1 2 2 3 2 4 1 211198 2 100080 3 110016 4 100080 1 4% 2 3 3 R95 C 1003-3734 2016 02-0129 - 05 Research of British drug procurement and supply mechanism and the enlightenments for China LI Qian 1 2 GUAN Hai-jing 2 DONG Guo-qing 3 LIU Guo-en 2 4 1 School of International Pharmaceutical Business China Pharmaceutical University Nanjing 211198 China 2 Center for Health Economic Research Peking University Beijing 100080 China 3 Business Administration College Shenyang Pharmaceutical University Shenyang 110016 China 4 National School of Development Peking University Beijing 100080 China Abstract Reforming the current centralized bidding system of drugs and achieving scientific and rational drug selection are urgent issues of China's medical reform. The British drug procurement models and processes were systematically carded and analyzed in this paper. Several facts were found. First Britain practices separation of dispensing from prescription SDP. Centralized procurement is implemented only for generic drugs in public hospitals which accounted for 4% of the total cost of drugs. Independent purchasing is implemented for drugs in community pharmacies and patent drugs in public hospitals. Second prices of drugs paid by medical insurance are decided by the British government but purchase prices of drugs are determined through negotiations between medical institutions or community pharmacies and pharmaceutical suppliers. Third NICE plays an important role in drug pricing adjusting health insurance directory as well as promoting rational use of drug. Key words the United Kingdom drug procurement National Institute for Health and Clinical Excellence NICE 18710012239 E-mail qianli0623@ sina. com E- mail ggliupku@ gmail. com 129 2016 25 2
25% 2015 2 10% 75% 90% 1 general practitioner GP 2012 self-employed GDP 9. 3% 4 12% 2 2 40. 4% 3 2. 1 NHS 12% 7 3 1 4 6 5 NHS na- NHS tional health system NHS medical NHS assistance system MAS private The association of the British health insurance PHI Pharmaceutical Industry ABPI pharmaceutical price regulation scheme PPRS primary British Generic Manufacturers Association BGMA care secondary care NHS 1 EMA European Medicines Agency DH The Department of Health MHRA Medicines and Healthcare Product Regulatory Agency NICE National Institute for Health and Clinical Excellence black or grey list NHS 2 negative lists selected list scheme SLS NHS 1 Black list 2 Grey list GSL general sales list drug Rx prescription drug P pharmacy drug 1 130 2016 25 2
2. 2 etendering system National In- stitute for Health and Clinical Excellence NICE 7 1999 NICE CMU 8 pre qualification questionnaire PQQ NHS 2. 2. 1 1957 invitation to tender ITT PQQ ITT PPRS PQQ /ITT secure message area PQQ ITT NHS PQQ /ITT response envelope Technical Envelope NICE Commercial Envelope PQQ /ITT NICE NHS 6 NICE 2. 2. 2 NHS NICE NHS PQQ response Envelope NHS 2. 2. 3 NICE NICE 6 3 frame- work contacts 3. 1 3. 1. 1 NHS 3 20% 60% 20% 5 Commercial Medicines Unit CMU PQQ 1 2 3 4 2 8 2 9-11 131 2016 25 2
CMU 2 3. 1. 2 4. 1 NHS CMU NHS 3. 2 70% ~ 80% NHS Pharmaceutical Services Negotiating Committee PSNC 12 NHS claw-back policy 5. 6% ~ 11. 5% 9. 2% 13 4 4. 2 3 4% NHS NICE 132 2016 25 2
4. 3 NHS NHS uk /about /who-we-are. 2014 4. 4 NICE 10 14 2015 1 Chinese Journal of NewDrugs 2016,25(2) EB /OL. 2015-02 - 28. http / /www. gov. cn / zhengce / content /2015-02 /28 / content_9502. htm. 2 Organization for Economic Co-operation and Development. OECD Data of Health resource DB /OL. 2013 2014-01 - 10. http / /www. oecd. org /health. 3. 2013 J /OL. 2013 2014. http / /www. nhfpc. gov. cn /htmlfiles / zwgkzt / ptjnj / year2013 / index2013. html. 4. J. 2010 22 22 110-111. 5. J. 2013 7 47-51. 6 The National Institute for Health and Care Excellence. NICE Chapter Z /OL. 2013-04 - 20. https / /www. nice. org. 7 Department of Health. The CMU is part of the Medicine Pharmacy and Industry Group of the department which looks at supply and procurement in hospitals EB /OL. 2011-03 - 04. https / /www. gov. uk/government /collections/commercialmedicines-unit-cmu. 8 Department of Health. The Commercial Medicines Unit's e Tendering system. 2014 2014-03 - 04. https / /cmu. bravosolution. co. uk / web / login. shtml. 9. N. 2011-12 - 30. 4.. J. 2015 24 21 2420-2424. 11. J. 24 23 2746-2750. 12 Department of Health. Adjustment to Generic Medicine Reimbursement Prices from April2014 EB /OL. 2014 2014-03 - 24. https / /www. gov. uk /government /publications /generic-medicine- reimbursement-prices-april-2014. 13. J. 2012 6 68-70. 14. NICE J. 2011 14 3 193-195. / 2015-08 - 14 櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌櫌 2015 9 18 2015 2015 56 2015 99 100 100 133 2016 25 2