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at present, the essence of national centralized procurement is a two-stage bid evaluation: the first round is an evaluation of technical standards, and the second round is a commercial competition. this mechanism has led to the pharmaceutical industry falling into a "race to the bottom" state. winning bidders often pursue the lowest cost, and ultimately focus on "low price and meager profit", making it difficult to continuously improve drug quality and supply chain. the consequence of this compression of the value chain is the risk of a "substandard market" in the market.
in order to change the "race to the bottom" situation, the national centralized procurement needs to explore a more scientific and reasonable evaluation index system. relying solely on price and quality comparison is not enough to measure the true value of drugs. a comprehensive bid evaluation method should be adopted, combining multiple factors such as corporate management system and credit evaluation for comprehensive evaluation. only when government departments, experts and scholars jointly participate in the formulation of a comprehensive bid evaluation index system can a more scientific evaluation mechanism be formed, and the winning companies can be encouraged to improve the quality and management level of drugs.
in addition, the drug regulatory system also needs to be reformed simultaneously. at present, it mainly relies on post-event supervision and lacks dynamic monitoring of drug quality. it is urgent to strengthen the real-time quality supervision of selected drugs and strengthen daily supervision, changing from "post-event" to "ex-ante" supervision mode. more importantly, consistency evaluation should not be just a one-time assessment. the drug regulatory authorities should conduct continuous evaluation and absorb feedback and data from researchers and clinical institutions to make drug quality standards more perfect.
patients’ needs are the primary consideration, so the government needs to actively solve the problem of “not being able to buy original research drugs”. on the one hand, generic drug companies should be encouraged to improve drug quality and management capabilities; on the other hand, original research drug companies should be guided to transform and upgrade and embrace the chinese market. multinational pharmaceutical companies need to abandon the high-profit model and reduce academic promotion to reduce market operating costs in order to better adapt to the development needs of the new era.
finally, the existing policy needs a certain degree of flexibility. if patients are willing to purchase original research drugs at their own expense, diversified selection channels should be provided, such as designating some designated hospitals as original research drug supply guarantee units, or establishing a temporary drug allocation platform to meet the needs of patients. only through refined management can the efficiency of drug supply be effectively improved and "one product, one policy" be achieved.
