Xu Shaoshi: To explore the negotiation mechanism of innovative drugs, it is necessary to allow municipal hospitals to "tender twice"

Source: People's daily.cn on the morning of December 28, 2014, the 12th session of the Standing Committee of the National People's Congress jointly reviewed the report of the State Council on promoting the construction of urban and rural social security system as a whole, and made a special inquiry Xu Shaoshi, director of the development and Reform Commission, said in response to the question about the high proportion of individual self payment of medical insurance from Gu Shengli, that we should not only protect the basic, but also reduce the proportion of self payment of the beneficiaries of medical insurance Now the overall idea is to comprehensively promote from three aspects of strengthening medical insurance management, drug management and medical and health management To strengthen the management of medical insurance is mainly to control the cost At present, the general practice is to prepay the total amount and share the over expenditure, which is shared by medical insurance institutions and hospitals, as well as control the cost according to the disease type, the project and the number of patients This year, the total payment control of basic medical treatment has been fully implemented, and the method of compound payment has been generally adopted The combination of payment by disease, payment by project and payment by the number of patients has played a certain role in reducing the level of patients' self payment Secondly, promoting the computerized management of prescriptions is conducive to strengthening the internal supervision of medical institutions, more importantly, to the supervision of medical institutions and medical personnel by medical insurance institutions, and also plays a certain role in reducing the proportion of patients who pay for themselves Third, explore and innovate the drug negotiation mechanism Now there are some severe patients, clinical must use some of the more expensive new drugs Some places have explored and negotiated to reduce the price of targeted drugs for some tumors, rare diseases and orphan diseases, and to include them in the payment scope of medical insurance, so as to ensure the treatment of these severe patients, and also to reduce the cost This is a big part of strengthening the control of medical insurance costs To strengthen drug management, improve drug bidding system, and strengthen drug management, mainly to improve drug bidding system Relevant departments, including the health and Family Planning Commission, have done a lot of work to solve the problems of what to recruit, how to recruit, how to distribute and how to supervise First, we should improve the procurement methods, implement online procurement for a number of drugs with sufficient production and competition, and adopt a multi-party negotiation mechanism for the procurement of patented drugs, drugs with exclusive production and drugs with insufficient competition For some drugs that must be used in clinical practice, but in a small amount, if they are produced more or not, they will be produced by designated enterprises This system is under constant exploration The second is to improve the drug supply mechanism, reduce the intermediate circulation link and the cost of circulation link Third, actively explore the gradual integration of drug procurement into the national unified resource exchange platform, open and transparent, implement bad records, and investigate and deal with violations of laws and regulations Fourth, further improve the transparency of drug procurement At present, the reform of public hospitals has not been fully pushed forward, so it is divided into two parts The pushed part allows municipal hospitals to bid twice, and the one that has not been pushed forward is pushed forward as far as possible, and unified bidding is implemented We will improve the management of the basic drug catalog, and improve the management of the basic drug catalog The list of essential drugs is gradually expanding There are about 520 kinds of essential drugs For common diseases, frequently occurring diseases, major public health service projects, prevention and control of major diseases, and the creation and selection of major new drugs, there are three parts: chemical drugs, biological products, proprietary Chinese medicines, including pieces of Chinese medicine Now 520 kinds of essential drugs are adjusted every three years to ensure the needs of medical services and patients, and to reduce the proportion of patients who pay for themselves to some extent.