National Healthcare Security Administration: Will continue to vigorously promote centralized procurement of drugs in 2024.

The State Council held a routine policy briefing on June 14. Deputy Director of the National Healthcare Security Administration, Huang Huabo, stated that in 2024, efforts will continue to promote the centralized procurement of pharmaceuticals, emphasizing coordination in the selection of procurement varieties. The work will be carried out at both national and local levels, with national and local efforts complementing each other to continuously expand the coverage of centralized procurement. At the national level, at least one batch of drugs and one batch of high-value medical consumables will be procured. The national organization of drug procurement will continue to focus on the evaluation of generic drug quality and consistency in efficacy, ensuring sufficient competition among drugs. The original text is as follows: State Council Routine Policy Briefing: Overview of "Key Tasks of Deepening Medical and Health System Reform in 2024" The State Council Information Office will hold a routine policy briefing on the afternoon of June 14, 2024 (Friday) at 3:00 PM, where Deputy Director of the National Health Commission Li Bin, as well as officials from the National Healthcare Security Administration, National Health Commission, and National Medical Products Administration will introduce the "Key Tasks of Deepening Medical and Health System Reform in 2024" and answer questions from reporters. Deputy Director of the State Council Information Office and Spokesperson, Xing Huina: Ladies and gentlemen, good afternoon. Welcome to the State Council's routine policy briefing. Recently, the General Office of the State Council issued the "Key Tasks of Deepening Medical and Health System Reform in 2024." To help everyone better understand the situation, we have invited Deputy Director of the National Health Commission Li Bin, Deputy Director of the National Healthcare Security Administration Huang Huabo, Deputy Director of the National Health Commission Shen Hongbing, and Deputy Director of the National Medical Products Administration Huang Guo to introduce the relevant information and answer questions. First, let's have Mr. Li Bin give a brief introduction. Deputy Director of the National Health Commission Li Bin: Dear friends from the media, good afternoon. Deepening reforms in the medical and health field is an important initiative in the reform of people's livelihood. The Central Committee of the Party and the State Council attach great importance to it, and the people are very concerned. Next, I will introduce two aspects. First, I will introduce the progress of the medical and health system reform in 2023. 2023 is the opening year for the comprehensive implementation of the spirit of the 19th National Congress of the Communist Party of China. Various regions and departments have conscientiously implemented the decisions and deployment of the Central Committee of the Party and the State Council on deepening medical reform, adhered to the general tone of seeking progress while maintaining stability, closely coordinated, and vigorously implemented tasks, achieving positive progress and results in various work areas. In promoting the coordinated development and governance of medical care, medical insurance, and pharmaceuticals, and in in-depth learning and promotion of the Sanming medical reform experience. Strengthen departmental coordination and carry out the eighth and ninth batches of nationally organized drug procurement, the fourth batch of medical consumables procurement, further reducing the costs of drugs and consumables. Guided all regions to comprehensively implement the dynamic adjustment mechanism for medical service prices, with 28 provinces further streamlining medical service prices. Adjusted and improved the medical insurance drug list. More than 90% of the regions with overall planning have carried out reforms for payment by disease diagnosis-related groups or disease-based value payment. Continued deepening of the reform of the drug review and approval system, with a significant acceleration in the approval of new and good drugs. In promoting the expansion of quality medical resources and the balanced layout of regions, and improving the medical service system. There has been orderly progress in the setting up and construction of national medical centers and national regional medical centers, with the implementation of 13 categories of national medical centers and 125 national regional medical centers construction projects. Focus on improving the medical level at the municipal and county levels, enhancing grassroots service capabilities. From the perspective of the establishment of national medical centers and regional medical centers, it has basically covered provinces with weak medical resources, gradually reducing the number of people seeking medical treatment across provinces. From the perspective of enhancing grassroots service capabilities, over 75% of the township health centers and community health service centers meet basic standards. In deepening the reform of public hospitals and promoting the high-quality development of public hospitals. Carry out special actions to improve medical quality, further improve nursing services, and improve the medical experience, enhancing service levels and quality. Guided 11 key provinces in comprehensive medical reform to promote the high-quality development of public hospitals in a targeted manner, with innovative breakthroughs in key areas in 30 cities designated as demonstration cities for public hospital reform and high-quality development, with significant improvements in key indicators for the high-quality development of co-built demonstration hospitals in the provinces. In improving the public health system and strengthening the medical and health talent team. Steadily promote the reform of the disease prevention and control system, focusing on enhancing public health service capabilities. Emphasize the strengthening of the medical and health talent team at the grassroots level, recruit 120,000 resident physicians and train 47,000 general practitioners. Launch the implementation of a special plan for college students to become rural doctors, achieving a historic opening of resources to rural doctors. Next, I will introduce the key work tasks for deepening the medical and health system reform in 2024. Recently, the General Office of the State Council issued the "Key Tasks of Deepening Medical and Health System Reform in 2024," focusing on promoting the coordinated development and governance of medical insurance, medical care, and pharmaceuticals, promoting the high-quality development of healthcare, and ensuring that the people have more sense of gain, happiness, and security. Seven aspects of work tasks have been clarified: First, strengthen the organizational leadership of medical reform, promote local governments at all levels to further implement the responsibilities of comprehensively deepening medical reform, consolidate and improve the reform promotion mechanism, explore the establishment of efficient policies in medical insurance, medical care, and pharmaceuticals. Coordination mechanisms for information interoperability and regulatory linkage. Second, promote the extensive experience of the Sanming medical reform, advance centralized procurement of drugs and medical consumables to improve quality and expand coverage, deepen reforms in medical service prices, medical insurance payment methods, and public hospital salary systems, among others. Third, further improve the medical and health service system, enhance public health service capabilities, strengthen the construction of primary healthcare service capabilities, orderly advance the setting up and construction of national medical centers, and national regional medical centers, deepen the reform of closely connected medical alliances, promote the innovation and development of traditional Chinese medicine, enhance the capacity of healthcare personnel, and carry out pilot reforms of high-quality and efficient healthcare service systems. Fourth, promote the high-quality development of public hospitals, based on the thorough implementation of the promotion of high-quality development of public hospitals and the performance appraisal of public hospitals, introduce a new set of measures to further promote high-quality development. Fifth, promote the improvement of a multi-tiered healthcare security system, improve the basic healthcare security system, and develop commercial health insurance. Sixth, deepen reforms and innovations in the pharmaceutical field, improve drug use and management, deepen the drug review and approval system.Reform the approval system, improve the mechanism for ensuring drug supply.The seventh key reform is to coordinate and promote other key reforms, including promoting digital empowerment in healthcare reform, increasing the number of user-friendly and convenient application scenarios, further promoting the construction of infant and toddler care service systems and integration of medical care and elderly care, and strengthening comprehensive supervision in the medical and health field, among other tasks. Overall, the "Key Tasks" document adheres to putting the people at the center, emphasizing problem orientation and goal orientation, system integration and synergy, as well as innovation and tangible results. Next, we will follow the decisions and arrangements of the Party Central Committee and the State Council, fully leverage the coordinating role of healthcare reform, work together with relevant departments in various regions to implement the "Key Tasks", strengthen monitoring of healthcare reform, summarize and promote local experiences and practices in a timely manner, and push the national healthcare reform work to a new level. Now, I and my colleagues from relevant departments are willing to answer your questions. Thank you. Xing Huina: Now you can ask questions, please state your news organization before asking. Xinhua News Agency reporter: This year's Government Work Report clearly states the need to promote the coordinated development and governance of medical care, medical insurance, and pharmaceuticals. The key tasks of healthcare reform also include related work arrangements. How can the three aspects of medical care, medical insurance, and pharmaceuticals work together to improve the health and well-being of the people and their perception of reform? Thank you. Li Bin: Thank you, I will answer your question. The reports of the 19th Party Congress and this year's Government Work Report have both clearly put forward the need to "promote the coordinated development and governance of medical insurance, medical care, and pharmaceuticals". This is an important part of deepening healthcare reform and a significant measure to achieve the strategic goal of Healthy China. Medical care is at the core of people seeking medical treatment and rehabilitation. It is the most direct relationship with the people, and the most tangible experience. Medical insurance funds are the "life-saving money" for people seeking medical treatment, and also an important source of funding for medical services and pharmaceutical products. Pharmaceuticals are an important means of medical and health services, directly related to the quality, safety, capabilities, and levels of services. In other words, medical care, medical insurance, and pharmaceuticals are inseparable, and together they ensure the health and well-being of the people, requiring relevant departments to work together in the same direction to better meet the new expectations of the people for a better life and to directly benefit the people through healthcare reform. This year's key tasks in healthcare reform propose to explore the establishment of a unified and efficient policy coordination, information linkage, and regulatory linkage mechanism for medical care, medical insurance, and pharmaceuticals. In terms of policy coordination, it is necessary to strengthen the overall leadership of the Party in deepening healthcare reform, emphasize putting people's health at the center, innovate cross-departmental mechanisms for the coordinated development and governance of the three aspects, ensuring that the goals and measures of reform policies are consistent, coordinated, and effective, improving the overall efficiency of governance. Many places have explored beneficial initiatives in this regard. Chongqing, for example, has established a special reform working group for the coordinated development and governance of medical care, medical insurance, and pharmaceuticals, led by the Party Committee and the government, composed of relevant departments, which focus on the advancement and resolution of key issues and problems of healthcare reform, assigning relevant departments to take turns in overseeing the daily work of the working group to advance healthcare reform steadily. In terms of information linkage, placing greater emphasis on the sharing of data and operational linkages among the three aspects, focusing on business applications such as mutual recognition of inspection results, one-stop settlement of costs, standardized queries for electronic health records, telemedicine, and medical treatment in different regions, effectively improving decision-making and service capabilities in coordinated governance and operation evaluation. In this regard, proactive exploration has been carried out in places like Hainan to integrate medical insurance, health, and market supervision into a single network, aiming to achieve real-time statistical analysis and data sharing, as well as real-time data calls. In terms of regulatory linkage, to address issues and problems in the medical and pharmaceutical fields that harm the rights and interests of the people, comprehensive measures are needed, with strengthened departmental cooperation and enhanced regulatory oversight throughout the entire chain, establishing a regulatory framework with unified standards and mutual coordination among the three aspects. By establishing and improving joint law enforcement and punishment mechanisms, the safety and health rights and interests of the people are effectively safeguarded. Thank you. The Beijing News reporter: Prices of drugs and medical supplies entering centralized procurement often see significant reductions. How does the National Medical Insurance Administration ensure that the quality of the products selected through centralized procurement is not compromised despite the price reduction? Thank you. Li Bin: I will now pass this question to Huang Huabo from the National Medical Insurance Administration. Huang Huabo, Deputy Director of the National Medical Insurance Administration: Thank you for your question. First of all, I want to clarify one thing: the price reduction of the selected products in centralized volume-based procurement mainly comes from savings in enterprise marketing costs. The logic is as follows: centralized procurement pools the demand of medical institutions nationwide to form a procurement target, inducing fair competition among enterprises to generate reasonable prices. Once selected, products can be sold directly to hospitals according to the procurement contract, with hospitals committing to purchasing the agreed-upon quantity within the specified time and prioritizing the purchase and use of the selected products. This greatly reduces marketing costs for drug manufacturers. Additionally, centralized procurement requires medical institutions to settle payments to companies promptly and is supported by the policy of prepayment from medical insurance funds, effectively solving the problem of long repayment cycles and saving significant costs for enterprises. These cost savings in the distribution process are the main space for reducing prices. Passing on the benefits of price competition to the people. To ensure that the quality of the selected products is not compromised despite the price reduction, three main measures have been taken. First, setting quality entry thresholds. The national organization of drug procurement has set requirements for enterprise and product qualifications, using consistency assessment of quality and efficacy as the threshold for generic drugs to participate in centralized procurement, avoiding the occurrence of inferior products driving out better ones in competition. Second, establishing a coordinated quality supervision mechanism. Information on enterprises and products selected through national organized procurement is shared with the drug regulatory department, and selected products are included in a key supervision list. In cases where quality issues arise with selected products in national organized procurement, the medical insurance agency and the drug regulatory authority jointly carry out disposal procedures, imposing penalties such as disqualification from selection, inclusion in a "violation list", etc., continuously sending a signal of "zero tolerance" for quality issues. Third, conducting real-world studies on clinical efficacy and safety. More than 30 large tertiary hospitals nationwide have been commissioned to conduct two phases of real-world studies on the clinical efficacy and safety of generic drugs selected through centralized procurement, currently covering 37 widely used clinical drugs from the first three rounds of procurement. The research results show that the selected generic drugs are equivalent to the original drugs in clinical efficacy and safety, demonstrating that the overall quality of domestic generic drugs has withstood the test. The third phase of clinical efficacy and real-world studies is currently underway, covering the drugs from the fourth and fifth rounds.We will continue to release research results on more than 20 varieties of group procurement. Guiding and serving the innovation research and development of pharmaceuticals, constantly improving standards, optimizing procedures, increasing efficiency, improving services, and releasing the policy dividends of accelerating the listing of "new drugs and good drugs", a large number of innovative drugs and Innovative Medical Management devices have been approved for listing. Here is a set of data. According to statistics, from 2022 to the present, a total of 82 innovative drugs and 138 Innovative Medical Management devices have been approved. In just the first five months of this year, 20 innovative drugs and 21 Innovative Medical Management devices have been approved. Among them, there are new biotechnology products that people are concerned about, such as CAR-T and monoclonal antibodies, as well as innovative traditional Chinese medicine products, as well as artificial hearts using full magnetic levitation technology, and CT image-assisted detection software using artificial intelligence technology. Both in terms of quantity and quality, it is at the forefront globally. It can be said that China's development of innovative drugs is strong and promising for the future. 1. 2. 3. 4. Relevant work situation. The experience of healthcare reform in Sanming has been explored, formed, and developed in long-term reform practices, and has withstood theoretical scrutiny and practical testing. In late May of this year, the National Health Commission held a press conference specifically to introduce the relevant work of promoting the experience of healthcare reform in Sanming. Recently, there has been specialized research and deployment of further promoting the experience of healthcare reform in Sanming. The key work areas for 2024 include: firstly, strengthening policy support. We will deeply summarize and analyze the good experiences and practices of Sanming and other typical regions, research and draft policy documents for further promoting the experience of healthcare reform in Sanming, redeploy, reinforce, and enhance the promotion of the experience of healthcare reform in Sanming and other regions across the country, increase the promotion efforts of typical experiences, and expand the demonstration effect. Secondly, intensifying guidance. Organize training courses to promote the experience of healthcare reform in Sanming, provide training to comrades responsible for healthcare reform work at the provincial and key municipal levels, guide local areas to deeply understand the essence of healthcare reform in Sanming, further increase innovation, and deepen reforms in key areas and critical links. Hold work scheduling meetings and exchange meetings to learn and promote the experience of Sanming, and provide guidance to local areas for the promotion of the experience of healthcare reform in Sanming. Strengthen exchanges in reform in various regions, promote mutual learning and mutual improvement. Thirdly, deeply explore typical cases. Carefully consider and deeply explore the typical practices of healthcare reform in the eastern, central, and western regions, summarize the experiences of deepening healthcare reform in different regions of economic and social development, so that each region has examples to learn from, and further enrich and expand the connotation of the experience of healthcare reform in Sanming. At the same time, increase efforts to promote and publicize the practices and experiences of typical regions, creating a strong atmosphere of learning from and catching up with Sanming. In addition, we will also organize relevant forces in the field to guide Sanming to further explore and innovate in healthcare reform, further deepen comprehensive reform to promote the coordinated development and governance of the three-tier healthcare system, enhance the collaborative capacity of the system, unleash the power of information technology in healthcare reform, and deepen, expand, and enhance in these aspects, continue to pave the way for national healthcare reform, set an example, and be a role model.Thank you for introducing these situations. Red Star News Reporter: My question is also about the quality of drugs selected in centralized procurement. The quality of drugs is directly related to public health and safety. Can I ask what considerations the National Medical Products Administration has in strengthening the supervision of the quality and safety of drugs selected in centralized procurement? Thank you. Li Bin: I invite Comrade Huang Guo from the Medical Products Administration to answer this question. Huang Guo: Since the initiation of centralized procurement, the National Medical Products Administration has always regarded selected products as a top priority and has continuously strengthened supervision. We believe this is the bottom line for safeguarding the quality and safety of drugs in the medical reform. We emphasize implementing comprehensive supervision. For drugs and medical devices selected in national centralized procurement, we implement 100% "full coverage" of both production inspections and product sampling inspections. Production inspections are conducted on companies, while product sampling inspections are conducted on listed products. The inspections cover over 600 drug manufacturing companies and over 200 medical device manufacturing companies selected in national centralized procurement and their products. For individual companies found to produce non-compliant products and individual products found to be substandard in sampling inspections, the drug regulatory authorities immediately take measures such as suspending production, importation, sales, and serious disciplinary actions, publicly exposing the issues. Journalists can see some of the information we have released online. We continue to carry out special actions. Since 2022, we have successively organized nationwide special actions focusing on drug safety and consolidation of drug safety measures to strengthen the supervision of selected products in centralized procurement. We have deployed drug regulatory departments at all levels to be problem-oriented, organize companies to fulfill quality responsibilities, identify risks, and focus on resolving risks at an early stage. We focus on strengthening intelligent supervision. On one hand, we are enhancing the drug tracing system along the entire chain, urging drug marketing authorization holders to assign drug traceability codes to selected products in centralized procurement according to regulations. This code acts as an electronic ID for drugs and establishes a sound information-based traceability system. We are working together with the National Medical Insurance Administration to further improve and promote this system. On the other hand, in some key areas, we are promoting the digital transformation of drug production. Building on the completion of the digital transformation of vaccine production, the National Medical Products Administration recently released the "Three-Year Action Plan for Smart Supervision of Blood Products Production." From now until the end of 2026, all blood product manufacturers will gradually establish an information management system covering the entire production, testing, and other processes, effectively improving the efficiency of blood product supervision and providing a higher level of assurance for the quality and safety of blood products. We continue to strengthen inter-departmental collaboration. The National Medical Products Administration and the National Medical Insurance Administration have established a daily communication and quality information feedback mechanism for selected products in centralized procurement. Any issues identified are promptly addressed through collaborative measures, and in short, there is "zero tolerance" for quality issues. Director Hua Bo has already provided an introduction earlier, so I won't repeat it here. With the advancement of the above regulatory measures, overall, the quality of selected products in centralized procurement in China has remained stable and reliable. Next, the drug regulatory authorities will continue to strengthen robust supervision, strengthen the quality and safety responsibility of companies, guide companies to improve their quality management systems, and operate in compliance. At the same time, they will reinforce regulatory responsibilities, continuously strengthen supervision, inspection, quality sampling, adverse reaction monitoring, and cooperate with the medical insurance department to constantly optimize and improve procurement policies, allowing quality and compliant companies to demonstrate their competitive edge in procurement, ensuring that the people can have access to more and better assured drugs. Thank you. Xinhua News Agency Reporter: The pilot work of the medical institution disease control supervisor system has been launched in many places. What is the current progress of this work? What achievements have been made in the implementation process? Thank you. Li Bin: Thank you for your question. I invite Comrade Shen Hongbing to introduce the relevant situation. Shen Hongbing: Thank you for the question. Exploring the establishment of the disease control supervisor system in medical institutions refers to setting up part-time or full-time disease control supervisors in public hospitals, grassroots medical institutions, and private hospitals to supervise the implementation of disease prevention and control work in medical institutions and urge the implementation of the responsibility for reporting infectious diseases and public health emergencies, moving the disease control supervision to an earlier stage. This is a new institutional design, and there is no mature experience to draw from. In 2023, the National Health Commission, together with the National Administration of Traditional Chinese Medicine, launched pilot work in Shanghai, Zhejiang, Anhui, Henan, Hubei, Guangdong, Sichuan, Shaanxi, Gansu, and other 9 provinces. With joint efforts from all parties, positive results have been achieved. First, we explored how to select disease control supervisors. Pilot areas have tailored their approaches to make full use of various channels and optimize the selection of personnel. They have also explored the optimization of the quantity and composition of personnel. For example, in Zhejiang Province, they explored implementing a "one person, multiple points" model for small and medium-sized medical institutions, a "multiple persons, one point" model for large comprehensive hospitals, and a "multiple persons, multiple points" model for medical communities. Second, we explored the main responsibilities of disease control supervisors. The National Health Commission, alongside the National Administration of Traditional Chinese Medicine, issued the "List of Infectious Disease Prevention and Control Responsibilities for Medical Institutions," which outlines 33 specific tasks, clarifying the responsibilities of medical institutions in infectious disease prevention and control and other public health services. This also provides a policy basis for how disease control supervisors should carry out their duties. Third, we explored promoting medical and health collaboration and integration. In the pilot, disease control supervisors actively played their roles, facilitating medical institutions to detect, report, and respond to infectious diseases promptly. For example, in Hubei Province, disease control supervisors played the role of "scout," "communicator," and "instructor," conducting inspections to prompt medical institutions to investigate and evaluate abnormal signals monitoring and take actions. In Sichuan Province, disease control supervisors extended their supervision to the "last mile" by conducting on-site inspections and participating in hospital meetings. Overall, positive progress has been made in the first phase of pilot work. Building on the pilot work from last year, we will further expand the pilot scope this year to all provinces and Xinjiang Production and Construction Corps, moving from local to nationwide, steadily and surely, to ensure tangible results. Thank you. Xing Huina: One last question. 21st Century Business Herald Reporter: Hierarchical medical system is an important institutional design for deepening healthcare reform. What measures will be taken this year to improve the service capacity at the grassroots level and promote the high-quality development of public hospitals? Thank you.How to establish an orderly diagnosis and treatment pattern? Thank you.Li Bin: Thank you for your attention to the hierarchical diagnosis and treatment system. Let me introduce the relevant situation. Enhancing the service capabilities at the grassroots level and promoting the high-quality development of public hospitals are important aspects of the construction of the hierarchical diagnosis and treatment system, as well as the main focus. It is of great significance to improve the quality and efficiency of medical services, facilitate the public to seek medical treatment nearby, and receive good medical treatment. The main focus of this year's work includes the following aspects: 1. In terms of enhancing grassroots capabilities, firstly, promote the improvement of grassroots capabilities and levels. Strengthen the construction of central health centers, enhance the level of equipment provision and comprehensive medical service capabilities, and focus on the construction of departments with shortages such as pediatrics, respiratory medicine, dentistry, and rehabilitation medicine. Promote the comprehensive development of close-range county medical consortia, focusing on promoting the sinking of personnel, technology, services, and management, enhance the overall service capabilities of counties, and enable more common and prevalent diseases to be treated effectively at the county level. Implement family doctor contract services, national basic public health services, promote the inclusion of village health clinics in medical insurance designated management, implement 10 measures for grassroots convenience and benefit, and continuously improve the accessibility and satisfaction of the public in seeking medical treatment at their doorstep. Secondly, provide "external aid" to the grassroots. Organize support from city tertiary hospitals to county hospitals, support from city secondary and above hospitals to community health service centers, support from city hospitals and county hospitals to township health centers, and support from township health centers to village health clinics. Through "group-style" assistance, establish expert work studios, teacher-apprentice programs, and other methods to effectively promote the enhancement of grassroots service capabilities. Thirdly, cultivate "backbone" talents. This year, around 8,000 rural-order-oriented free undergraduate medical students will be recruited for township health centers in the central and western regions. Continuously carry out training projects to enhance the capacity of grassroots health personnel, focusing on improving the diagnosis and treatment capabilities, health management capabilities, and the identification, disposal of common and prevalent diseases among grassroots backbone personnel. Guide various regions to promote the special recruitment and treatment guarantee work for college student rural doctors to attract college students to stabilize their service in rural areas. In terms of promoting the high-quality development of public hospitals, at the provincial level, continuously promote the overall action plan for the high-quality development of public hospitals to drive progress and urge localities to implement support policies for the high-quality development of public hospitals. Further guide 11 comprehensive medical reform key provinces to explore the path for the high-quality development of various levels and types of public hospitals. At the prefectural level, implement the demonstration projects supported by central finances for the reform and high-quality development of public hospitals, strengthen project management, support demonstration cities to lead the formation of experiences of high-quality development of municipal and county-level public hospitals, focusing on 14 large-scale high-level public hospitals for the pilot of high-quality development and establishing a sound modern hospital management system pilot to promote innovation in disciplines, technology, services, management, and talent cultivation, create models for high-quality development and templates for modern hospital management systems. I have introduced these, thank you. Xing Huina: Today's press conference ends here. Thank you to the speakers and media friends. Goodbye. This article is excerpted from "China Net", GMTEight editor: Ye Zhiyuan.