflects public welfare，can we completely eliminate & ldquo; press the gourd to float & rdquo; phenomenon。

 

  Mao Zongfu thinks，Next policy will continue to improve，Adjust the price of medical services to a reasonable range，Reform medical insurance payment method，Strengthen supervision。As long as the reform is pushed by & ldquo; Three Medical Links & RDQUO;，Turning to the system of drug care for medicine，Pharmaceutical companies gradually change the small scattered vicious competition situation，Drugs will eventually return to a reasonable price。