The Health Care Administration issued a heavyweight document, an out-of-hospital market or a big change

"Pharmaceutical Network Industry Dynamics" Recently, the State Health Insurance Administration issued a "notice on the issuance of the total regional points law budget and pay by disease score pilot work programme."
According to the notice, in order to continuously promote the reform of medical insurance payment methods, improve the transparency of medical services and improve the efficiency of the use of health insurance funds, the State Health Insurance Administration requested that the pilot city declaration materials be organized in accordance with the Pilot Work Programme and informed by October 20 to the Medical Management Department of the Health Insurance Administration.
Among them, it is worth noting that the notice also pointed out that the National Health Insurance Administration is expected to spend 1-2 years, the overall regional health insurance budget and the point method combined to achieve hospitalization to pay according to the disease-based multi-composite payment method.
to gradually establish a system of payment for medical services based on diseases, results-oriented, and improve the communication and negotiation mechanism between medical insurance and medical institutions.
to strengthen the quantitative assessment based on disease, so that medical behavior can be quantified, comparable and so on.
industry analysts believe that the big Data Diagnosis-Packet Intervention, DIP, announced by the scheme, is in fact the big data DRGs of the past.
It is understood that DRG is a group packaged by the fixed payment method, patient treatment costs "one price" packaging charges, large prescriptions, large examinations, misuse of supplies and other acts, will increase the cost of the hospital, rather than improve profits, so DRG payment will make the hospital in the premise of ensuring the quality of care, to minimize expenditure, reduce costs, improve efficiency.
it is learned that in Zhejiang Province, there have been Jinhua, Zhangzhou, Taizhou three district cities and Deqing, Ryan and other county-level co-ordination areas to carry out the DRGs points to pay for the pilot work.
results show that good results have been achieved, and the two objectives of "control fund" and "quality improvement" have been initially achieved.
and the difference between DIP and DRGs is mainly that the grouping method is different, DIP grouping method is simpler, its settlement unit is the group, and drGs settlement unit is the sub-group below the group, relatively more complex.
, Guangdong Province, is a typical DIP pilot city.
the Foshan Medical Insurance Bureau disclosed that in the first half of 2019, the city's average total cost growth rate of 0.44%, down 90% YoY, the city's unreasonable growth in medical expenses has been effectively controlled.
and the regional points method make hospitals compete with each other, greatly increasing the willingness of hospitals to participate.
In fact, for pharmaceutical companies, whether DRGs or DIP, its gradual gradually pushed away at the provincial and municipal levels, will further accelerate the reform of medical institutions, will also bring about a reshuffle of the entire medical industry.
for hospitals, the reform of the way health care is paid will not only directly affect hospital profitability, but also affect doctors' drug habits.
for pharmaceutical companies, the current window for pharmaceutical companies to change their business ideas and product structures to meet the requirements of new markets in the future has been very short.
If pharmaceutical companies want to develop more smoothly, they need to move from interest-driven to thinking about the clinical value of their products, so as to change the way they develop their products, and there is no doubt that companies with obvious cost advantages and strong research and development capabilities will go further in this unknown war.