The latest notice from the National Health Commission affects a large number of pharmaceutical companies

01 A major focus of medical reform: high-quality development of public hospitals

Yesterday, the Department of System Reform of the National Health and Health Commission issued the "Notice of the Secretariat of the State Council's Medical Reform Leading Group on Implementing the Opinions on Promoting the High-quality Development of Public Hospitals", saying:

In order to implement the "Opinions of the General Office of the State Council on Promoting the High-quality Development of Public Hospitals" (Guobanfa [2021] No.

Guobanfa [2021] No.

The above notice requires the medical reform leading groups of all provinces (autonomous regions and municipalities) to take promoting the high-quality development of public hospitals as the key task of deepening the reform of the medical and health system, and comprehensively promote the implementation of policies and measures for the high-quality development of public hospitals

The Secretariat of the Leading Group for Medical Reform of the State Council formulated the "Evaluation Indicators for Promoting the High-quality Development of Public Hospitals by Provinces (Autonomous Regions and Municipalities) (Trial)", and conducts an annual evaluation of the promotion of high-quality development of public hospitals in various provinces (autonomous regions and municipalities)

That is, one of the focuses of the medical reform in the next few years is the high-quality development of public hospitals.

According to the notice, the leading coordinating agencies of the provincial medical reform are required to submit the self-assessment report to the Secretariat of the State Council Medical Reform Leading Group before the end of May each year

As for the evaluation data of the development of public hospitals, it is mainly captured from the existing information systems such as the medical reform monitoring system, the health statistical yearbook, the health and health financial annual report, the performance assessment of public hospitals, and the satisfaction survey

02 These aspects directly affect pharmaceutical companies

According to Cyberland's "Evaluation Indicators for Promoting High-Quality Development of Public Hospitals in Provinces (Autonomous Regions and Cities) (Trial)", it includes 8 first-level indicators and 27 second-level indicators

The following indicators and indicator requirements may directly affect the development of the pharmaceutical industry and pharmaceutical enterprises

1.

At the end of 2021, the National Health and Medical Commission issued the "Notice of the Secretariat of the State Council's Medical Reform Leading Group on the Implementation of the Implementation Opinions on Promoting the Experience of Sanming City, Fujian Province and Deepening the Reform of the Medical and Health System".

As one of the core essentials of Sanming's medical reform, Sanming's medical reform operator Zhan Jifu once said in a speech that Sanming promoted the "three-medical linkage" around medicine, medical insurance and medical care a few years ago, and won the "reduction in drug prices, medical staff".

The implementation of the three-medical linkage in public medical institutions across the country will lay a solid foundation for the follow-up medical reform.

2.

Promoting the high-quality development indicators of public hospitals requires controlling the scale of general outpatient clinics in tertiary hospitals, increasing the number of inpatients in the county, and achieving a reasonable level of diagnosis and treatment in primary medical institutions
.

It is expected that the follow-up counties will be the most important terminal to relieve the pressure of diagnosis and treatment of common diseases.
As for the requirements of the State Ban Fa [2021] No.
18 document, national medical centers, clinical medical research centers, and regional medical centers shall be set up based on existing resource planning to form key clinical specialties.
The responsibility for tackling key technical problems in the diagnosis and treatment of difficult and critical illnesses will be mainly undertaken by tertiary public medical institutions
.

As different levels of medical institutions form different functional orientations and serve different patient needs, the pharmaceutical market will also differentiate based on different levels of medical institutions
.

3.
Full coverage of county-level traditional Chinese medicine hospitals

In addition to the above-mentioned indicators for general hospitals, the coverage rate of county-run TCM medical institutions, that is, counties with county-run TCM medical institutions (Traditional Chinese Medicine hospitals, TCM outpatient departments and TCM clinics run by the government within the county-level administrative divisions in China) The number of administrative regions at the county level / the total number of administrative regions at the county level × 100%, and the target requires the gradual realization of full coverage
.

Previously, an authoritative expert in the pharmaceutical industry told Cyberland that one of the obstacles to the development of the Chinese medicine industry is the number of Chinese medicine hospitals, the number of Chinese medicine practitioners, and the recognition of Chinese medicine by doctors who account for the majority of clinics
.

In recent years, many ministries and commissions have issued supporting measures to support the development of traditional Chinese medicine under the organization of the State Council.
If it can truly be used by institutions, prescribed by doctors, and trusted by patients, it may truly promote the development of traditional Chinese medicine
.

In addition, under the indicator of leading the new trend of high-quality development of public hospitals, the utilization rate of TCM decoction pieces among outpatients and discharged patients in tertiary public TCM hospitals is also mentioned (the number of outpatients using TCM decoction pieces / the total number of outpatients × 100%; The number of patients using Chinese herbal medicine pieces / the total number of discharged patients × 100%), and the indicators are required to reach a reasonable level - it is uncertain whether it means good or bad
.

4.
Control the increase in expenses

Under the indicator of improving the new efficiency of high-quality development of public hospitals, it also includes the average length of stay in tertiary public hospitals (total bed days occupied by dischargers/number of discharged patients), and the increase in the average cost of outpatient and inpatient visits in public hospitals.
One requirement is reduced to a reasonable level, and the second requirement is controlled within a reasonable range
.

At the same time, the proportion of public hospital medical service income (excluding medicines, consumables, inspection and laboratory income) to public hospital medical income (medical income - drug income - health material income - inspection income - laboratory income) / medical income × 100%, required Gradually increase to a reasonable level
.

In addition to the price reform and performance reform of medical services in public hospitals, another way to increase medical service income is to control the income of medicines, health materials, and inspection and testing
.

V.
Increase the proportion of payment by disease

The evaluation indicators also require that the proportion of inpatient insured persons who pay by disease (DRG, DIP, and single disease) to the total number of inpatient insured persons in public hospitals should be gradually increased to a reasonable level
.

According to the "Notice of the "14th Five-Year Plan" National Medical Security Plan" issued by the General Office of the State Council on September 29, 2021, by 2025, the hospitalization expenses paid by disease diagnosis-related groups and by disease types will account for all hospitalization expenses.
ratio of 70%
.

The "Three-Year Action Plan for the Reform of DRG/DIP Payment Methods" issued by the National Medical Insurance Administration also clarifies that from 2022 to 2024, the task of DRG/DIP payment method reform will be fully completed
.
By the end of 2024, the reform of the DRG/DIP payment method will be carried out in all coordinating regions across the country; by the end of 2025, the DRG/DIP payment method will cover all eligible medical institutions that provide inpatient services, and basically achieve full coverage of diseases and medical insurance funds
.

DRG and DIP changed the previous payment by item (according to all the medicines, medical service items, medical consumables used in the process of diagnosis and treatment, how much was used, and how much was settled, which once spawned excessive medical behaviors such as "big prescription" and "big inspection"), Changing the cost of medicines and inspections from a profit center to a hospital's cost center can standardize medical behavior and effectively control the unreasonable growth of medical expenses
.

As the largest medical terminal, the development trend of refined and high-quality public hospitals will have an unignorable impact on the new pattern of medical institutions across the country and the differentiation of the new pharmaceutical market.
Medical practitioners need to respond in advance
.

Attached: