Over 400 policies throughout the year analyze the 7 key words of medical reform, and find out the direction of medical policy formulation and implementation | 2020 annual inventory

2020 is certainly a year of full-scale fight against the epidemic, but after the epidemic prevention into the normal stage, the social operation is back on track, the new medical reform in the field of health care policy line is no exception.
since the launch of the new medical reform in 2009, the General Office of the State Council has issued the key tasks of the year, and decomposed into various departments.
departments of the State Council shall formulate corresponding policy documents in accordance with key tasks and promote the implementation of key tasks.
, from the key tasks of deepening medical reform every year, we can get a glimpse of the policy direction and logic of the year.
affected by the outbreak, the key tasks for 2020 will be released in the second half of the year.
arterial network analyzes the 2020 medical policy based on the Notice of the General Office of the State Council on the Key Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2020 (hereinafter referred to as the "Mission").
after analyzing the full text of the Mission, the arterial network sorted out the seven key words that appeared most frequently (words that did not include reform, health, etc. to express macro significance): epidemic prevention and control, public health, procurement, payment, medical service price, medical security, performance appraisal.
2020 health care policy panorama, arterial network drawing these keywords are closely related to the year-round hot policy.
Arterial Network from the official website of the competent departments to count 407 medical policies in 2020, of which 306 national health care commission, 44 articles of the State Health Insurance Administration, 57 articles of the State Drug Administration, the various departments of policy and medical reform keywords combined to analyze the implementation of medical reform.
From a general point of view, the improvement of the epidemic prevention and control and public health system, so that the health care system to restore and maintain normal, improve public health level, is the prerequisite for the implementation of reform;
The outbreak prevention and control to promote the breakthrough of the medical insurance system Recently, the new crown epidemic again in many parts of the country, unlike the beginning of 2020, from the official to the public, to treat the outbreak more calm and determined.
the most effective and safest screening measures through localized, highly effective full nucleic acid testing, and the new crown vaccine has been introduced and started to target populations, with 10 million doses of vaccination completed.
these are the embodiment of the results of the year's anti-epidemic, behind the epidemic prevention and control policy support.
2020, a total of 87 outbreak prevention and control policies have been put in place, the largest number in several key areas.
these policies mainly from the medical, medical and payment three links to support the work of epidemic prevention, and achieved 14 breakthroughs.
The main policy breakthroughs related to epidemic prevention and control, sources: the official website of various departments, arterial network finishing and drawing medical links, the National Health and Health Commission led the formulation of various normative documents, work programmes, work guides, focusing on public protection, community prevention and control and grass-roots screening, medical treatment and scientific research, health care protection and incentives.
, the new coronary pneumonia diagnosis and treatment programme has been updated as medical workers' awareness of the virus and the disease has increased.
It is worth mentioning that the National Health and Health Commission issued two articles in 4 days to encourage Internet consultation and treatment, on the one hand to relieve the pressure of hospital treatment, on the other hand, to avoid ordinary patients online treatment caused by cross-infection.
Internet medical treatment has thus become the "air battlefield" of epidemic prevention and control, the penetration of life has reached an unprecedented level, ushering in a year of major outbreaks in the industry.
drug and device links, in accordance with the Emergency Approval Procedure for Medical Devices, the drug regulatory authority may implement emergency approval for the required medical devices in the event of a threat of a public health emergency.
the State Drug Administration has thus launched the corresponding emergency approval mechanism, especially through the nucleic acid testing kit, the rapid approval of protective materials, to alleviate the first-line demand for anti-epidemic.
For new crown drugs and vaccines, the State Drug Administration has also creatively established a joint working mechanism for research and evaluation, through "side research and development, side submission, side review", to maximize the time for review and approval, to promote China's first new crown virus vaccine conditional market, a number of epidemic prevention and control drugs to carry out clinical trials.
, the State Health Insurance Administration, the National Health Care Commission, the Ministry of Finance and the General Administration of Taxation have taken measures to provide financial support for the treatment of the epidemic.
For new crown patients and suspected patients, free treatment, for non-new crown patients, Internet medical services into the payment of medical insurance, for medical institutions, medical insurance agencies to advance part of the funds to reduce the pressure of advance funds, for enterprises, the phased reduction of basic medical insurance fees for employees, to ease the pressure on enterprises.
According to the data of the State Administration of Health Insurance, a total of 9.75 million insured units will have a cumulative reduction of 165 billion yuan in health insurance premiums in 2020, with a cumulative settlement of 2.84 billion yuan in patient expenses and 1.63 billion yuan in medical insurance payments.
as income and spending have changed, the balance of health-care funds in 2020 will also show corresponding characteristics.
changes in the income and expenditure of the health insurance fund, data source: National Health Insurance Administration, arterial network map As shown in the chart above, the income of workers' health insurance will decline significantly in 2020, while expenditure will rise significantly, resulting in a decrease in the overall balance rate.
, however, residents' health insurance income is on the rise and income is falling.
, this is mainly due to increased awareness of protection among the population and a decrease in the number of medical visits for illness, especially in paediatric respiratory diseases.
So, with the balance ratio of workers' health insurance and residents' health insurance falling by one liter, the overall balance ratio of health insurance funds has not decreased significantly, from 14.73 percent in January-November 2019 to 13.31 percent in January-November 2020, with little impact on subsequent health-care reforms.
it is not difficult to see that the health care system, with system-wide efforts, in the outbreak after a large-scale outbreak played a role in pulling the tide.
basis for promoting the normal operation of social economy and the prerequisite for deepening medical reform to continue smoothly.
public health repair hardware and software short board outbreak put the improvement of public health system to a more important position, "strengthening public health system construction" has also been included in the first task of deepening medical reform.
2020, public health-related policies, based on the experience of epidemic prevention and control, mainly from hardware and software improvement to repair the short board.
Policy requirements for the construction of hardware and software in the public health system Source: National Health Commission, Arterial Network Drawing Hardware, In May 2020, the National Development and Reform Commission, the National Health And Wellness Commission and the State Administration of Traditional Chinese Medicine formulated the Capacity Building Program for Public Health Prevention and Control, and put forward five major construction tasks, including: modernization of the disease prevention and control system, upgrading the capacity of county-level hospitals, improving the urban infectious disease treatment network, upgrading and upgrading major epidemic treatment bases, and promoting the rehabilitation of public facilities.
"Programme", each task has put forward specific construction standards, highlighting the "combination of peace and war" to maximize the use of resources.
the construction of a major epidemic treatment base as an example, the document lists the amount of reserves used for intensive treatment and emergency supplies for critically ill patients, which will generate corresponding equipment procurement needs.
Major outbreak treatment base emergency treatment materials reference reserve list (calculated by a single base), source: National Health And Wellness Commission, arterial network drawing software, the National Health And Wellness Commission, the State Administration of Traditional Chinese Medicine issued the "National Public Health Information Construction Standards and Norms (Trial)", focusing on the next 5-10 years of construction, application and development of the basic requirements, further clarify and strengthen the basic content and requirements of public health information construction.
In addition, in basic public health services, the per capita subsidy standard has been raised to 74 yuan in 2020, the new 5 yuan funding has been fully implemented to rural and urban communities, the overall use of primary health care institutions to carry out the new crown pneumonia epidemic prevention and control personnel funds, public funds and other expenditures, strengthen the grass-roots epidemic prevention and control funds and improve the epidemic prevention and control capacity, strengthen primary health and epidemic prevention and control.
guidance, institutions at all levels involved in public health have begun to reform, upgrade or build.
the Chinese government procurement network shows that in 2020, including "public health" procurement projects reached more than 1000, project demand to construction, medical equipment-based, buyers are mostly large hospitals, county-level health departments.
also have some projects to start construction or first results.
for example, the National Medical Center for Major Public Health Events, which is based at Tongji Medical College affiliated with Huazhong University of Science and Technology, was opened in July 2020 and is expected to be completed in June 2022.
public health system is urgent, but it is also a long-term large-scale project, is to deepen the long-term smooth progress of medical reform.
in the next 3-5 years, public health construction will be an important work.
of emergency treatment equipment, information systems and even intelligent applications from institutions at all levels will drive the development of the corresponding industries.
, the collection of consumables significantly reduced prices, drug collection into the normal "mission" in the "procurement" mainly refers to centralized belt procurement.
2020, the collection of state-organized products will be extended from pharmaceuticals to high-value consumables, starting with the crown stent.
From local organizations to national organizations, supplies collection sharply reduced prices In fact, Jiangsu, Shandong, Zhejiang and other places have carried out supplies collection, to inter-provincial alliances, provincial, municipal alliances, municipal-level centralized bidding, involving cardiovascular, orthopaedic, ophthalmology and other fields of high-value supplies, as well as infusions, retention needles, syringes and other low-value supplies, for the national collection has accumulated experience.
2020 part of the local consumables collection, source: public reports, arterial network drawing in the first batch of high-value consumables collected by the national organization, the crown stent procurement cycle of two years, the first year of the total amount of intention to purchase more than 1.07 million.
selected from 10 crown support products from the last 7 companies.
average price of the selected bracket in the national election has dropped from 13,000 yuan to about 700 yuan, a decrease of more than 90%, and is expected to save 11.7 billion yuan in medical expenses each year.
medical supplies classification is complex, similar medical supplies also have a number of different functional properties, patients due to individual differences in the use of the same kind of supplies, often also need different specifications models.
crown stent is a standardized product, relatively unexclied in medical supplies, the same brand, the same type but different specifications of the crown stent to perform the same price.
addition, it is calculated that in 2019 the national use of coronary braces about 1.5 million, the cost of about 15 billion yuan, accounting for 1/10 of the country's total cost of high-value medical supplies.
degree of standardization, the use of the amount of high proportion, these may be the crown support as a high-value consumables collection of the beginning of the reasons, the two characteristics also determine the direction of the next collection of varieties.
there is no doubt that high-value consumables collection and drug collection have similar logic, that is: low false high prices, squeeze the circulation of water.
is particularly important for enterprises to build a multi-level product system, using collecting products to increase market share, research and development of high-end products to meet the needs of patients with different consumption capacity, it is also a strategy.
, however, high-value consumables are very different from pharmaceuticals.
high-value consumables often require surgery by a doctor and also involves the training of doctors.
, how to reflect the value of the doctor's labor, how to carry out the doctor's education, this is a question that has to be considered.
drug collection has entered the normal stage, pharmaceutical enterprises to transform innovative drug collection, in 2020 carried out the second and third batch of national drug collection, and gradually entered the normal stage.
, the second batch of 32 drugs was selected, the third batch of 55 drugs were selected, the average price reduction of both batches of drugs is 53%.
, two years have passed since the first collection, the 4-plus-seven collection, and we can't help but wonder, what happened to the drugs and businesses that were winning the bid? There are four listed companies among the winning companies in the 4-plus-seven series, which will report their 2019 results in 2020.
Huahai Pharmaceuticals selected six products in the 4-7 collection, according to its annual report shows: in 2019, the company's sales costs fell 25.79 percent year-on-year, the main reason is the promotion of national collection, the corresponding marketing fees, labor and other costs reduced.
, product promotion service charges have dropped significantly.
, which was also selected in the 4-plus-7 series, reported a rapid increase in market share after the winning bid.
2019, the company's annual sales revenue was RMB329 million, up 58.28 percent year-on-year.
4-plus-seven episodes, First Sound Pharmaceuticals' Bichi winning bid, but its prospectus did not separately disclose the product's revenue changes.
, However, Synthe Pharmaceuticals announced changes in sales of the failed product Shuftan.
Shuftan failed to make the bid in both the 4-plus-7 and the second batch, not only affecting sales, but also under pressure from the downstay of prices brought about by the collection, and the average selling price also declined.
sales fell 27.1 per cent in the first half of 2020, helped by falling prices and sales.
Sound Pharmaceutical Shuftan sales situation, data sources: Acoustic Pharmaceutical prospects, arterial network drawing from a policy point of view, drug collection normalization and the implementation of consumables collection, further to enhance the capacity of medical insurance security, improve the income of medical personnel services to leave room.
from an industrial point of view, pharmaceutical companies gradually increase research and development investment, optimize the organizational framework, mining brought about by the industry optimization effect is emerging, this impact may also be reflected in the supplies industry.
DRG and DIP became the "double insurance" of payment reform, while the collection of more space, health care payment reform is also advancing simultaneously.
At this stage, the general direction of reform is to explore more sophisticated composite and diversified payment methods under the existing total budget system, including payment by disease diagnosis-related grouping (DRG), total regional points budget and payment by disease score (DIP).
2020, the DIP payment pilot was launched, and DRG payment was piloted separately.
the National Health Insurance Administration issued a DIP paid work programme, technical specifications and DIP disease catalogue and other documents.
the pilot arrangement between DIP and DRG,Source:NHS, Arterial Network Consolidation