新动向!耗材降价政策落地,高值耗材带量采购将开始

2019-06-24 整理:米克 赛柏蓝器械/每经网

无论是耗材零加成,还是高值耗材的带量采购,国家对该领域的重点管控都已成了不争的事实。

无论是耗材零加成,还是高值耗材的带量采购,国家对该领域的重点管控都已成了不争的事实。

取消耗材加成政策落地

北京市政府宣布于6月15日零时在北京市推开医耗联动综合改革,全市近3700所医疗机构按医用耗材进价收费。这也是北京在取消以药养医后,将再次告别以耗养医。

对于政策的落地与执行情况,赛柏蓝器械选择了在耗材上消耗量相对较大的牙科医院进行探访,在北京大学口腔医门诊的挂号与收费窗口处看到,玻璃上张贴着《取消医用耗材加成承诺书》。

内容指出,我院自15日零时起开始实施北京医耗联动综合改革,所有向患者收费的医用耗材价格已全部按采购价收费。

赛柏蓝器械采访了刚刚完成缴费的一位患者,他谈到:“这个政策实施的真快啊,我没想到,我患了龋齿、髓腔内也有感染,还有其他的牙病,目前在进行小手术的治疗,周期很长,正好在横跨了政策实施的前后,缴费的时候有明显感觉,比以前降了。”

据了解,北京市卫健委这次改革除了对耗材取消加成以外,还将降低仪器设备开展的检验项目价格。欲通过这些措施让开药、使用支架和导管等医用耗材不再给医疗机构带来额外利益,废除这样的补偿机制。

医改不是只盯着降价

那患者支出费用的总额100%都会下降么?

北京市卫生健康委主任雷海潮日前表示,此次医改不只是一味降价,中医、病理、康复、手术的服务价格水平有所调高。虽然在医疗服务项目价格方面,按照“总量控制、结构调整、有升有降、逐步到位”原则,降低了资源消耗性项目的价格,但是也会提高脑力体力投入较大的项目价格。

同时,对于患者来说,不同疾病患者费用有降有升,比如使用高值耗材较多的病种,费用可能会下降;以技术劳务治疗项目为主的病种,费用可能会有所增加。

改革之后,北京市医疗费用总量基本平衡。对此,相关部门已进行细化分析,对由于价格调整可能引起费用涨幅明显的病种,会通过控费、医保政策结合救助政策予以解决。

降价对经销商是利好?

北京市启动降价之后,6月18日,国家卫健委、国家中医药局发布了《医疗机构医用耗材管理办法》。文件要求,医疗机构采购医疗设备时,应当充分考虑配套使用医用耗材的成本,并将其作为采购医疗设备的重要参考因素。

一位国内医疗器械企业高管对媒体表示,降价对国内医疗器械企业既是机遇也是挑战。在医疗机构降低采购成本的情况下,原本价格高的进口耗材,有望被价格低、质量好的国产耗材替代,这是机遇。

但是整个行业面临的挑战也不可小觑,结合此前的耗材阳光采购等多项政策,整体医疗器械行业都面临降价压力,企业需对原有的流通环节和销售模式进行变革。

在业内看来,进口医疗器械价格较高,加强成本控制能够促进高质量、更低价格的国产医疗器械替代。

在医保控费、药品/耗材零加成的大趋势下,从前“不差钱”的大三甲医院已经逐步开始控制成本,三甲医院作为医疗支出的头部企业,将逐步转向一些性能优异、成本低廉的国产设备,这对经销商来说可能是一利好消息。

高值耗材即将带量采购

近日,安徽卫健委官网发布了2019年综合医改重点工作及责任分解,从巩固现有医改成果、完善试点改革措施、创新破解医改工作难题、强化医改工作保障措施等四方面列举29项工作要点,布局2019年医改工作。

文件明确,开展药品耗材带量采购。支持现代医疗和医药产业发展,落实“首台套”药械产品推广应用等政策,不断完善药品耗材带量采购实施办法,改造升级省级药品集中招标采购信息系统,推进“17+13+X”种抗癌药惠民落地,开展高值医用耗材带量采购,建立完善药品耗材谈判议价机制。

可以看出,安徽这一政策的推行是对于此前国务院颁布政策的落实。今年6月5日,国务院办公厅印发《深化医药卫生体制改革2019年重点工作任务》,文件指出将制定医疗器械唯一标识系统规则。

具体包括,逐步统一全国医保高值医用耗材分类与编码,对单价和资源消耗占比相对较高的高值医用耗材开展重点治理,改革完善医用耗材采购政策。

此前,5月末,国家医疗保障局调研组到山东省公共资源交易中心开展时提到,自2019年1月国家推出“4+7”药品集中带量采购试点政策至今,已取得明显效果,“如何学习借鉴药品带量集中采购做法,控制高值医用耗材价格相对较高的局面,国家医保局对此深入有关省份进行专题调研。”

这些消息已经足以印证:高值耗材领域也要开展4+7形式的带量采购。

械企董事长:建议审慎推行带量采购

对于高值耗材带量采购,业内也有不同声音。

今年两会上,全国政协常委、全国工商联副主席、上海微创医疗器械(集团)有限公司董事长兼首席执行官常兆华表示,带量“4+7”采购试点是医保局解决我国“医保缺口”问题的探索性措施之一,对于降低药价、消除部分不合理中间环节,节省国家有限的医保资金或有积极作用。但在“4+7”的实际效果尚未得到准确全面的评估之前,不宜轻率地扩展至高端医疗器械领域,尤其是直接影响患者生命健康安全的高值耗材。

常兆华认为,而我国高值耗材产业实力依然薄弱,目前尚无统一的编码体系和评分标准。最重要的是,目前没有任何科学的方法来区分高值耗材的不同质量层次或等级,若采用低价中标的惯常做法势必会引发“劣币驱逐良币”现象。

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    2019-06-26 bioon3
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    2019-06-26 30397605
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    2019-06-26 wolongzxh
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