Medical network - February 13 people club department has finished joint health development planning commission jointly revised on the pay of insurance of primary medical treatment to drug standard rules of guidance (draft) "(hereinafter referred to as" draft "), again to solicit comments from various ministries and agencies, health care payment standard is expected to formally draft fastest in February, the most late march with the new medicare drug directory. Health insurance payment standard is different from the past in proportion of reimbursement way, its biggest luminescent spot lies in a hospital and health care payment standard sale price gap between, allowing the hospital. Thus, forcing the hospital active suppressing drug prices.
As a result, competition will be great changes in the generic drugs and clinical required products, through the "generics consistency evaluation of industrial enterprises" price pressures or will be reduced. And for the price system mainly by gold sales to maintain, low cost performance products, health care payment standard, health care, hospital medicine accounted for the inspection measures will lead medical institutions reduce the structural layers of drug dosage, reduce it will translate into high quality generic drugs and innovative drug market.
▍ all for drug prices
"Health care payment standard will be introduced together with the medical insurance directory." Chinese medicine enterprise management association ming-de yu, told reporters that "people club department national ministries and commissions such as setting the rules, the provincial government to formulate specific policies, as a whole the area set payment method."
In health insurance fee strength tighter control, medical insurance fund under the background of increasingly tight, as "medicare catalog + payment standard", the regulators is clearly hope that the pharmaceutical industry can understand its meaning.
"Medicare payment standard" refers to the three basic medical insurance ginseng protect personnel in the use of medical insurance directory of drugs, medical insurance fund to pay for drugs benchmark, medical insurance fund according to the standard and health insurance payment provisions of the drug to the medical establishment that decide a dot of insurance of primary medical treatment, designated retail drug store (called the orgnaization above) to pay for drugs.
The personage inside course of study tells a reporter, the paper focus on drug efficacy and the balance of the price, that price, in order to avoid the main expensive medicine and auxiliary medicine supplier old want to make the idea of health plate. The government emphasis on the establishment of dominated by market price formation mechanism, in order to reduce drug prices artificially high brought by artificially low coexist.
Health insurance payment standard acquisition tendering price not only, still with "two votes", drug firms ex-factory price, the channel price, electricity price, price drugstore and terminal price is majestic, adopting the agency system and channel chaos for companies, is a clear sky out of the blue. At the same time, foreign companies have a patent period after the original medicine into the health care, will also follow the standards of imitation payment, the balance paid by patients themselves.
National center for health development planning commission health development research Gu Xue not, "says Dr. Health insurance payment standard is according to the equivalence on the effect of drug in the treatment and clinical alternative, will have an alternative drug groups, according to a benchmark to determine each drug insurance compensation levels. "Strict sense, the payment standard is not a pricing system, but a kind of compensation mechanism, it is a limit to control drug expenses insurance compensation level implementation of policy, by reducing the need for expensive drugs (from the buyer) and stimulate drug producers to take the initiative to reduce the price (from two aspects of the supplier) to reduce the reference pricing system involved in drug prices." Gu Xue said.
▍ hospitals will main compounds bargains
Health care standards not only change the payment form, the key point in "arouse the enthusiasm of hospital lower drug prices. Because the difference allows for hospital, the hospital will have power to negotiate with drug firms, both its strength and professional will better than the existing local matters and people club department. This is the updated version of the second negotiation, most generic drugs will be cleaned.
Under the medicare payment standard, designated agencies can be retained drugs the difference between the actual sale price and the payment standard. Around this, will have different rules, in some places can leave the hospital directly, in some places to submit financial subsidy to the hospital, depending on the situation after making orgnaization on purchasing drugs have more power to demand a drug suppliers.
Under the rules of the original payment, hospitals have no incentive to lower drug prices. Proportional to pay medical insurance drugs, medicines are suitable addition, the higher the price, the more profit hospital; Zero drug addition, the higher the price, drug supplier to hospital gray the greater profit space.
And the implementation of the medicare payment standard, make medical institutions as the main body of active drug purchase price lower. Due to medical institutions is the most real grasp drugs market demand information, so the medical institutions shall be subject to lower drug prices and efficiency than inevitably matters such as the more direct interest related government departments. This is health care payment standards can guide the formation of medicine the essence of the real market price.
As a result, the pharmaceutical manufacturers will face the price pressure is more apparent than ever.
The personage inside course of study tells a reporter, better curative effect for those who are or will be hard to replace the innovation medicine, no price pressure is too great, and there are more alternatives to high-priced medicines will face bigger pressure reduction, such as finished generic drugs imported drugs consistency evaluation, manufacturers more proprietary Chinese medicine, and even some exclusive varieties of traditional Chinese medicines have more competitive alternative prices will face greater pressure.
▍ generics consistency evaluation is the premise
With the implementation of the health insurance payment standard, for exercise unified payment benchmark of generic drugs, and thus of generic drugs to ensure consistency of curative effect, is the precondition of medicare payment standard can attend. Paid throughout the global implementation of the drug standard of countries and regions, such as Germany, Britain, in generic drugs registration review to ensure that generic drugs are consistent with the original drug quality.
However, China's pharmaceutical industry compared with the developed countries are different. Pharmaceutical industry in China for a long time is given priority to with generic drugs, generic drugs registration review in the pharmacopoeia of standards issued by the food drug administration and as a standard review, for really involved in the drug quality bioequivalence and in vitro dissolution consistency evaluation index is no clear censorship rules, namely "standard of imitation, not imitation products".
Looser generics market access conditions, with the common name in our country the general situation of pharmaceutical production by companies, but these production enterprises in the research and development capabilities, production process, quality control and so on difference is larger, resulting in our country with the quality and curative effect of generic drugs is not the same.
According to the current situation of drug quality in our country, the state drug administration have gradually realized that generics consistency evaluation as the key link of the drug registration reform, has become a new health reform to promote the "supply side" of the important supporting work. In 2016, the generic consistency evaluation into the policies to promote intensive period. On March 5, released by the general office of the state council concerning the evaluation opinions of generic quality and curative effect of consistency ", a clear evaluation objects and time limit, the reference formulation selection principle and evaluation method selection principle, officially kicked off the evaluation of the consistency of our country.
On May 25, the state drug administration in accordance with the requirements of article 8, issued "on the implementation of the general office of the state council to carry out the quality of generic drugs and curative effect evaluation opinion consistency > announcement of relevant matters, standardizes the generic declaration process consistency and evaluation of the content of the research for consistency evaluation made a request, marked the our country medicine consistency evaluation formally entered the stage of implementation.
At present, China's first batch of 289 by "generics" consistency evaluation of drug need to wait until 2018, considering the existing clinical trial resources, the company's core strategic product generics consistency evaluation is underway.
"In this context, the hospital is in the transitional period would take the initiative to adopt low price of homogeneous products, competition not big changes in the corresponding drug." Guosen medical researcher Jiang Weina think, after the transition period, competition will be great changes in the generic drugs and clinical required products, through the "generics consistency evaluation of industrial enterprises" price pressures or will be reduced. |
