江苏省医用耗材、试剂的“两票制”浮出水面

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                    <p><img data-type="gif" src="http://mmbiz.qpic.cn/mmbiz_gif/dx3KibwtDhvc6YBndBzrYvfAVPCGNAlsqB9f7SjRnXkibcO3P2CSjz7TnOO8RAArOGOjobic1D5DCTCzzAoxv9jfw/0?wx_fmt=gif" data-ratio="0.1703125" data-w="640"  /></p><p>5月24日，江苏省卫计委发布《江苏省公立医疗机构药品采购推行“两票制”实施方案（征求意见稿）》（以下简称《意见稿》），面向社会公开征求意见，反馈时间截止2017年5月31日前。</p><p>&nbsp;</p><p>　　该《意见稿》对江苏省<strong><span style="color: rgb(0, 153, 102);">药品</span></strong>“两票制”的落地做出了具体部署，但也提出，鼓励有条件的地区在医用耗材和检验检测试剂集中<strong><span style="color: rgb(0, 153, 102);">采购</span></strong>中推行“两票制”。</p><p>&nbsp;</p><p>　　至此，江苏省已经给出了答案：在推进药品“两票制”同时，并不会强制推行耗材、试剂“两票制”。但是，也不排除部分市县会先行推出耗材、试剂“两票制”。</p><p>&nbsp;</p><p>　　今年4月13日，江苏省卫计委、省编办、省政务办曾联合发文，决定在全省范围内开展医用耗材和检验检测试剂集中采购，要求各地于7月底前以市为单位启动实施集中采购工作，年底前实现上网采购。5月9日，全省耗材、试剂集中采购工作推进会又在扬州召开，各市均汇报了当前工作进展和下一步打算。</p><p>&nbsp;</p><p>　　江苏全省以市为单位的耗材、试剂集中采购工作即将展开，而鉴于该省药品“两票制”执行时间要与省标同步，不出意外的话，省内哪些市会赶在这一轮就推出耗材、试剂“两票制”也将很快有答案。</p><p>&nbsp;</p><p>　　其中，泰州这个地级市，是已经提出，要对临床检验试剂和除电生理类、非血管介入类、起搏器类、神经外科类、眼科类、血管介入类之外的所有医用耗材实行“两票制”的，相关文件正在征求意见之中。</p><p>&nbsp;</p><p>　　而由南通市代管的县级市——启东市，就在前几天才加入了药品耗材联合限价采购三明联盟，依据相关协议，也是得实行耗材“两票制”。启东市还是全国4家县级公立<strong><span style="color: rgb(0, 153, 102);">医院</span></strong>综合改革示范县之一，其实行耗材“两票制”意义格外重要。</p><p>&nbsp;</p><p>　　另外，依据《意见稿》，江苏省在药品“两票制”的界定上与国家版有所不同，相关差异也或将反映到省内对耗材、试剂“两票制”的界定上。</p><p>&nbsp;</p><p>　　江苏省方案规定：药品生产企业或科工贸一体化的集团型企业设立的全资或控股（超过50%，下同）商业公司（全国仅限1家）销售本企业（集团）药品时视同生产企业，销售非本企业（集团）药品时视同流通企业。</p><p>&nbsp;</p><p>　　这一界定的亮点之一是，强调了控股要超过50%。还在于将生产企业下面的商业公司分成两种情形各自考量。</p><p>&nbsp;</p><p>　　一般来说，国内生产企业下设的销售公司都是只销售自家产品的，但也不排除有些还会<strong><span style="color: rgb(0, 153, 102);">代理</span></strong>销售别家产品。严格按照国家版“两票制”方案的话，此类销售公司不能视同生产<strong><span style="color: rgb(0, 153, 102);">企业</span></strong>。而江苏版方案作了拆分，此类公司销售自家产品时不算一票，销售别家产品时算一票。这样就相对放宽和更务实一些了。</p><p>&nbsp;</p><p>　　江苏省方案还规定：境外药品国内总代理（含国内分包装企业）、生产企业之间产品经销权转让的受让方、不具备药品经营资质的药品上市许可持有人委托代为销售药品的生产企业或流通企业可视同生产企业，以上三种情形均全国仅限1家。</p><p>&nbsp;</p><p>　　此处，对“国内分包装企业”的强调等也是一大亮点，更多考虑到了生产企业的一些现实问题。</p><p><img data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/dx3KibwtDhvcFf6wmVRj8ibwY5LGyx0zRrcRpFdiaoddoAIjmmWSbCdgeqhQVKIics4ZmodHalAWolEYbSKQbDRKWw/0?wx_fmt=jpeg"  /></p><p style="max-width: 100%; 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