Transparency is the key to drug price reform

Source: medical geography may 10, 2016 The deregulation of the management of the highest retail price of most drugs is a significant change in the marketization reform of the price mechanism in the field of medicine in recent years, which is closely connected with the main mode of international drug price management, that is, not directly limiting the market transaction price, and guiding the rational formation of the drug market price by strengthening the comprehensive supervision of medical insurance control, purchase negotiation and price behavior monitoring In order to cooperate with the implementation of the opinions on promoting drug price reform, which came into effect on June 1, 2015, the national development and Reform Commission issued the notice on strengthening the supervision of drug market price behavior, requiring the price authorities at all levels to immediately organize and carry out the special inspection of drug price for half a year The purpose is to standardize the price behavior of drug market, maintain the price order of drug market, and ensure the smooth implementation of drug price reform The special inspection of drug price expired at the end of November Judging from the market performance and the actual situation of government supervision in recent half a year, although there are also some market prices of low-cost drugs and drugs in short supply, the overall price operation of the drug market is basically stable, which shows that the market-oriented reform direction of drug price is correct Compared with foreign experience and the new trend of drug price management, the drug price liberalization policy tests the rationality of the market and the responsibility of supervision, which requires more transparency of the market behavior of pharmaceutical enterprises and more in place supervision of relevant departments 1、 A new report released by the World Health Organization (who) in March 2015 shows that European governments have realized that the provision of new treatment methods is becoming more and more difficult, and there is an urgent need for transparency and cooperation to promote the reduction of drug prices Who criticized the opaque policy of pharmaceutical companies in drug pricing In order to recover the R & D investment of new drugs as soon as possible, pharmaceutical companies often "strive to set the price of new drugs higher than that of existing drugs" This has become overburdened for European countries and even more challenging for low - and middle-income countries with inadequate regulatory mechanisms and weak health systems Professor David Haslam, health technology consultant of nice, also pointed out that the market behavior of the pharmaceutical industry must be more transparent, and pharmaceutical companies must explain how drug prices are made, because when pharmaceutical companies make pricing decisions, no one "outside the conference room" knows how to make decisions The government and pharmaceutical companies often determine the supply and price of new drugs through so-called negotiated framework agreements, and the negotiation process is "quite opaque" If we want to realize the principle of transparent supervision and make up for the defects of drug pricing policy, governments need to "strengthen cooperation and share experience" As the market competition in Europe is more fierce than that in the United States, drugs in various countries generally tend to be cheaper alternatives, prompting many pharmaceutical companies to offer more price discounts In July of the same year, Novo Nordisk pharmaceutical company in Denmark announced that it had stopped selling its new drug tresiba in Germany, the largest pharmaceutical market in Europe, because accepting the low price required by Germany would gradually weaken its ability to invest in new drugs The market price of many newly developed drugs in Europe has to be lower than that in the U.S., and the price of repatha (evolocumab), a newly launched cholesterol lowering monoclonal antibody, which has attracted much attention recently, is only 50-60% of that in the U.S European medical institutions, such as France and Italy, are also trying to promote the use of low-cost and effective alternative drugs, including Bio similar products of biotech drugs for injection, and encourage the use of cheap drugs It is reported that the price of prescription drugs in the United States is currently the highest in the world In 2013, the per capita cost of prescription drugs in the United States was nearly 40% higher than that in Canada, more than twice the average level of major industrialized countries, and nearly five times that of Denmark In September 2015, U.S Senate nonpartisan Senator Bernie Sanders ）A new legislative bill was proposed to solve the problem of high drug prices in the U.S market compared with other developed economies The core of the bill is to require the U.S federal government to make good use of group buying power and health care plan to carry out drug price negotiations, and stipulate that pharmaceutical companies should report drug research and development costs and sales prices in markets outside the U.S., so as to restore the coverage of low-income beneficiaries The minimum allowance policy for health care drugs The prescription drug affordability act of 2015 in the United States will authorize the Department of health and human services (DHHS) to negotiate drug prices with pharmaceutical companies, which is expected to save $541 billion in drug costs in 10 years 2、 The key to drug price reform lies in the transparency of the market and the deregulation of drug prices, which requires that the "invisible hand" of the market mechanism be more transparent Through market competition, technological progress and quality improvement, the rapid development of the pharmaceutical industry in the past decade is obvious to all Most pharmaceutical enterprises have enjoyed the reputation of providing "quality, high price and real" drugs to the society In the past, the shackles of drug price policy restricted the sustainable development of many high-quality brand pharmaceutical enterprises Just because the regulatory policy of drug price ceiling is open, which is most beneficial to high-quality brand pharmaceutical enterprises, pharmaceutical leading enterprises should restrain the impulse to obtain unreasonable high profits, reasonably increase prices, orderly competition, continue to serve public health care and maintain a good image of the market Social responsibility As a special commodity related to the national economy and the people's livelihood, one of the keys to give full play to the "visible hand" of price marketization pricing is to first break the monopoly barriers and form a more transparent market supply structure with multi-body competition; the second key is that the decision-making of price reform should be scientific and standardized, and not allow "blind and confused" pilot projects in various regions Only in this way can we avoid the whirlpool of drug price policy, which is "one tube is dead, one release is disorder", and win the understanding and support of the masses Drug price liberalization needs the government to regulate the "tangible hand" more in place After the drug price was released, the "rising voice" of the government's regulatory responsibility began to ring In order to cancel the government pricing of drugs, it is necessary for the government to supervise the process and results of drug price operation with stronger and higher standards, and to take comprehensive supervision measures to ensure the reasonable and stable market price As the "opinion" made clear, we should improve the mechanism of classified drug purchase, study and formulate payment standards for Medicare drugs, promote medical institutions and retail pharmacies to reasonably determine the purchase price, and the price authorities should focus on monitoring the price behavior of drugs with insufficient competition, and seriously investigate and deal with price fraud, price collusion and monopoly behaviors according to law At present, there are some price frauds in drug circulation market, such as false high or false low prices, price discrimination in different regions and so on In fact, the government regulatory system has long been in place For example, in 2001, the State Planning Commission issued the "provisions on the prohibition of price fraud", which listed 13 kinds of price fraud However, due to the poor implementation of the regulation, the policy has become nothing To improve the drug price supervision measures, we must establish an effective cost-benefit analysis framework, improve a scientific and reasonable price control system and an open and transparent price supervision system, so that everything can be effectively reformed on the basis of transparency As the basic attribute of commodities, the price of drugs can be determined by the market, but its special situation with more public welfare is difficult to be fully digested by the market In addition, the government needs to improve the response mechanism and supervision responsibility under special circumstances to ensure that it can not only relieve the anxiety of the masses about the price increase, but also avoid the irregular operation and unfair competition of enterprises The price order after the drug price liberalization reform is a reagent to test the effect of the reform Only when the market price is transparent and the order supervision is in place, can the masses share the results of the reform and development, and can the medical reform problems no longer be "difficult".