As the final year of the 14th Five-Year Plan, 2025's successful completion of its goals and tasks not only lays a solid foundation for a good start to the 15th Five-Year Plan period but also demonstrates the significant achievements the country has made in the coordinated development and governance of the three medical systems (medical services, pharmaceuticals, and healthcare). Focusing on the area of centralized drug procurement, the core strategy for 2025 is to lay out plans around several dimensions, including the standardization and improvement of centralized procurement policies and the listing and withdrawal mechanisms, and the comprehensive monitoring and governance of pharmaceutical prices and procurement credit. 01 Centralized Procurement Policy In March 2025, the "Draft Plan for Further Optimizing Centralized Drug Procurement Policies (for Public Comment)" circulated within the healthcare industry and caused a stir. In May 2025, a second draft of the same plan circulated again. A comparison of the two plans reveals that this plan aims to deepen the reform of centralized drug procurement with volume guarantees and balance price competition with quality supply. Its core content can be summarized in six aspects: adjusting entry thresholds and strictly adhering to quality standards ; optimizing procurement and bidding rules to prevent vicious competition; improving the weighting mechanism to enhance execution flexibility; strengthening implementation and payment guarantees; full-chain quality supervision and information transparency; optimizing implementation measures and standardizing follow-up and evaluation. Overall, the "Plan for Further Optimizing Drug Centralized Procurement Policies (Draft for Comments)" focuses on continuously optimizing each link of the centralized procurement process by refining multi-dimensional requirements while taking into account the principles of " stabilizing clinical use, ensuring quality, preventing bid rigging, and combating involution ." Regarding the online listing system, in April 2025, the "Consensus on Drug Online Listing Rules for Provincial Medical Procurement Platforms," initiated by the medical insurance bureaus of Hebei, Zhejiang, Guangdong, Guizhou, Xinjiang, and other provinces and regions, with the participation of other provincial bureaus, circulated within the industry and attracted attention. This consensus is a comprehensive summary of local work practices, providing a reference for local medical procurement platforms to improve drug online listing rules and optimize online listing services, and is applicable to the unified and standardized management of newly submitted online listing prices. The consensus on online drug listing rules also clarifies that provinces implementing price controls on listed drugs can refer to the relevant requirements of the consensus to formulate their own control rules. Therefore, various regions have successively issued draft rules for public comment and official versions applicable to their respective provinces. Analysis of the "Consensus on Drug Listing Rules for Provincial Pharmaceutical Procurement Platforms" reveals that the key points of the listing rules are divided into three parts:
• The basic principles and requirements for confirming drug listing on the online platform are as follows: Listing must include a price, and dishonest behavior will be strictly investigated; Enterprises' independent pricing and negotiated prices, as well as corresponding direct listing rules, will be implemented; The format and unit of measurement for drug listing will be standardized.
• The core governance logic is clearly defined—the price comparison rules for regular drugs listed online: The consensus sets out detailed price comparison relationships for drugs of different types, channels, dosage forms, specifications, packaging, regions, etc., and introduces a "red and yellow label" risk warning mechanism.
• Improve and standardize the management process for listed drugs , encompassing all stages including filing and procurement, price registration, drug removal from the list, risk management, dynamic adjustment, pre-monitoring, procurement monitoring and analysis, and internal control management.
Furthermore, combining the online listing rules published by various regions, it can be seen that the online drug listing process is developing towards institutionalization, standardization, and transparency, strengthening the management of the listing process, and improving policy transparency to promote a fair and orderly centralized drug procurement market. 03 Price Governance In early 2025, the National Healthcare Security Administration officially launched the " National Drug Online Listing Price Overview ." This table comprehensively summarizes and displays online price information from various regions, marking abnormal prices to achieve dynamic monitoring and precise intervention of drug prices nationwide, and to promote the continuous rectification of unreasonable high online prices in various regions. In early June 2025, the National Healthcare Security Administration issued the "Notice on Further Improving the Credit Evaluation System for Drug Prices and Procurement ," which officially came into effect in September 2025. This system aims to improve the effectiveness of the credit evaluation system, increase the crackdown on dishonest behavior, and guide enterprises to proactively comply with regulations. Key measures include expanding case information sources and improving evaluation efficiency; simplifying the creditworthiness levels from four (general, moderate, serious, and extremely serious) to three (dishonest, seriously dishonest, and extremely seriously dishonest), significantly lowering the threshold for determining the amount of each level of dishonesty, and imposing maximum penalties for bribing medical insurance staff or engaging in bid rigging in centralized procurement; and increasing the cost of violations and incentivizing proactive correction through tiered handling, nationwide coordination, price reductions and reinstatement, and standardized operating procedures. In early July 2025, the National Healthcare Security Administration issued the "Notification of Drug Price Risk Clues (First Batch) ," distributing clues of suspected high-priced traditional Chinese medicines to various provinces. Provinces and cities responded actively, issuing notices on drug price risk governance or publicizing the results of online price governance. In addition, provinces and cities also monitored and governed drug prices according to their respective online rules and promptly published relevant governance information to achieve transparency in price governance. 04 National and Local Centralized Procurement Currently, a total of eleven batches of national centralized procurement of drugs have been completed . Except for the sixth batch, which was a special procurement of insulin, the rest were all chemical drugs. In April 2025, various provinces and cities successively implemented the tenth batch of national centralized procurement, with a procurement cycle from the date of implementation of the winning bids to December 31, 2027. In July 2025, the first phase of information submission for the 11th batch of national centralized procurement began (the second batch began submission in September 2025); in August 2025, the 11th batch of national centralized procurement commenced the volume reporting process; on October 27, 2025, the 11th batch of national centralized procurement opened bids and produced winning bids, with all 55 varieties successfully procured . The 11th batch of national centralized procurement made a series of major optimizations focusing on " stabilizing clinical use, ensuring quality, combating internal competition, and preventing bid rigging ," including: optimizing the volume reporting method, allowing reporting by manufacturer to ensure precise matching between selected brands and clinical needs, reducing the cost of switching drugs; raising the bidding threshold, increasing requirements for production experience and GMP compliance inspections, and strengthening drug quality assurance; adhering to the principle of "no centralized procurement for new drugs/small-scale varieties," introducing "anchor prices" and a mechanism for reviving innovation, and guiding price stabilization. Meanwhile, the unified continuation of the first to eighth batches of national centralized procurement is also progressing steadily . According to the list of proposed procurement varieties released at the end of October, it covers all previous centralized procurement varieties (excluding those that failed to win bids or were cancelled), totaling 316 varieties. However, according to information released by the National Centralized Procurement Continuation Alliance at the end of December, 317 varieties have actually been submitted for information, with the addition of rivaroxaban oral immediate-release dosage form (2.5mg) compared to the October list. The procurement period is from the actual implementation date of the winning bid to December 31, 2028. Overall, regarding national centralized procurement of pharmaceuticals, with the continuous improvement and optimization of the rules for the tenth and eleventh batches, although the bidding rate has decreased and competition remains fierce, the winning bid rate has still increased. The improvement of national centralized procurement rules will also help local centralized procurement projects raise the entry threshold, optimize relevant winning bid rules, and standardize implementation requirements. Currently, local centralized procurement projects still primarily focus on chemical drugs, especially those that haven't passed evaluation. However, the national government is continuously introducing various policies to encourage local governments to promote centralized procurement of traditional Chinese medicine (TCM) preparations. Several localities have already launched dedicated centralized procurement projects for TCM preparations, either independently or through alliances. In conclusion , at 2025, the final year of the 14th Five-Year Plan, a fairer, more transparent, and efficient market environment has been successfully built through refined adjustments to centralized procurement rules, unified and standardized online listing systems, and comprehensive deepening of price governance. This series of policy measures has not only effectively curbed inflated prices and unfair competition but also ensured drug accessibility while maintaining quality standards, making clinical medication use more reassuring and patient medication more affordable. Looking ahead, with the continued implementation and effectiveness of these reform measures, the high-quality development of the pharmaceutical industry will be further promoted, providing a more solid and powerful guarantee for the health of all people.

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