-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
-
Cosmetic Ingredient
- Water Treatment Chemical
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
At the beginning of 2022, shortly after the new medical insurance catalogue came into effect, the story of patients with Fabry disease in Hebei Province running around to get drugs in hospitals was wiped
out.
In order to use the newly entered negotiated drugs in the medical insurance catalogue in local hospitals, patients engaged in a three-month tug-of-war
with local hospitals, medical insurance bureaus, and health commissions.
The origin of the story is that Fabre's "miracle medicine" and Takeda's "Ripjia" entered the medical insurance drug reimbursement catalog
at the end of 2021 through national medical insurance negotiations.
This is the first case of "sky-high rare disease drugs" included in China's medical insurance, and the state has vigorously publicized it, patients are eager to hope, and the market is also excited.
The story of Fabry's miracle drug "Ripja" is a silhouette
of the difficulty of entering the hospital.
At the beginning of 2022, four years have passed since the National Health Insurance Administration started normalized drug negotiation access at the end of 2018
.
Compared with other drugs, Guotan drugs have innate advantages in entering the hospital, but it is still not easy
.
1.
The original intention of the national medical insurance negotiation
The national medical insurance negotiation will bring more good drugs to Chinese insured patients at a price that the medical insurance fund and patients can afford, improve the level of medication for the people, and enable the people to live healthier and longer
.
This is a path
with Chinese characteristics that leads drug prices back to a reasonable level.
Since 2018, with the normalization of the national negotiation mechanism for drugs, more than 500 new drugs have been included in the medical insurance catalogue
through negotiation and price reduction.
There is no doubt that state negotiations have successfully solved the problem
of patient economic accessibility of innovative drugs through drug price reductions and medical insurance reimbursement.
But before patients actually use drugs and get reimbursed, the publication of the drug list is only the first step
.
2.
The combination of the National Health Insurance Administration and the National Health Commission for negotiating the landing of drugs
It must be said that for the landing of negotiated drugs, the National Medical Insurance Administration and the National Health Commission have given policy support
.
In the Notice on Adapting to the Normalization of National Medical Insurance Negotiations and Continuing to Do a Good Job in the Landing of Negotiated Drugs (Medical Insurance Letter [2021] No.
182) jointly issued by the National Health Insurance Administration and the National Health Commission, five combination punches are clarified:
Pharmaceutical Council and Hospital Entry: Each designated medical institution should implement the main responsibility for rational drug use, establish a linkage mechanism between the allocation of drugs in the hospital and the adjustment of the medical insurance drug catalog, and since the official release of the new version of the catalog, it is necessary to timely and coordinate the convening of the pharmaceutical council according to the needs of clinical drugs, "should be fully matched"; Temporary procurement by hospitals: For negotiated drugs that cannot be temporarily included in the supply catalog of medical institutions, but have real clinical needs, they can be included in the scope of temporary procurement, establish a green channel, simplify procedures, shorten the cycle, and purchase in a timely manner;
"Dual channel" and prescription circulation: For drugs that cannot be equipped temporarily, it is necessary to establish and improve the prescription circulation mechanism, and improve the accessibility of drugs through channels such as "dual channel";
Separate payment for medical insurance (excluding the mechanism for total hospital medical insurance): Eligible regions should actively explore and improve the policy of separate payment for negotiated drugs, and gradually include more negotiated drugs in the scope of separate payment
Adjustment of the weight of DRGs: For diseases that implement the reform of payment methods such as DRG, the weight
of the disease should be reasonably adjusted in a timely manner according to the actual use of the negotiated drugs.
As the actual supervisor and assessment department of the hospital, the National Health Commission, in the "Performance Evaluation Operation Manual of Tertiary Public Hospitals", the negotiated drugs are excluded from a series of cost control assessment indicators (including the increase in medical income, the increase in the average cost of outpatient visits, the increase in the average cost of outpatient times, the increase in the average cost of hospitalization, and the increase in the average cost of drugs per hospitalization), so as to avoid hospitals affecting the use of
negotiated drugs due to concerns about the indicators.
3.
The dilemma and insufficient incentives of public hospitals
Healer's Parents' Heart
.
Doctors will also face pressure to repeatedly explain to patients if the hospital is not equipped with good drugs that have been advertised in the negotiations, and if the price is greatly reduced, doctors will also face the pressure
to repeatedly explain to patients.
As the first person responsible for negotiating the rational clinical use of drugs, why do medical institutions hesitate to introduce and use negotiated drugs? The main reasons are as follows:
1) After the zero-difference rate reform, hospital pharmacies have become cost centers, and lack the motivation to expand;
2) The conditions for the preservation of some innovative drugs have higher requirements, involving the upgrading of hospital pharmacy software and hardware and the training of pharmacy management personnel, and hospitals lack the motivation to equip them;
3) Although the National Health Commission has excluded national drugs from the public hospital cost assessment index, it has not clearly encouraged hospitals to equip negotiated drugs;
In addition, the exclusion treatment of negotiated drugs that do not account for the proportion of drugs and do not account for the total medical insurance budget is also uneven
in the implementation process.
Generally, the number of drugs equipped in pharmacies in tertiary hospitals is about
1,500.
Since 2018, with the normalization of the national negotiation and access mechanism for drugs, more than 500 new drugs have been included in the medical insurance catalogue
through negotiation and price reduction in the past five years.
On a practical level, it is indeed difficult
for hospitals to include each of these drugs in the catalog.
Therefore, although there is a national policy as a sword, the admission of national drugs is not a smooth horse
.
The use of drugs for rare diseases will be limited by the local level of diagnosis and treatment and whether patients are treated, and drugs with multiple treatment options in the same treatment field will still face selection and competition
.
It is not a matter of requiring medical institutions to "hold a pharmaceutical meeting in a timely manner" and "allocate all the matches
".
={"common":{"bdSnsKey":{},"bdText":"","bdMini":"1","bdMiniList":false,"bdPic":"","bdStyle":"0","bdSize":"32"},"share":{},"image":{"viewList":[" weixin","sqq","qzone","tsina","tqq","tsohu","tieba","renren","youdao","fx","ty","fbook","twi","copy","print"],"viewText":"share:","viewSize":"24"},"selectShare":{" bdContainerClass":null,"bdSelectMiniList":["weixin","sqq","qzone","tsina","tqq","tsohu","tieba","renren","youdao","fx","ty","fbook","twi","copy","print"]}}; with(document)0[(getElementsByTagName('head')[0]|| body). 
