Regarding the price reform of medicines, relevant national departments have issued a number of key documents. After the “Opinions on Promoting Drug Price Reform†issued in 2015, the NDRC no longer controls the price of drugs, and the price of drugs forms a drug payment standard based on market competitive prices. Most drug government pricing has long been canceled, and as of now, the medical insurance payment standard has not been officially introduced in the past two years, and it is in a state of “difficult to produceâ€. Where is the tangled point?
After the publication of the 2017 edition of the medical insurance catalogue, the medical insurance payment standard regarded as the most important factor in the pharmaceutical market market is being actively prepared for publication by the Ministry of Human Resources and Social Security. The focus of the industry is twofold: First, what will be the standard of medical insurance payment? The attitude is available; second, what is the current progress in the negotiation of national drug prices for innovative drugs?
First of all, why is the medical insurance payment standard difficult to produce? Dong Zhaohui, deputy director of the Medical Insurance Department of the Social Security Research Institute of the Ministry of Human Resources and Social Security, analyzed two factors during the 31st China Pharmaceutical Industry Development Summit Forum: first, the issue of price formation in the pharmaceutical market and the coordination of price policies. Combined with some current status, factors such as monopoly and rebate of medical institutions have disrupted the market price of drugs; centralized drug bidding has been implemented, but there is only market price in the market where there is no bidding price; and drugs are implemented on the basis of purchasing price. With zero mark, the hospital's procurement market is no longer there. For the introduction of medical insurance payment standards, the market reference price is of great significance, but without the market mechanism, there is no concept of market price.
Another difficulty is the inherent institutional problem of medical insurance payment standards. As a single payer, medical insurance, like the National Development and Reform Commission and the Drug Bidding Office, faces the problem of “monopolyâ€. If medical insurance sets a payment standard outside the market, it is equivalent to the pricing of the NDRC in the current year, and it is difficult to obtain pricing information. If medical insurance directly enters the market for quantity procurement, it will face the problem of buyer monopoly faced by the bidding office. , disrupting the market mechanism. How can medical insurance payment standards be better?
In addition, many experts have said that the national health insurance fund is limited, the trend of medical insurance over-expenditure is more and more obvious, and it also greatly affects the formulation of medical insurance payment standards.
1, looking for pricing reference
Dong Zhaohui pointed out: "The key to solving these difficulties is to find a good price reference system, and this reference system can be supervised by the public."
According to this line of thinking, there are two references to the development criteria for future payment standards. One is to find market prices that are not directly intervened by medical insurance, including the wholesale price of the upstream market and the international market price. For a big country like China, at the international level. The market has a large trading volume and has pricing power itself. Therefore, the upstream wholesale price is more important, and the international price has a reference value but is not suitable.
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