On November 4, the official website of the State Medical Insurance Administration issued the notice on doing a good job in the continuation work after the expiration of the national organization's centralized drug procurement agreement. The circular pointed out that, in principle, all countries should continue to carry out centralized drug procurement with quantity after the expiration of the agreement on centralized drug procurement, and should not "only negotiate price without quantity". Holders of marketing licenses for the original drug, reference preparation and drugs that have passed the consistency evaluation of quality and efficacy of generic drugs can participate.

In order to implement the opinions of the general office of the State Council on promoting the normalization and institutionalization of centralized drug procurement (GBF [2021] No. 2), consolidate the achievements of the reform of centralized drug procurement organized by the state and realize the smooth succession after the expiration of the procurement agreement, the relevant work requirements are hereby notified as follows.

1、 Attach great importance to the continuation work after the expiration of the agreement

The smooth implementation of the succession work after the expiration of the agreement on centralized drug procurement organized by the state (hereinafter referred to as "succession work") is an important link in implementing the decision-making and deployment of the CPC Central Committee and the State Council on the reform of the centralized drug procurement system and promoting the normalized and institutionalized operation of centralized drug procurement. All localities should fully understand the importance of doing a good job in this work, earnestly integrate their thoughts and actions into the decision-making and deployment of the Party Central Committee, adhere to the people-centered principle of "integration of recruitment and procurement and linking quantity and price", follow the direction of reform, focus on stabilizing market expectations, stabilizing price levels and stabilizing clinical drugs, and focus on provinces (autonomous regions, municipalities directly under the central government and Xinjiang production and Construction Corps) Or inter provincial alliance as a unit, comply with laws and regulations, carry out continuous work smoothly, and guide the society to form long-term stability expectations.

2、 Carefully carry out the connection work

（1） Insist on purchasing with quantity. In principle, after the expiration of the agreement on centralized purchase of drugs organized by all countries, they shall continue to carry out centralized purchase with quantity, and shall not "only negotiate price without quantity". Holders of marketing licenses for the original drug, reference preparation and drugs that have passed the consistency evaluation of quality and efficacy of generic drugs can participate. The medical institution shall report the demand of the drugs to be purchased in combination with the actual use, clinical use and medical technology progress of the previous year. The medical insurance department shall summarize the total demand submitted by the medical institution and determine the agreed purchase quantity in combination with the proportion of the carrying quantity. In principle, it shall not be less than the agreed purchase quantity of the previous year. For medical institutions whose reported demand is significantly lower than the purchase volume of the previous year, they shall be required to explain and strengthen the supervision of their purchase behavior. The allocation rules of purchase quantity shall be clearly agreed in advance to ensure that the agreed purchase quantity is allocated to each selected enterprise and each medical institution.

（2） Carry out succession by classification. Focusing on maintaining the stability of the market and clinical medication, comprehensively considering various factors of enterprises and products, the selected enterprises and prices are determined through inquiry, bidding and comprehensive evaluation.

1. For the varieties selected during the last round of centralized purchase, in principle, inquiry shall be carried out on the basis of stabilizing the price level and clinical medication. If the price of the last round of winning in the province is not higher than 1.5 times the lowest price in the country, an inquiry shall be made to all qualified enterprises based on the price of the last round of winning in the province; If the last round winning price in the province is 1.5 times higher than the national minimum winning price, an inquiry shall be made to all qualified enterprises based on no more than 1.5 times the national minimum winning price. The upper limit of inquiry is the highest winning price in the country in the last round. The winning enterprise and the winning price can be determined according to the enterprise's willingness to quote and in combination with the comprehensive evaluation results of the enterprise and its products.

2. If the inquiry is unsuccessful, or the winning result is generated in equal amount in the previous round of centralized purchase, or the actual sales price of non winning products in the current market is significantly lower than the lowest winning price in the province in the previous round of centralized purchase and there is actual supply, the winning enterprise and winning price can be regenerated through bidding.

Provinces with large demand or high demand for supply guarantee are encouraged to select the same variety from multiple enterprises, and the price difference between different successful enterprises shall be fair and reasonable. According to the principle of linking quantity with price, the agreed purchase quantity of each selected enterprise shall be clarified. The purchase agreement period can be determined by referring to the relevant rules of the national organization for centralized drug purchase, the purchase cycle can be adjusted appropriately, and the execution time of different centralized purchase batches can be gradually unified. Encourage comprehensive evaluation on the supply, performance, product quality and clinical response of enterprises.

（3） Strengthen credit and performance evaluation. Integrate the credit evaluation and performance into the main links of the succession rules, so as to play a substantive role in the application qualification, winning qualification, winning order and supply region selection of enterprises. If the successful enterprise is determined by comprehensive evaluation, all provinces shall incorporate the enterprise's credit evaluation and performance into the comprehensive evaluation factors and give a higher weight. If comprehensive evaluation is not adopted for the time being, the pharmaceutical price and bidding and procurement credit evaluation shall be regarded as one of the important conditions for the shortlisting of enterprises. Under the same circumstances, the enterprises with better credit evaluation shall be selected first. Enterprises that have been selected in the previous round, if the comprehensive evaluation results or good credit and performance, can be given priority in the follow-up work; In case of poor credit and performance, punishment shall be given in the succession rules. If the applicant enterprise is listed in the "list of violations" by the state organized drug joint procurement office or is recognized as dishonest to varying degrees by the province, it may take disposal measures such as moving back the winning order, reducing the proportion of carrying capacity and reducing the supply area according to the regulations until its qualification to participate in the succession is suspended.

（4） Improve supporting policies. We will continue to implement the prepayment of medical insurance funds and reduce the pressure on medical institutions to collect payments. We will improve the online rules for centralized purchase varieties, further coordinate the medical insurance payment standard with the winning price, and effectively improve the sense of access of patients.

（5） Strengthen the supervision of performance. Establish and improve the information traceability system of selected drugs to ensure the traceability of selected drugs in the whole process of production and circulation. Carry out monitoring and evaluation on the supply and credit of the selected enterprises, compact the performance responsibility, and apply the evaluation results to the future centralized mining work. Regularly monitor the purchase, use and payment collection of medical institutions to ensure that medical institutions use the selected products reasonably, give priority to the use of selected products and collect payment in time.

3、 Strengthen organization and Implementation

Local medical security departments shall earnestly shoulder the responsibility of overall planning, coordination, supervision and guidance, refine and improve the regional implementation plan, strengthen policy coordination and work cooperation with relevant departments, carry out continuous work in a timely manner, and report major problems to the State Medical Security Bureau in a timely manner. The state organizes the joint drug procurement office to continue to do a good job in daily monitoring and analysis, and supervise and urge the implementation of procurement results.