Observe the similarities and differences between the system development of foreign countries and my country in the access of medicines in the medical insurance catalog

Recently, the news of the national medical insurance negotiations has continuously touched the heartstrings of pharmaceutical people
.

With the gradual increase of the elderly population in our country, the price reduction of medicines is a general trend

There are currently three types of access for medical insurance drugs in my country

There are currently three types of access for medical insurance drugs in my country

With the continuous deepening of China's medical and health system reforms, the medical insurance catalogue and essential medicine catalogues have gradually developed into scientific management and refined.
Therefore, the access system for such drugs will gradually be scientific and rationalized, not just based on prices
.

In July 2020, the National Medical Security Administration Order No.

How do foreign countries adopt medical insurance access?

How do foreign countries adopt medical insurance access?

In fact, in the entry of foreign medical insurance, cost control is also the key, especially for some new drugs or exclusive products
.

Different countries have different strategies, but they are basically the same

For innovative drugs, medical insurance negotiations are the main focus

For innovative drugs, medical insurance negotiations are the main focus

For innovative drugs, medical insurance negotiations are the main focus
.

Some of the policies of various countries around the world are based on the results of expert discussions, and some are based on the special evaluation of pharmacoeconomics.

The negotiation of innovative drugs for New Zealand drugs is mainly based on the perspective of reducing the burden on patients.
For example, some drugs may remain unchanged in price, but the payment ratio of medical insurance can be increased to reduce the actual payment price, and the patent of the drug can be changed through an agreement.
Extend the period, or let it enjoy a special patent protection extension period
.

In this way, the pharmaceutical company can get benefits, while reducing the price of medicines, and finally the patients get benefits

For branded generic drugs, low price is king

For branded generic drugs, low price is king

After the agreement protection period or patent protection period of some original research drugs expires, all manufacturers that imitate the drug can participate in the bidding for access to the medical insurance product catalog
.

And the time limit obtained through the bidding method of ranking is not permanent, but has a time limit of 2 to 3 years

The medical insurance catalog products are based on the common name, which is a drawback

The medical insurance catalog products are based on the common name, which is a drawback

The current medical insurance catalog in China is classified and managed according to the generic name of the drug.
After the drug is included in the medical insurance catalog, all manufacturers under the generic name can receive medical insurance payment.
The biggest problem here is that the same generic drug from different manufacturers may be The pricing strategy is different, the outer packaging is also different, the production level and the economic conditions of the venue are also different, resulting in the same generic name of the generic drug, due to different manufacturers, product prices vary greatly
.

On the one hand, this approach has weakened the bidding enthusiasm of different manufacturers, and on the other hand, it has led to the high prices of actual generic drugs entering medical insurance in the market

On the contrary, in foreign countries, generally speaking, as generic drugs are gradually on the market, when there are more than two manufacturers of generic drugs, bidding will be conducted for the generic products
.

Only the manufacturer that has won the bid can obtain the exclusive authorization, and at the same time sign a purchase agreement with the medical insurance to obtain the sole medical insurance payment license

Stable drug supply is an important evaluation indicator

Stable drug supply is an important evaluation indicator

The stability of drug supply includes the stability of company operations, the stability of supply, and the stability of quality
.
The biggest problem here is that some pharmaceutical manufacturers in our country will not be able to supply drugs continuously and steadily after winning the bid, leading to a shortage of drugs in the market, which can only result in the purchase of drugs at high prices on the black market
.
On the other hand, it has also prompted some manufacturers to conduct malicious bidding.
After bidding at a low price below the cost, they did not continue to supply medicines, resulting in a shortage of medicines
.
Therefore, the stability of drug supply has become an important evaluation criterion for evaluating whether drugs have obtained medical insurance access
.

summary

summary

At present, there have been some objections to the admission of drugs or innovative drugs simply based on drug prices (low prices)
.
In the future, comprehensive clinical evaluation of drugs that examines the value of drugs in multiple dimensions will surely be introduced into the medical insurance access system
.
However, in the past 10 years, squeezing out the water that exists in various medicines is the most important work goal in the medical insurance policy
.
After most of China's drugs have been screened for admission through price negotiations, a stable system has been formed.
China will further promote comprehensive drug evaluation that examines multiple dimensions and multiple values ​​to improve the clinical quality evaluation of drugs
.
Exploring to use refined management as the basis and comprehensive clinical evaluation of drugs as the method to gradually realize the scientific and rational management of the medical insurance catalogue
.