A new round of band collection: inertial expression OR logic conflict?

Wen /DV health bulletrecently, "genuine" collection catalog and volume procurement of medical insurance balance retention rules circulated in the industry, and explicitly asked medical institutions in early July to complete the relevant drug annual dosage measurement work, which means that the third round of drug band collection work led by the Medical Insurance Bureau has been at least two steps forwardfor the expected year to achieve another round of drug price cuts, industry inertia expressed as "mountain rain want to wind full of buildings", it seems that always can create a life of you, blood and rain immersive experiencethis argument is far less brainwashed than last year's hotly-publicized "soul-style negotiations" in a central city---
"Do you drop 0 points a few points to calculate the decline?" Think again! "
the soul of the negotiator opposite, opposite the female manager of the drug factory sitting with a snort to wipe away two lines of blue tearsHowever, people who have seen running men and being very picked on this kind of reality show should smile, either the script is well written or the negotiation skills are good, and both need to perform just fine2018, control fees, price reduction, fight rebates is the focus of the industry to talk about capital, policy direction determines the bottom logic of enterprise operation, is to exit the field, or to convert the track, still belong to the proper chat method, and in many "headache stoic pain" policy regulations, pharmaceutical companies more choice is "two feet" together, that is, to maintain the "high open high cost" of the inherent model of innovation or generic drug research and development inputIts internal logic is: after all, the strategic basis of band collection is "consistency evaluation" and "competitive", in 2-5 years can only be based on the number of varieties evaluated and whether or not more than 3 competitive varieties and gradually implemented, and exclusive varieties and occupy hospital drug sales More than 80% of other non-belt procurement varieties (currently about 600 or so) still have to adapt to the existing rules of the game, and increased research and development efforts is for 3-5 years after the strategic considerations, it is generally believed that under the pressure of health insurance revenue and expenditure, rebates can not play, of course, washing is also importantback to the beginning, looking ahead to a new round of band collection to return to the role of the Health Care Board as a "strategic buyer", in the drug must involve the supply side, buyer, user of the different scenarios, we will inevitably think about these issuesthe highest decline of more than 90% in the first 2 rounds of the belt purchase and the average decrease of more than 50%, is the result of strategic buyers to manage the inflated high drug pricesFrom the market, the drug price is of course inflated, and the so-called "virtual" is actually implied rebates in the drug price, rebates to doctors need to be through CSO, raw (package) material procurement and other ways to wash out the cash, and the above-mentioned decline can be considered closer to express the rebate and cost of space, then, in the face of a very unbalanced negotiation between the two sides, the consideration of political correctness will be greater than the market game considerations, at the same time, a "ticket called access" is the most practical trading chipsDoes the setting of possible new rules (e.gred lines, gradients, multiple winning bids, quote fuses, etc.) mean that the overall decline will be milder than before? For varieties with high competitive indices (e.gmetformin, dozens of competitions) are more likely to see a real floor price, while only three competing varieties are still likely to be de-marked by more than oneA happy few sorrows, the winning bid naturally get the designated allocation of market share, not winning or abandoned the bid can be expected to non-medical terminal, pharmaceutical enterprise behavior logic and its market economy main body match, profit is the fundamental survival of the enterprise Under normal circumstances, the market transaction price is formed by the buyer and seller, the profit signal makes more sellers join, competition makes the product price is getting lower and richer, the variety is more and more abundant, forming a virtuous circle Is the final outcome of the negotiations decided by the market or by administrative intervention? hospital is the final purchaser of medicines, the hospital is not a warehouse Only when hospitals have a proper lying policy license will there really be an incentive to take on the collection of belt stakes Otherwise, Yin Fengyang violation, dark Chencang (such as abnormal reporting, abnormal inventory) is the inevitable result Allowing hospitals to access health-care balances for drug purchases would give hospitals the incentive to purchase and use low-cost drugs, and would also allow hospital revenues to shift from dark Otherwise, under the current zero-rate regulation, the hospital is losing money to sell medicine, the purchase price of drugs can be "not lost" however, allowing hospitals to obtain the proceeds of drug procurement balance is the basic logic of the normal market environment, can not use the inherent thinking of administrative institutions to give too much restraint, otherwise the result of implementation is likely to be "tasteless, abandoned pity" The collection of dozens of varieties of tens of billions of markets, for the entire trillion-dollar public hospital drug market, there is not yet completely disruptive, the hospital's own account is easy to calculate More important is how to maintain the sustainability of health care and collection policies This requires dynamic adjustment of the standard of medical insurance payment, but only if the health insurance bureau can see the real price of drug transactions in real time, and not the price of the eternal price in a procurement year, the wide participation of the supply side, real-time competition, diversity, fluctuations in the price can provide a scientific basis for adjusting the standard of medical insurance payment So, in the future, how will the health care bureau's procurement price policy for medical institutions develop? even if the patient is the end user of the drug, the intervention patient is still using the doctor's prescription, the patient's medication habits are trained by the doctor, can also be changed by the doctor in China, most doctors do not get a reasonable income from their own labor Dr Zhang Qiang, founder of China's first doctor's group, said in a blog post that with the grey income, doctors are always walking a tightrope on the edge of laws and regulations, with a knife hanging over their heads collection policy feedback to the doctor is "positive incentive" or "negative incentive", determines whether the collection policy can finally land If we still manage a profession such as high-tech, high-risk and supposedly high-paying doctors in accordance with the inherent methods of personnel (preparation) of institutions, even if there is a policy permit for the retention of the health insurance balance mentioned above, it will inevitably fall into the "big pot of rice" and will form a "negative incentive" for the enthusiasm of doctors Can the health care bureau take control of the hospital when the problem arises? Who should run the hospital? Are managers' interests convergent? see the inner logic is helpful to understand the individual behavior, only respect the law, return to common sense, can get normal behavior results, only for brick-throwing jade, above.