Medical network - February 13 under the state council general office recently issued "on further reform and improve the pharmaceutical production circulation use policy several opinions do hair [2017] no. 13 (countries), for the full impact of the pharmaceutical industry of the curtain is pulled open, and for drug companies, the most intuitive drug prices feelings or will emerge quickly in a short time, many departments jointly" audit "and price information sharing will no longer be alarmist, prices may at any time in the face of the bottom of the" wear "and" back to prototype "risk.
Prototype ▍ prices or the "back"
Do hair [2017] no. 13 in the "countries" file, article 12 clearly put forward: "strengthen the price monitoring information. The drug price monitoring system, promote the pharmaceutical market price information transparent. The food and drug regulatory departments establish the ex-factory price information of led to start the traceability mechanism, establish a unified price information platform across departments, with drug centralized purchasing platform (public resources trading platform), the medical insurance payment platform, interconnection, strengthen with the relevant tax data sharing. To inflate prices of raw materials and pharmaceutical factory price of drug manufacturers, prices, food and drug supervision, taxation and other departments to investigate in accordance with the law, pay taxes receivable, shall be investigated for the responsibility of the relevant responsible persons. Strengthen the insufficient competition pharmaceutical factory (port) price, the actual purchasing and selling price monitoring, the abnormal price changes or with varieties of drugs price difference is too high, should be timely research and analysis, when it is necessary to carry out the cost price of special investigation."
According to the content of the reform, policy drafting process involved in the discussion of the expert reminds, the state council issued by the state do hair [2017] no. 13 "medicine change documents, is to guide the development of pharmaceutical industry in the next five years or longer programmatic document, covering the whole industry chain, very informative, should study carefully study, each paragraph in the file, or even a word, there are may have corresponding supporting policies, in terms of article 12, there are several key information point is worth attention to:
The first it is going to start to establish drug price information across departments, interconnection platform.
The key here is "across departments and connectivity". We all know, the past for a long time, unimpeded information interaction between different departments is not enough, even some of the time, have the possibility of deliberately hidden, so in the different departments to formulate policies and gathering information, there are some barriers of information asymmetry. If establish drug prices information across departments connectivity platform, each department share the other relevant departments at the same time, drug price information were collected may bring because of information asymmetry and loss of the price advantage, based on the national medicine tube drug bidding procurement information platform, based on the prices paid for information collection platform, and from all over the country by the department of health medical insurance fixed-point organizations collected in the actual transaction price information, the lowest price information, realize the sharing between government departments, public, will make the current drug price transparency.
The second is Shared with the relevant tax data.
This just ten words, may be ignored by many people in the industry, and this is a very important policy of "bad" signal. Any actual cost, the phenomenon about the price, may be an open secret, there are probably in most drug bidding procurement, otherwise it is impossible to every time when I get the results of the bidding always has a lot of drugs was cut down how much the price.
There is no doubt that the drug prices artificially high, or low, is not normal phenomenon, should be the price is reasonable is science. As regulators, how to understand the actual circumstances of the drug cost? "Sharing" with the relevant tax data will be very deadly a recruit, the pattern is down, how many enterprise actual pay taxes, the data is often hard, normally the enterprise does not take the initiative to extra pay too much tax, on the contrary under legal compliance, many enterprises have the motive force to seek reasonable tax avoidance, tax tax from the enterprise data as the breakthrough point, to trace drug price and cost composition, could make the true costs of drug prices back.
Difficult? It isn't difficult at all.
Since May 2016 tax reform, fully implementing "change", and in July after fully launched online gold three period system, based on the product of information flow in the VAT tax bill paper traces the very simple. A certain product in the process of actual production and sales business, how much to pay value added tax, the core of the raw materials composition and cost price, only need through tax data out at a glance.
So, drug price information detection platform, once the realization of cross functional connectivity, when implementing data sharing with the tax departments, on the day of may is drug real cost price back to prototype. You notice? On January 9, jointly issued by the nine ministries and commissions of the state of "the reform do hair [2016] no. 4" two votes policy documents, one is the state administration of taxation jointly issued by the unit.
The third is to inflate the price of raw materials and pharmaceutical factory price of pharmaceutical production enterprise, to investigate in accordance with the law, pay taxes receivable, shall be investigated for the responsibility of the relevant person in charge.
With above analysis across departments, connectivity, and tax data sharing, and then set out to check whether there is any price behavior, may be the ants. And so strict punishment measures are put forward, and tend to "pay taxes" and the "criminal offence", because after full implementation of the camp to increase, the VAT problem is not a small problem, don't pay attention may be there is the possibility of violation of criminal law, there are some serious.
The fourth is necessary to carry out the cost price of special investigation.
This requirement is, of course, found the bigger of the two "abnormal" to start. Once for some drugs to carry out the cost of special investigation, plus there are tax data sharing, the survey out close to the real cost is nothing too big obstacle. Change because the full implementation of the camp, gold three period has been launched, if two years ago, the department in charge of for cost check or difficult (mainly is the basic condition is insufficient, trouble, time-consuming), but right now, times have changed, is easy to check.
▍ drug prices in the future how?
In May 2015, was the industry known as major positive drug prices the deregulation policy, namely, the national development and reform commission issued a "hair change price [2015] no. 2015" file on the notice issued by the advance of drug price reform opinions, the document clearly put forward, according to the market plays a decisive role in the allocation of resources and better play to the role of government requirements, gradually establish take the market as the leading drug price forming mechanism, maximum limit reduces the government's direct intervention of drug prices. But at the same time, adhere to the pipes, to strengthen the price, such as health care, bidding and purchasing policy of cohesion, make full use of market mechanisms, synchronous strengthening medical costs and price behavior comprehensive regulation, effectively regulate the behavior of drug market prices, promote drug market prices maintain a reasonable level.
File proposed future drug pricing mechanism is, in addition to narcotic drugs and the psychotropic drugs of category I, eliminate drug government pricing, improve the mechanism of the drug purchase, give play to the role of health charged fees, drug actual transaction prices are mainly formed by the market competition.
The file in to strengthen the medical costs and the price behavior of comprehensive regulation, a clear request, cancel the drug after the government pricing, with the reform of drug purchase and payment policy of cohesion, promote the medical institutions and retail pharmacy initiative to reduce the purchase price. Fixed-point medical institutions and pharmacies should submit to the health care and price departments drug actual purchasing price, retail price and purchasing quantity and other information. Through the reform of medical insurance payment, the establishment of medical institutions, the reasonable diagnosis and treatment of internal incentive mechanism for the rational use of drugs.
This time "countries do hair [2017] no. 13" medicine article 16 of change the file request, strengthens the medical insurance fund budget management, vigorously promote the reform of medical insurance payment methods, fully implementing is given priority to with the macro-reforms, capitation payment, pay by bed, and other methods of combining multiple payment methods, reasonable medical insurance payment standard, the drug supplies, check assay by medical institutions such as income into cost, make active regulating medical behavior of medical institutions, reduce running cost.
Medical institutions will be real bargaining with drug firms? If the price is to can't drop the wear of floor price, does the doctor can not guarantee the "income", the doctor just quit? Everyone staring at "the doctor income" how to improve that's right, if the doctor lawful income increase problem is not solved, do a lot of problems is difficult.
In terms of the present rules, every doctor to get the gray income 100 yuan, the possible causes of the 400 yuan medical expenditures (if in accordance with the 25% rebate calculation), as the government of the relevant interests, regulators can completely by eliminating the doctor gray income, save health care costs, costs for health care will be saved, and then give some encourage doctors, into the doctor's lawful income (such as save health care of 400 yuan, 200 yuan for incentives), so the doctor through the legal way to get income than get grey income is higher, the doctor won't go to adventure illegal, such incentive and restraint effect will be reflected. Relevant departments do not realize this? Of course is already reached an agreement, the problem is that the relevant departments will do?
Earlier in August 2016, xi general secretary in the national health and health conference clear instructions "allows the regulation and control of medical and health institutions to break through the current institution wage, allow the medical service revenue after deducting costs and in accordance with the provisions, extraction of various funds is mainly used for personnel rewards".
General secretary of the "two allow" will make a major breakthrough in the reform, a few days ago (February 10), the state of human social security department and other four departments have issued on the salary system reform of public hospitals will be carried out pilot work guidance ", adjust the structure of the doctor income, improve the doctor is launching the reform of legal income problem.
These policy information, can be simple to understand, the hospital within the scope of the standard can find ways to reduce costs (as much as surplus, or make more money, the medical service price reform has started), hospital to earn money to pay the related fund, can legally assigned to a doctor, doctor to improve legal income.
Before the doctor to raise income doesn't work, the doctor's compensation system is in strict accordance with the institution of accounting standards. When the doctor's resolved the problems of high legal income, drugs in the doctor's status, great changes will take place, stripping barriers, it is not problem, hospital outpatient pharmacy is being cut drug prices have power, is because of the price of cut down the hospital profits can be Shared.
Under the new mechanism, doctors taking kickbacks behavior and the interests of the hospital, and under the previous system arrangement, the doctor's rebate behavior does not directly harm to the economic interests of the hospital, the doctor kickbacks, high drug prices high, down 15%, corresponding hospital earn more, even zero rate, also does not affect the hospital interests, if have the rebate, high prices of drugs must be more). When the interests of the rebate behavior of doctors and hospitals and hospital overall interests conflict, the real supervision mechanism will be set up. More importantly, can get legal high income (even illegal income is higher than), why again to take the risk?
By review of drug price reform of "hair change price [2015] no. 2015" file, learning recently promulgated by the state council "countries do hair [2017] no. 13" medicine changed files, contact the general secretary's speech spirit for the doctor income problem last year, combined with just put "people club department is sent [2017] no. 10" file, as well as the upcoming "about pay of insurance of primary medical treatment drugs standard rules of guidance", was clear to the future trend of prices is the basic (main medicare drug) : be determined by the health department payment standard, under the payment standard of medical institutions was hellbent bargaining reduce procurement costs, hospital purchasing real price but also to the health care sector, share price department, and in determining the pay standards, in addition to the collection market of the real market price, the tender and bid price, price negotiations, can put out the tax data reference at any time.
In the future, the possibility of drug prices in the bottom is large! |
