Summary of the implementation of the two-invoice system in 11 provinces across the country!

　　This year, 11 provinces and 200 cities will implement the two-invoice system. Different from the redundant and complicated pharmaceutical production and circulation levels in China at this stage, the so-called "two-invoice system" actually means that the drug manufacturer issues an invoice to the circulation enterprise, and the circulation enterprise issues an invoice to the medical institution.
　　Regarding the implementation scope of the "two-invoice system", the "Implementation Opinions on the Implementation of the "Two-invoice System" in the Procurement of Drugs in Public Medical Institutions (Trial)" has clearly stated that the "two-invoice system" should be gradually implemented in the procurement of drugs in public medical institutions, and other medical institutions are encouraged to implement the "two-invoice system". The public medical institutions in the pilot provinces of comprehensive medical reform and the pilot cities of public hospital reform should take the lead in implementing the "two-invoice system", and other regions are encouraged to implement the "two-invoice system" and strive to implement it nationwide in 2018.
　　The State Council has made it clear that the pilot provinces of medical reform should promote the two-invoice system throughout the scope, encourage the one-invoice system, and hospitals and drug manufacturers directly settle payments, while pharmaceutical companies and distribution companies calculate distribution costs. This year, 7 new provinces were added to the pilot list of medical reform. Together with the previous 4 provinces, the number of pilot provinces for medical reform in the country has reached 11, namely Anhui, Fujian, Jiangsu, Qinghai, Shaanxi Province, Shanghai, Zhejiang Province, Sichuan Province, Hunan, Chongqing, Ningxia, etc.
　　Anhui
　　Province From November 1, 2016, all public medical institutions in Anhui Province implemented the "two-invoice system" in drug procurement, which is the first time in the country. Previously, only some provinces implemented the "two-invoice system" in their public hospital reform pilot cities.
　　At the same time, Anhui encourages the "one-invoice system", where drug manufacturers and public medical institutions directly settle drug payments, and drug manufacturers and drug dealers only settle distribution costs, further compressing the profits of drug distribution companies. For grassroots remote medical institutions, they are allowed to issue another drug purchase and sales invoice on the basis of the "two-invoice system" to ease the distribution pressure of pharmaceutical companies in remote areas and ensure grassroots drug supply.
　　Shaanxi
　　Shaanxi Provincial Health and Family Planning Commission issued a document, deciding that from January 1, 2017, the "two-invoice system" will be implemented in the procurement of consumables in urban public medical institutions across the province, and the "two-invoice system" will be implemented in county, town and village medical and health institutions in due course.
　　To support the implementation of the "two-invoice system", Shaanxi will also simultaneously increase the concentration of consumables distribution in urban public medical institutions and reduce the number of distribution companies. The number of drug and consumables distribution companies in tertiary medical institutions shall not exceed 15 respectively; the number of drug and consumables distribution companies in secondary medical institutions shall not exceed 5 and 15 respectively.