Yu Mingde: prediction of six major medical policy trends in 2015

Source: big smart news agency 2015-1-21 although the data has not been released, it is estimated that the total sales volume of the pharmaceutical industry in 2014 will increase by 13.3% and the profit will increase by 11.6% In 2015, it will not be higher than that in 2014 At present, the provinces with negative medical insurance expenditure revenue and expenditure are Beijing, Shanghai and Guangzhou, which have obvious pressure on cost control The keynote of 2015 is summed up as follows: "the economy is down, the reform is up" 1、 In the case that the central government of bidding vigorously promotes anti-corruption, there are still many cases of anti-corruption at the same time, so is bidding legal or not? The bidding office is a government department, which does not participate in all aspects of drugs, so the bidding is the main body dislocation The main body should be medical institutions, and the funds are also medical insurance, so it is not the government's business The implementation regulations of the government procurement law issued last year in China have provisions The unified management of funds, the first move every month and the proportion of local product procurement are all illegal Nowadays, many illegal acts are made by the government The marketization of drug pricing has been resisted all the time, but now it is anti-corruption to promote reform 2、 The second bargaining enterprises think that this is the execution of the enterprise late, and the appeal has certain rationality, but I do not fully support it The root of the problem is not the second bargaining, but the legal rationality of the first bidding 3、 The trusteeship of the pharmacy is not transparent and public Recently, 81 medical institutions have been entrusted to an enterprise by one place The enterprise has been directly negotiated with the mayor and the municipal Party secretary All hospitals do not know what is going on This is the power trusteeship, which has a great impact on the hospital Therefore, we agree that the trusteeship of the pharmacy is a wolf in sheep's clothing 4、 The list of low-cost drugs has been brewing for a long time A year ago, it was a major reform breakthrough in the work of the national development and Reform Commission In fact, the quantity is not important, because 533+ There have been many supplements, but the most important thing is to break the iceberg of the government's unified bidding: low-cost drugs can not be priced without bidding, and they can be directly traded online by medical institutions and pharmaceutical enterprises, which is a good trend of market orientation Although many places are reluctant to break it, this is a trend A number of policies followed up the low-cost drug policy, first-aid and rescue drugs and products with small dosage, cancelled bidding, and directly linked to the Internet for purchase Gynecological and paediatric drugs will also be managed according to this, and special drugs and drugs in short supply do not need unified bidding by the state So the low-cost drug list policy contributes a lot 5、 In the past, there were strict restrictions on the breakthrough of trading rules in the Internet drug trading market Now we need to go through various procedures At present, we know the breakthrough points include: agree to entrust a third party to distribute drugs, open the application subject (drug production and operation enterprises can apply), B2B does not need to be approved, B2C is also distributed to the province, not to the state There are more than 450000 existing retail stores, only some prescription drugs can be traded online, so a positive list may be made, which can be published one after another, and the administrative measures for Internet transactions may come out before the two sessions Circulation retail enterprises will be significantly affected, and hospital purchasing behavior will also be affected 6、 The payment price of medical insurance is still not mature It is estimated that it will not come out in the second half of the year Everyone is in the stage of different opinions We have given suggestions and five principles First, the principle of median price: the key to payment price is not price, but a payment standard How much money to sell is arbitrary, and how much money to pay is determined according to the income and expenditure of medical insurance fund In this way, the boundary between the government and the market is clarified It is suggested that the median price of the same variety won by 31 provinces and autonomous regions in 2009-14 be used as the payment standard, which should be considered in all aspects; The second is the principle of the same name and the same payment Now some enterprises raise the issue of quality differences, but the brands and quality of different enterprises should be handed over to the market for doctors and patients to choose Otherwise, the discretion of the government is too large Will the same name pay lower? It won't be Drugs with the same name can be purchased by multiple hospitals at the same time to meet multi-level needs Do not bid for one product, which is meaningless; third, separate politics from business and do not interfere The hospitals in the catalogue set their own bidding and purchasing methods, and the hospitals do not reimburse the expenses The government does not have to worry about it, and the patients are fully responsible for it Exclusive and innovative rare products can be negotiated, and high price varieties can be negotiated It's a good thing that Herceptin and others who go into the medical insurance reimbursement out of the catalog agree to put it in It's OK to pay 10%; Article 4: encourage innovation, change the practice of entering the medical insurance catalogue in five years, such as listing, and incorporate it in time, so that the masses can enjoy the innovation results; Article 5: patients and hospitals should make the benefits of saving and sharing There have been many meetings now, and there are opinions from all sides, maybe in the second half of the year 7、 In other policies, low-cost drugs are purchased directly online without bidding, and public hospitals of gynecology and pediatrics are also purchased directly online In Beijing and Zhejiang, doctors are allowed to practice more than one point, or even to practice freely, which is a very good reform direction Registration and approval parties will also issue policies There are also a few small policies, such as the approval of designated pharmacies for medical insurance, the new pharmacopoeia will be issued this year, the temperature requirements of warehouses will be changed, and may be extended As for the pressure on the health insurance fund, I think it is very important The premier is taking care of it At first, some provinces had poor ability to pay Now we can't guarantee that they won't overspend The last thing we should do is to include six kinds of cancer drugs into the basic drugs This one should not be done It can't be closed after opening It must have something to do with the tension of the medical insurance fund It couldn't be paid back that year The bidding plan of Zhejiang Province may be modified a lot Now they are flustered to come up with some policies to show the legitimacy of bidding, to prove their effectiveness and management effectiveness Recently, there are also meetings in Beijing, and the government departments are frequently looking for some scholars to boast In 2015, the overall growth is due to the increase of quantity There are a few things that will increase the price The increase of blood products will be very large, which can be increased exclusively, but most products have no channels for price increase With regard to traditional Chinese medicine injections, the proportion of traditional Chinese medicine injections is increasing year by year The statistics in the form of the Ministry of social security shows that it is unreasonable, and it is estimated that it will be affected to some extent With the elimination of unified bidding, medical institutions will become the main body of bidding and procurement Now there is a great resistance for doctors to be released and third parties to bid If both the price administrative control and the government's administrative control over bidding break through, it will be a great benefit to the hospital Only the hospital has the ability to suppress the price After several rounds of revision, the procedures are simplified and the transaction cost will be reduced rapidly Alibaba is said to have signed the same agreements with 12 provincial governments as Hebei provincial governments, and signed cooperation agreements on hospital information management and elimination of prescription monopoly The measures for the administration of drug Internet transactions will be issued before the two sessions, and will be gradually implemented after the two sessions The biggest concern is security issues The number of positive lists for the first time will not be too large As for the payment price of medical insurance, social security and relevant departments have done research The personnel are not in place, so the research on the payment price is not on the agenda, but it is expected that it will be promoted soon after the determination of the top leaders.