A province has not been evaluated generic drug price reduction knife medical insurance payment standards to develop a great new idea!

On August 26th, Hainan Province officially issued the Implementation Plan for the Purchase of Drugs in 2020 (draft for comments) (hereinafter referred to as the "Programme").
This program is slightly different from other provinces, take the price of generic drugs without evaluation, in the medical insurance payment standards developed quite profound: the original research, evaluation and other products within three years to the generic drug winning varieties close.
1 In medicines with large clinical usage, higher procurement amount, full competition, mature clinical use and no generic drug evaluation by quality and efficacy under the same generic name, the procurement varieties are determined through expert selection.
Brief review At present, many provinces in the implementation of volume procurement, is basically packaged procurement, mainly for one or two over-evaluation and generic drugs for collective volume procurement, and Hainan alone for un-evaluated generic drugs with volume procurement, this situation is relatively rare.
the industry early circulation, the top 100 varieties will be in the procurement range of this volume, to Hainan pharmaceutical market existing stock, can include the top 100 varieties has been rare.
(ii) In accordance with the procurement alliance medical institutions throughout the year (January 1, 2019 - December 31, 2019) selected varieties with the generic name generic drugs (excluding analog preparations, FDA-certified and sold in Europe and the United States) procurement volume of 50% as agreed procurement volume, antibiotic products with the selected varieties of procurement of 50% as the agreed purchase volume.
a brief review to take out 50% of the purchase of generic drugs in volume exchange, the remaining 50% of the market where to go? The big probability direction is that the selected product in order to meet the purchase volume on the basis of re-volume, to 60%, 70% forward.
, it is expected that the flow label varieties, over-evaluation of the original research products to leave a certain amount of space for use.
price limit, the selection (1) clear the scope of the quotation.
the quotation of the declared enterprise shall not be higher than the minimum purchase price of the current national registered network, and the quotation shall be considered invalid if the quotation is higher than the minimum purchase price of the current national registered network, the quotation is 0 or not quoted, and the declaration shall be disqualified.
brief review of this Hainan to the lowest purchase price of the national network as a limit price, the author understands, one refers to the provincial level, only the provincial level has the variety of hanging net.
refers to the lowest purchase price.
, that is: the lowest purchase price of the provincial network platform.
(ii) to determine the enterprise to be selected.
through the qualification examination of the number of enterprises of 3 varieties, confirmed by both purchasing parties, in line with the relevant requirements of this quotation of the lowest quotation enterprises to obtain the proposed qualification.
the enterprise through the qualification examination of the number of varieties of 2 enterprises, the organization of a negotiating expert group and the lowest quotation enterprises to negotiate price negotiations, to reach an agreement, the enterprise obtained the proposed selection qualification.
can not reach an agreement, the variety is treated as a flow mark.
basically follows the double envelope procurement mechanism, for fully competitive varieties, the low price to obtain the market.
to conduct bargaining negotiations on under-competitive varieties.
third, the use of unseeded varieties (1) to implement the hanging network system.
the selected drugs to the selected price to hang the net, with the generic name (including dosage form) did not select the drug, in the commitment to the lowest national list price, can hang up the network procurement.
If a declared enterprise is allowed to purchase a variety with a generic name that has not been selected, the purchase of the register shall be carried out in accordance with the price not higher than the selected price, and if the price of the original research drug and the participating preparation is higher than the price of the selected drug, the purchase price shall be purchased in accordance with the lowest listed price in the country.
for the unseeded products, the program still gives the procurement channel, that is, the lowest price in the country to hang the net.
It is worth noting here that the unseeded varieties of the same generic name for the declared tender (no longer specifically refer to the dosage form here) are still given the hanging network channel, i.e. the (difference) of the network purchase at a price not higher than the selected price (other dosage forms).
fourth health insurance payment standards to develop (i) adjust the payment standards.
will use the selected price as the standard for payment of health insurance.
In accordance with the principle of gradual and gradient price reduction, the original research drug under the same generic name (including the preparation of the competition, FDA-certified and sold in Europe and the United States) gradually adjusts the medical insurance payment standards, guides the rational use of drugs, and the payment standard adjustment method is implemented in accordance with the relevant requirements of Joan's Health Insurance (2019) Document No. 215.
patients use drugs that cost more than the payment standard, the portion that exceeds the payment standard is paid by the patient, and the portion within the payment standard is prorated by the patient and Medicare.
According to the provisions of the relevant national policies, the price of the varieties selected in the national product (over-reviewed and evaluated) shall be the standard for payment of medical insurance, and ordinary generic drugs shall not be higher than the standard of payment for medical insurance.
in Hainan, on the contrary, the generic drug's selected price as the standard for medical insurance payment, so that the original research price downwards.
To some extent, since the relevant varieties have not been evaluated products, can not form a full competition, so that the original research price reduction, then directly let generic drugs open the way, kill a low-cost road, please follow up the original research.
to achieve the original research price reduction, generic drug replacement purposes.
but in the absence of a review of the product, will this simply falling price reduction trigger further industry thinking? In the future, the relevant lower price varieties will have a review of the product appear? It's debatable.
overall, Hainan's collection and mining program is not hot, there is no particularly radical provisions, the only thing worth noting is not enough competition for the range and strength of the variety bargaining, which is an uncertainty.
In addition, Hainan for the development of medical insurance payment standards, in fact, in a different province has not walked the road, that is, since there is no evaluation of varieties, the rope directly let generic drugs appear, the price down, guide the original research price adjustment.
The core terms document is November 20, 2019 Hainan Province Medical Security Bureau and other nine bureaus issued the "Hainan Province to fully implement the national organization of drug centralized procurement and use of pilot expansion of the implementation of the program", although this document is only related to national varieties, but in this way, still adapted to generic drugs and original research.
hainan collection this time out of a new way to reduce prices, will lead other provinces to follow suit? It's worth looking forward to.
.