3月4日，第五届“声音·责任”医药行业全国人大代表、政协委员座谈会在京召开，会上多位委员代表将矛头指向了“二次议价”，呼吁谨慎试点进行。

On March 4,The fifth"Voice, responsibility"Pharmaceutical industry to the National People's Congress/CPPCC member symposium held in Beijing,A number of member representatives to the meeting"The second negotiation",Trial calls for caution.

　　所谓二次议价，是指医疗机构在省级药物招标结果的基础上，对中标药品进入医院采购之列时，进行再一次杀价。药企普遍担心，“一旦全面放开二次议价，将议价权下放至医院，那么医院作为一个大的垄断方，其庞大的议价能力将会让制药企业的日子更难过。”

The so-called secondary bargaining,Refers to the medical institutions at the provincial level based on the results of drug bidding,To the bidding procurement of drugs into the hospital,To bargain again.Drug firms generally concerned,"Once fully liberalised secondary bargaining,The bargaining power sent to the hospital,So hospital monopoly as a major party,Its huge bargaining power will make life harder for pharmaceutical companies."

　　

◇信号 Cardiac signal

　　

二次议价将被放开 The second negotiation will be let go

　　在2013年全国卫生工作会议上，卫生部部长陈竺提出，“可探索由公立医院管理部门代表辖区内所有公立医院在省级集中招标采购的基础上，进行成交确认，实现带量采购、量价挂钩，最大限度降低药品价格。”医药行业分析人士认为，陈竺此番表态正是“二次议价”将被放开的信号。

National health work conference in 2013,Minister of health Chen zhu,"Can explore all within its jurisdiction by a representative of the public hospital management department on the basis of public hospital in the provincial centralized bid procurement,Clinch a deal to confirm,With quantity purchasing/Pegged to the quantity and price,Lower drug prices."Pharmaceutical industry analysts said,Chen's comments"The second negotiation"Signal will be let go.

　　我国公立医疗机构对药品进行集中招标采购，始于1999年，此后经过几年试点后全面推开。2010年，卫生部等七部委联合制定的《医疗机构药品集中采购工作规范》明确规定，医疗机构按照合同购销药品，不得进行“二次议价”，严格对药品采购发票进行审核，防止标外采购、违价采购或从非规定渠道采购药品。

Public medical institutions in our country on drug centralized bid procurement,Began in 1999,After years of pilot after full implementation.In 2010,,Seven ministries and commissions such as the ministry of health jointly[Medical institutions and drug centralized purchasing job specification]Make clear a regulation,Medical institutions shall, in accordance with the contract selling drugs,May be undertaken"The second negotiation",Strictly for drug purchase invoice for review,To prevent the outside purchases/WeiJia procurement channels to purchase drugs or from the rules.

　　然而，这一规定在实际操作上出现了松动迹象。去年9月，有媒体爆出商务部拟出台《关于药品流通行业改革发展意见》，明确涉及“二次议价”，该文件试图将不规范的“暗扣”改为“明扣”。暗扣是指药品分销企业给医生个人的提成，明扣则是将暗扣这种暗箱操作的做法变成医院与药企之间的讨价还价，医院将这笔收入纳入本单位的绩效考核，并进行再分配。

however,This provision in practice appeared signs of loosening.In September of last year,The media reported the ministry of commerce is proposed[About the medicine circulation industry reform and development of ideas],Clear involved"The second negotiation",This document attempts to non-standard"Dark buckle"Instead of"Ming buckle".Dark buckle is refers to the pharmaceutical distribution enterprises to doctors personal commission,Ming is a dark buckle buckle the black-box approach into a bargaining between hospitals and drug companies,Hospitals will this revenue into the performance evaluation of the unit,And redistribution.

　　目前，卫生部、发改委、商务部、国家食品药品监督管理局等部门正在加紧制定方案。有消息透露，或将出台的规范是2012年卫生部等七部委联合制定的《医疗机构药品集中采购工作规范》的延续，新出台的规范将在三个方面进行大幅度调整，即二次议价、招标价格、流通环节。

At present,The ministry of health/The national development and reform commission/The ministry of commerce/The state food and drug administration departments is stepping up efforts to formulate solutions.It was revealed,Or will be issued specification is set by the seven ministries and commissions such as the ministry of health jointly in 2012[Medical institutions and drug centralized purchasing job specification]A continuation of the,The new specification will be significant adjustments in three aspects,That is the second negotiation/Bidding price/circulation.

　　二次议价从最初的被禁止，到或将全面放开，业内人士认为，这是为了取消强制招标。由于在药品购销过程中政府主导统一招采，剥夺了购销双方的议价权，遏制企业正常的质量价格竞争。招标实际成了市场的二次准入，但是政府又不完全说了算，导致二次准入之后又面临着二次议价，情况越整越复杂。

Secondary bargaining from initial be banned,Or will be fully open,The personage inside course of study thinks,This is in order to cancel the bidding.Due to the government in the process of drug distribution unified action,Deprived of purchasing and selling both sides of the bargaining power,Normal quality price competition.Tender actually become access to secondary markets,But the government does not fully in charge,Lead to secondary access again after facing the second negotiation,More the more complex situation.

　　

◇反应 His reaction

　　

药企欲联合抵制 Drug companies to boycott

　　然而，二次议价将被放开的信号，却让药企十分紧张。在日前举行的医药行业全国人大代表、政协委员座谈会上，委员代表们呼吁全行业联合起来抵制，否则全行业正常的秩序都将被打乱。

however,The second negotiation will be let go,Drug companies are very nervous.In the pharmaceutical industry to the National People's Congress held a few days ago/CPPCC member symposium,Member representatives called for the industry to unite to resist,Otherwise the whole industry will be disturb the normal order.

　　是否允许医院“二次议价”，这是药品集中采购实施以来业内密切关注的问题，在该现象的背后，是各方的利益博弈。

Whether to allow the hospital"The second negotiation",This is drug centralized purchasing problem since the industry pay close attention to,Behind this phenomenon,Is the interests of the game.

　　“一旦议价权下放至医院，它的二次议价能力非常强，制药企业只有两种选择，要么失去价格底线，要么失去市场。”全国人大代表、河北石药集团董事长蔡东晨不无担忧地表示。

"Once the bargaining power devolved to the hospital,Its secondary bargaining power is very strong,Pharmaceutical companies have only two choices,Or lose price bottom line,Or lose the market."The National People's Congress/Hebei Cai Dongchen shiyao group chairman, worries is said.

　　有药企人士表示，在目前企业利润不断下滑的情况下，再实行二次议价，企业的运营成本必定会增加，无疑令企业的生存更加举步维艰。同时，二次议价也无法改变医生收回扣等现象，“此举令医药企业除了养医生，还要养医院”。

There are drug firms, he says,Under the condition of the current corporate profits falling,Implement the second negotiation again,Enterprise operating costs will increase,Undoubtedly makes the enterprise's survival more difficult.At the same time,Secondary bargaining also can't change the phenomenon such as doctors receiving kickbacks,"Move to pharmaceutical enterprise in addition to the doctor,To keep the hospital".

　　蔡东晨指出，二次议价不仅损害工业企业，更重要的是损害着消费者的利益。“二次议价的钱有的是在价格中体现，他按价格给你开。有的直接在你的合同上让点、暗扣。暗扣这个钱到底是以什么方式支付，有的是货款支付，有的是拿别的钱来支付，实际上养了腐败，养了垄断方。”这样的结果会导致企业亏损，生产药品不赚钱。

Cai Dongchen pointed out,Secondary bargaining is not only damage the industrial enterprises,More important is to harm the interests of consumers."The second negotiation money has reflected in the price,He give you at this price.Make some directly in your contract/Dark buckle.Dark buckle the money what is what is the mode of payment,Have a plenty of payment,Have a plenty of take other money to pay,In fact have corruption,Have a monopoly party."The result will lead to enterprise losses,Drug production not to make money.

　　“一些廉价的好药，会因为价格太低，企业不赚钱而减少生产，最后退出市场。而老百姓廉价的药买不到，只能买高价的药，最终损害了百姓的利益。”座谈会上，有药企负责人建议，消费者要享受优质的医疗服务，要享受安全、价格合理的药品，政府可以把这部分钱直接补给消费者让他自由选择。

"Some good medicine of cheap,Because the price is too low,Companies don't earn money and reduce production,Finally pulling out of the market.And ordinary people can't buy cheap medicine,Can only buy high price of medicine,Ultimately harm the interests of the people."symposium,There are drug firms, head of the proposal,Consumers to enjoy high quality medical services,To enjoy the safety/Reasonable prices,The government can put the money directly supplies consumers the freedom to choose.

　　全国人大代表、河南辅仁药业董事长朱文臣则认为，招投标本来是一种好的模式，既然政府都认可了，只是在运行过程中有问题，就没有必要推翻原有的这种模式。

The National People's Congress/Henan furen pharmaceutical chairman Zhu Wenchen argues,Bidding is a good model,Since the government approval,It is just in the process of running,This is no need to overturn the original models.

　　

◇效果 Cardiac effects

　　

或难完全杜绝暗扣 Or difficult to completely eliminate dark buckle

　　中银国际证券分析认为，尽管此次两会来自医药产业界的代表联名反对二次议价，但预计二次议价两会后松绑是大概率事件。“我们判断两会后发布的2012年版《医疗机构药品集中招采规范》中会松绑二次议价。”

Boc international securities analysis,While the CPPCC delegates from pharmaceutical industry joint against secondary bargaining,But the second negotiation is expected to loosen after two sessions is a big probability event."We judge two sessions after the release of 2012[Medical institutions and drug concentration in specification]Will loosen the second negotiation."

　　但不管结果如何，围绕二次议价的争议还将继续下去。事实上，一直以来各方的争论声就没有停歇，争论焦点之一，即二次议价后能否杜绝暗扣。

But no matter how the results,Controversy surrounding the second negotiation will continue.In fact,,Has long been the sides of the debate, there is no pause,One of the focus of debate,After the secondary bargaining can eliminate dark buckle.

　　在中国医药企业管理协会副会长牛正乾看来，药价虚高、回扣泛滥这一问题之所以久治不愈，而且愈演愈烈，根本原因就是药品加价率管制政策，以及与之配套的禁止二次议价政策，违背了基本的经济规律。

In China pharmaceutical enterprise management association, vice President of cows are dry,Drug prices artificially high/Rebates overflow issue of this one,And worse,Root cause is JiaJiaLv drug control policies,And prohibits the second negotiation policy related to it,Violates the basic economic laws.

　　不过，反对者却认为，二次议价是拿制药工业一部分用于研发的钱以回扣的方式让利，以求将产品卖出去。这样可能会导致降低原料质量、改变或降低工艺过程，改变工艺过程，降低生产成本，由此会拖累整个医药行业的发展。

but,Opponents think it is,Secondary bargaining with the pharmaceutical industry is part of the money used to develop incentives in the form of rebates,In order to sell products to go out.This may lead to reduce raw material quality/Change or lowering process,Change process,Reduce the production cost,This will drag down the entire pharmaceutical industry development.

　　“我觉得二次议价允许也好，不允许也好，‘明’、‘暗’都会双轨并行，给了明扣，并不意味着就可以把暗扣杜绝。”北京大成律师事务所合伙人姚岚表示。

"I think the second negotiation allowed or not,Don't allow it,‘Ming’/‘dark’Will be double-track system,To the Ming buckle,That doesn't mean you can put the dark buckle to eliminate."Beijing dacheng law firm partners Yao Lan said.

　　有专家认为，二次议价符合市场经济规律，但是只是一个治标的策略，不能从根本上解决目前医生收回扣、医患关系紧张及“看病难”、“看病贵”等问题。根本的治疗措施是尽快实现“管办分开”，完善医保制度，从根本上进行改革。记者 赵兵辉

Some experts think,Secondary bargaining accords with market economy rule,But just a treats the strategy,Doctors can't fundamentally solve the rebates/The doctor-patient relationship nervous and"The doctor is difficult"/"See a doctor expensive"Problems such as.Is fundamental for the treatment of as soon as possible"Tube separated",Improve the system of health care,Fundamentally reforms.The reporter zhao hui