20 countries talk about varieties of single-column outpatient co-ordination payment!

Medicine Network December 18, Fujian Provincial Medical Security Bureau recently issued a notice, from January 1, 2021, will be McGregor, Slepag, Posentan and other 20 countries to negotiate a single outpatient drug co-ordination payment.
The cost of medical insurance drugs paid by the insured persons in the outpatient clinic of the designated medical institution shall not be set up a starting line, the reimbursement ratio shall be 80% of the employees, 60% of the urban and rural residents, and the cap line shall be shared with the local workers' medical insurance or the annual cap line of the urban and rural residents' medical insurance.
not surprising that the competition in the Chinese market has intensified this attempt in Fujian.
The National Health Insurance Administration and the National Health and Health Commission jointly issued the "Notice on doing a good job in the 2019 national health insurance negotiations on drug landing" clearly stated that "local health insurance departments should be scientifically calculated, carefully organized, in order to ensure the safety of the Fund and reasonable use of drugs, and actively explore payment methods in line with local realities."
For negotiated drugs suitable for outpatient treatment, with a longer life cycle and higher course of treatment costs, the burden on patients can be reduced by including special outpatient disease protection and exploring single-disease payments, according to the fund's income and expenditure.
" market analysts pointed out that because of the average wage in the developed areas of the eastern coastal region, the corresponding provinces of the co-ordination fund is more generous, outpatient co-ordination reimbursement can be relatively high, the form is more flexible.
fact, in Fujian 2020 health care work points, has proposed to "explore some countries to negotiate a single drug outpatient co-ordination payment policy."
According to the contents of Fujian's notice, the first batch of medical insurance drugs to be paid for by the state-negotiated drugs are selected from among the state-negotiated drugs, and follow the principle that the total annual cost of treatment is higher for outpatient use, long life cycle or standardized treatment, and that the adaptive disorder is not covered by the special outpatient diseases currently issued uniformly in Fujian Province.
, octreotide micro-ball injections are also included in a list of single outpatient co-ordination payments.
As a drug suitable for limb hypertrophic disease, gastrointestinal pancreatic secretion tumor, the application scenario of octreotide is quite rich, the existing domestic approval of 30 acetic acid octreotide injections sales results are also very prominent, the industry estimates the national market capacity of more than 2 billion yuan.
only imported octreotide micro-balls, the domestic share is much lower than ordinary octreotide injections, mainly due to high prices / economic affordability.
analysts believe that being included in a single outpatient co-ordination payment list may accelerate the replacement of the octreotide micro-ball market, but also promote the development of domestic related products, to achieve upgrading.
is worth noting that the Fujian health insurance department also attaches great importance to the use of drug compliance.
Never in the document clearly "to strengthen the monitoring of the use of single-list outpatient co-ordination payment of medical insurance drugs, urge fixed-point medical institutions to achieve standardized upload of relevant information on diagnosis and treatment, promote single-listed outpatient co-ordination payment of drug norms, rational use", in the payment scope of the rules are also reflected.
to treat macular edema anti-VEGF ophthalmology drugs as an example, this time included in Fujian's single outpatient co-ordination payment including Compaqsip, Abersip and LeiZhu monoanti.
Although there is a slight difference in the coverage of the three health insurance limits: Abersip's limited coverage of wet age-related macular degeneration (AMD), diabetic macular edema (DME), and Compaxip's adaptation to vision impairment caused by AMD and DME In addition to the disease, increased vision impairment caused by new blood vessels (CNV) in the vein membrane, and in addition to the visual impairment caused by AMD and DME and CNV, re-added visual impairment caused by macular edema secondary to retinal venous obstruction (RVO).
However, in co-ordinating the payments, it was emphasized that a maximum of nine payments per eye would be made, a maximum of five should be paid in the first year, and that the drug costs of Abersip, Reju monoantigen and Compaqsip would be calculated in combination.
not difficult to see, the future of related drugs market competition will be further intensified.
Of course, the medical insurance drugs included in the single-list outpatient co-ordination payment, Fujian will also be in accordance with the national medical insurance drug catalog adjustment, the province's outpatient special diseases and general outpatient policy changes and other factors, dynamic adjustment.
talk about varieties continue to benefit from the comprehensive analysis of Fujian's notice is not difficult to find that its main appeal is to speed up the national health insurance negotiations drug landing.
Therefore, in addition to the single-listed outpatient co-ordination payment, for the non-listed outpatient co-ordination payment of national negotiated drugs, but there are outpatient special diseases protection, because some outpatient special diseases cap line low, treatment is obviously not in place, but also requires the co-ordination areas can be in the original outpatient special treatment on the basis of the fund income and expenditure situation, through adjustment of the cap line to protect.
In fact, as a new market in recent years and clinical value is higher, the price is relatively high innovative drugs or exclusive varieties, the price of drugs negotiated by the State-negotiated varieties in the medical insurance negotiations significantly reduced, so that the accessability of drugs greatly increased, the market demand is strong.
this trend is particularly pronounced in pairs with other varieties.
meters net data show that in the first half of 2020, despite the impact of the epidemic, the sales of national negotiating varieties still showed a rapid growth momentum, up 47.11% YoY, the proportion of sales also increased from 2.8% in the first half of 2019 to 4.8% in the first half of 2020, it can be seen that such varieties in exchange for the market channel opened, the market development space is larger.
China's public medical institutions affected by the policy of the proportion of sales of various types of drugs and year-on-year growth sources: Minet China's public medical institutions terminal competition pattern, however, analysts also specifically reminded that the integration of outpatient co-ordination, especially in Fujian this time without a starting line single outpatient co-ordination payment, may bring about the corresponding varieties of market pattern changes - hospital terminal market expansion and the reduction of the off-hospital retail market, the relevant channels must pay attention to.
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