实施11年的“一品两规”,即将失效!
2018-07-30
来源:医药网
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直销专业网讯 实施11年的“一品两规”,即将失效!

▍通过一致性评价药品,大开绿灯

7月26日,山东卫计委发布《关于山东省公立医疗卫生机构药品和高值医用耗材集中采购工作有关问题的通告》(以下简称《通知》)。对通过一致性评价的药品,在招标采购环节,开了绿灯——和原研同组竞价,允许提价。

《通知》表示,对纳入公开招标目录范围内且通过仿制药质量和疗效一致性评价的药品(以国家药品监管部门核发的批准证明文件为准),列入第一竞价组,不受中标产品数量限制。

▍自主报价,可以提价

由生产企业在不高于同竞价组已中标产品、最高价格的范围内自主报价,经省公共资源交易中心审核、公示后挂网。

通过一致性评价,一个药品耗资600-1000万元,在这个规则下,给予了投巨资做一致性评价的药企,提价的机会。至于说,会不会有企业把产品报出和原研药接近的价格,见仁见智。

但至少给冲击原研药的仿制药,更多的战略空间,制定价格策略,会更加灵活。

▍仿制药政策落地,一品两规是束缚

自2016年2月6日,国务院办公厅发布《关于开展仿制药质量和疗效一致性评价的意见》后,从2017年12月29日开始,随着通过一致性评价的药品越来越多(截至目前已有5批共计58个品规),各个省份相继都出台了在招标采购、医院使用环节的鼓励政策。

大多数是采取直接挂网采购,但略有不同。陕西、广西取全国最低N省的平均价;山西、江苏规定不高于其他省份;和山东相似的是宁夏,宁夏废止了药品最高限价,此外,浙江、上海、湖北、重庆等地都有政策出台。

招标采购开绿灯,在使用环节,国务院明确要求“医疗机构要优先采购使用,通过一致性评价的药品”。

▍一品两规,将被摒弃

这意味着什么?行业资深人士李志轩老师告诉赛柏蓝,“一品两规”的限制,即将被全面突破!

“一品两规”,源出于卫生部2007年2月14日发布,当年5月1日起施行实施的《处方管理办法》第十六条:医疗机构购进药品,同一通用名称药品的品种,注射剂型和口服剂型各不得超过2种,处方组成类同的复方制剂1-2种,因特殊诊疗需要使用其他剂型和剂量规格药品的情况除外。

李志轩说,国家政策明确,招标采购只选用首先通过一致性评价的3个药品;又鼓励医疗机构优先采购使用;国家卫健委的一位官员也讲“仿制就是为了替代。”如果要做到这一点,首先就要摒弃“一品两规”的限制。

否则过一致性评价的意义在哪里?

▍“一品两规”限制,对国产仿制药不公平

中国医药企业管理协会专家委员会委员(浙江省医药行业协会原会长)郭泰鸿也曾撰文称“一品两规”对国产仿制药并不公平。一些省的药品集中采购中,对“一品两规”执行有错位,把这“2种”认定为一种进口原研药、一种国产仿制药。国产仿制药数量上多于进口原研药,却要千军万马争夺那个“1”。这明显不利于国产仿制药而有利于进口原研药。

他说,经过两年多的努力和大量的资金投入,越来越多的国产仿制药通过了国家的一致性评价。质量的提升,使得国产仿制药的价格优势更为显现。所以,必须在药品集中采购中,让国产仿制药和进口原研药在一个平台上公平竞争。

▍浙江先行,已突破一品两规

5月9日,浙江省药械采购中心发布《关于通过质量和疗效一致性评价仿制药直接挂网采购的通知》表示,医疗机构在2018年底之前,可临时突破《处方管理办法》中有关使用药品一品两规的规定,增加采购使用通过一致性评价的产品。

历史的车轮总是向前的,要想真正让通过一致性评价的产品,吻合政策赋予的价值和期待,此后的政策需要配套。招标、采购和整个医保报销,进入医院的使用环节,都需要去构建相应的配套机制。

比如一品两规的限制,药占比的细化等等。至少,浙江开了个头,一品两规的限制,在实施11年后,看起来该被废除了。

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