Internet pharmacies only cost more than 20 yuan? A reporter's investigation found that Shanghai medical insurance pharmacies sell 82 yuan worth of drugs for procurement | drugs | medical insurance

Ms. Song, a Shanghai citizen, reported to Xinmin Evening News that she bought Shuanghuanglian Oral Liquid at a designated retail pharmacy for medical insurance. The price of the pharmacy was 82 yuan, almost three times the price of the Internet pharmacy, which made her puzzled.

The reporter of Xinmin Evening News made a survey, and the relevant departments gave a clear response: this medicine has been included in the traditional Chinese patent medicines and simple preparations purchase catalog in quantity in Shanghai, and the new price of "half discount" will be implemented soon. In addition, the Health Insurance Bureau has been studying to include Internet pharmacies in the scope of medical insurance payment.

Online and offline, significant price difference

Ms. Song told reporters that she recently purchased two types of medicine from a medical insurance designated retail pharmacy in Longbai Village, Minhang District, using her medical insurance card: Shengmai Yin and Shuanghuanglian Oral Liquid, with a unit price of 71 yuan and 82 yuan, respectively. Later, she accidentally found that the prices of both drugs in Internet pharmacies were "much cheaper".

At the medical insurance pharmacy, the price of Shuanghuanglian oral liquid is 82 yuan. The pictures in this article are the WeChat official account pictures of "Xinmin Evening News"

The reporter saw on the Meituan Medicine App that Ms. Song's purchase of Shengmai Drink is generally priced at around 60 yuan. "Considering the factors of online sales, this price difference is still acceptable," said Ms. Song, who was truly surprised by the price difference of Shuanghuanglian Oral Liquid.

Ms. Song purchased Shuanghuanglian Oral Liquid from Henan Tailong Pharmaceutical Co., Ltd., with a specification of 20 milliliters x 10 tubes. This kind of traditional Chinese patent medicines and simple preparations, which sells for 82 yuan in medical insurance drugstores, only sells for 20 yuan in Internet drugstores. For example, on the Meituan Buy Medicine App, the price of this Shuanghuanglian oral liquid from multiple stores ranges from 27 to 34 yuan; Tmall also sells it, even at a price lower than 27 yuan.

In Internet pharmacies, the price of the same medicine is much lower.

Purchasing drug prices can refer to

Ms. Song wondered: This Shuanghuanglian oral liquid is a drug listed in the medical insurance catalog. What price point is more reasonable?

The reporter logged into the Citizen Cloud App of Suishenban and entered the "Hospital Drug Procurement Query" column. Typing in the keyword "Shuanghuanglian", multiple records related to Shuanghuanglian oral liquid appeared. Among them, there were three manufacturers from Henan Tailong Pharmaceutical Co., Ltd., but one was a children's type, and the other two specifications were 10ml x 6 and 10ml x 12. According to the query instructions, it can be clarified that there is no procurement record for Shuanghuanglian oral liquid with a specification of 20 milliliters x 10 tubes in the past 30 days.

But the prices of the other two specifications of drugs mentioned above can still be used as a reference. The reporter first chose the specification of 10 milliliters x 6 tubes. According to procurement records from multiple medical units, the reference price for procurement is 25 yuan; Next, choose a specification of 10 milliliters x 12 tubes, with a reference price of 50 yuan. Now we can make some comparisons: 60 milliliters are priced at 25 yuan, 120 milliliters are priced at 50 yuan, so the pharmacy selling 20 milliliters x 10 pills for 82 yuan seems reasonable.

In fact, Ms. Song went to this designated retail pharmacy for medical insurance, and Shuanghuanglian was priced at 82 yuan, which is still considered "cheap". The reporter learned from another large chain pharmacy in this city that the sales price of "Tai Long" Shuang Huang Lian Oral Liquid sold by the company is 91 yuan according to the record price of the "Shanghai Pharmaceutical Procurement Service and Supervision Information System". According to the regulations of the local pharmaceutical management department, retail pharmacies can increase prices by a certain proportion to sell drugs on the centralized procurement platform.

It can be basically judged that if referring to the drug prices of medical institutions in Shanghai, medical insurance pharmacies selling this "Tai Long" Shuang Huang Lian oral liquid, whether for 82 yuan or 91 yuan, should not break the rules and be within a reasonable range.

Pharmacy drug prices are allowed to rise

There are three main channels for citizens to obtain drugs: hospitals, offline pharmacies and Internet pharmacies. How did each of the three operate differently, and how did they determine their respective drug prices? Why are there differences?

The reporter's investigation found that in the "Hospital Drug Procurement Query" column of the Citizen Cloud App of Suishenban, the price information of drugs purchased by designated medical institutions under the city's medical insurance can be found. The query scope includes some drugs listed in the medical insurance directory, and the information source is data uploaded by Shanghai medical insurance designated medical institutions to the "Shanghai Medical Procurement Service and Supervision Information System" in the past 30 days. The reporter noticed that the system can check the drug procurement status of "hospitals" rather than "pharmacies".

According to the regulations on pharmaceutical management, medical insurance designated medical institutions must place orders on the Sunshine platform after negotiating prices with the pharmaceutical factory when purchasing drugs, and the agreed prices must be consistent with the order prices. Given that the government has a "zero markup" policy for hospitals, the sales price can be calculated based on the hospital's drug procurement price. The procurement prices of different hospitals may theoretically differ, but in reality, they often tend to converge due to market factors.

And pharmacies are for-profit commercial institutions that have the autonomy to purchase drugs and do not need to place orders on the Sunshine platform; The selling price of drugs listed in the medical insurance catalog can be increased by a certain proportion based on the hospital's drug prices, but it must be uploaded to the Shanghai Medical Procurement Service and Supervision Information System. The Sunshine Platform is not responsible for or has control over the procurement and pricing of drugs by pharmacies, but reports and supervises the sales prices of medical insurance drugs.

Internet pharmacies are operated in a market way, and drugs are not included in medical insurance. Citizens buy drugs at their own expense. The Sunshine Platform has not yet included their purchase and drug prices into management.

It can be seen that among pharmacies, due to different procurement channels, the selling price of the same medicine may vary; When it is extended to offline pharmacies and Internet pharmacies, price differences are more likely due to different operating costs, channels, subsidies, etc. Internet pharmacies can also create low-cost "blockbusters" at any cost to drive sales and attention. It is entirely possible that the price of the same drug in offline pharmacies is higher than that in Internet pharmacies.

New price for quantity procurement, to be executed soon

Ms. Song said that selling Shuanghuanglian oral liquid for 82 yuan or even 91 yuan was not a violation. She understood the "truth", but she could not let go of the fact that Internet pharmacies were selling so cheaply: can't the prices of drugs in medical insurance designated retail pharmacies and hospitals be cheaper?

The Shanghai Medical Security Bureau responded to reporters that since the government abolished the administrative pricing of most drugs in 2015, Shanghai has adhered to the basic principle of market pricing in accordance with national requirements. The price of drugs, whether in medical institutions or pharmacies, is negotiated between medical institutions, pharmacies, and production enterprises. Through technological means, the Sunshine Platform ensures that both supply and demand sides negotiate prices in an open and transparent manner.

At the same time, the medical insurance department always keeps monitoring the actual sales price of related drugs. Once the price is abnormal, it will verify the supply channel of the drug, the sales price of the same drug in other provinces and cities, the sales price of the drug in different hospitals, different pharmacies and Internet channels in Shanghai, and conduct interviews on this basis to remind the supply and demand parties to agree on a reasonable price.

For the "Tai Long" Shuang Huang Lian oral liquid mentioned in the reporter's interview letter, the drug has been included in the city's traditional Chinese patent medicines and simple preparations procurement catalog in August this year. The bid winning procurement price currently announced is: 10ml × 6 tubes, 11.25 yuan; The specification of 10 milliliters x 12 tubes is 22.5 yuan. It is expected that the relevant prices will be implemented in designated medical institutions under Shanghai medical insurance in October.

The reporter learned that since 2014, Shanghai has been piloting quantity based procurement for some commonly used clinical drugs. Since 2018, we have taken on the responsibility of national drug procurement and carried out national drug procurement work. So far, we have successfully procured 8 batches of 333 types of drugs. The new batch of traditional Chinese patent medicines and simple preparations procurement catalogue launched in August this year covered 76 generic names of drugs. On August 30, the publication of the proposed winning results of procurement in volume was completed.

The Shanghai Municipal Medical Security Bureau revealed that, in order to facilitate the citizens to dispense drugs through the Internet, the medical insurance department is paying close attention to the research on incorporating Internet pharmacies into medical insurance payment.