State Council Information Office Briefing: Expanding the scale of centralized procurement and launching pilot evaluation

At 15:00 on June 10, the Information Office of the State Council held a regular briefing on State Council policies Wang Hesheng, deputy director of the national health and Health Commission, deputy director of the Secretariat of the leading group for medical reform under the State Council, and relevant heads of the Ministry of finance, the Ministry of human resources and social security, and the state medical security bureau attended and introduced relevant information on the key tasks of deepening the reform of the medical and health system in 2019, and answered questions from reporters Recently, the general office of the State Council issued the key tasks of deepening medical reform in 2019 "The document defines two key work contents: first, the documents to be researched and formulated, mainly involving 15 documents on encouraging imitated drug catalogue, standardizing the use of medical consumables, further deepening medical reform with centralized purchase and use of drugs as a breakthrough, charging for Internet diagnosis and treatment and medical insurance payment; second, the key work to be promoted and implemented, mainly focusing on solving the problem of unsightly medical treatment 21 specific works were put forward in the aspects of expensive disease and strengthening hospital management Including the key work of promoting the pilot of centralized drug procurement and use organized by the state, promoting the reform of high-value medical consumables, consolidating and improving the national basic drug system, and promoting the reform of medical insurance payment mode " Wang Hesheng pointed out that in the next step, all tasks of annual reform will be included in the standing book, which will be reported quarterly to strengthen the implementation of responsibilities Wang Hesheng pointed out that in 2018, focusing on the five basic medical and health systems and the establishment of a high-quality and efficient medical and health service system, a series of reform measures were implemented and significant phased results were achieved First, the construction of hierarchical diagnosis and treatment system was advanced in an orderly manner The comprehensive performance evaluation of medical consortia was launched, the contracted services of family doctors were standardized, telemedicine was promoted in an all-round way, and the county service capacity was improved 84% of county-level hospitals reached the level of level II and above Second, the modern hospital management system has been gradually established We will strengthen the construction of the party in public hospitals, select 148 hospitals to carry out pilot projects to establish and improve modern hospital management systems, promote reform of personnel compensation systems, launch performance appraisal in three-level public hospitals, and further improve medical services Third, the national health insurance system will be improved We will improve the management system of medical insurance, improve the level of medical security, and launch pilot countries that pay by disease diagnosis Poverty alleviation through health care was carried out in depth, and the scope of special treatment for serious diseases was expanded to 21 Fourth, the drug supply security system is increasingly improved The number of essential drugs increased to 685, the supply of medicines in short supply was strengthened, zero tariff for imported drugs was implemented, 17 kinds of anticancer drugs were greatly reduced and included in the national medical insurance catalogue, and the price of 25 selected drugs in the pilot of centralized drug purchase fell by 52% on average Fifth, the establishment of a comprehensive regulatory system was accelerated There are 308000 double random inspection units, accounting for 10% of the total We will launch special actions to combat fraud and defraud of medical insurance funds, strengthen price supervision and anti-monopoly law enforcement in the field of medicine, and establish and improve a joint disciplinary system for medical related crimes Sixth, a high-quality and efficient medical and health service system is being established We will increase financial investment, promote public health, promote the integration of prevention and control, and study actions to improve China's health The number of private hospitals accounts for more than 60% of the total number of hospitals Promote the development of Internet plus medical health, promote medical and nursing integration, and deepen medical education coordination In addition, Fu Jinling, director of the Department of social security of the Ministry of finance, Liang Wannian, director of the Department of physical reform of the national health and Health Commission, and Xiong Xianjun, director of the Department of medical service management of the National Health Insurance Bureau, all participated in the interview CCTV financial reporter: as a key work of this year's medical reform, what is the next step in the comprehensive reform of public hospitals? Wang Hesheng: the comprehensive reform of public hospitals has entered a new stage To deepen the reform, we need to focus on two aspects: first, according to the top-level design determined by the Party Central Committee and the State Council, we need to promote the "three doctors" joint reform, adhere to the idea of "cage for birds" and the path of "space, structure and connection", and take the pilot drug purchase and use organized by the state as a breakthrough, To strengthen the reform of drugs and high-value medical consumables, squeeze out the high price water, make room for adjusting the price of medical services in time, establish a dynamic adjustment mechanism that is conducive to rationalizing the price comparison relationship of medical services and optimizing the income structure of the hospital To summarize and evaluate the exploration and practice of reflecting the value of pharmaceutical services in local areas, and promote rational use of drugs We will further promote the reform of the compensation system in public hospitals, formulate guiding documents, implement the two allowed requirements, and further mobilize the enthusiasm of the medical staff We should also improve the investment policy of the government of public hospitals, relieve the worries behind the reform and development of hospitals, carry out the pilot of group payment based on disease diagnosis, continue to promote the reform of multiple composite medical insurance payment based on diseases, and mobilize the endogenous power of hospitals to reduce costs and save costs The second is to carry out the establishment and improvement of modern hospital management system pilot We will implement the president responsibility system, ensure the correct direction of hospital reform and development, and standardize, refine and scientize hospital management Comprehensively carry out the three-level public hospital performance appraisal work, and promote the hospital to achieve "three transformations and three improvements", that is to say, from the scale expansion type to the quality and efficiency type in the development mode, to improve the medical quality; from the extensive management to the fine management in the management mode, to improve the efficiency; in the investment direction, from the development and construction of the investment hospital to expand the distribution and improve the treatment Reporter from China News Agency: in the key tasks of deepening medical reform in 2019, it is proposed to establish a high-quality and efficient medical and health service system with Chinese characteristics Excuse me, what are the specific considerations? Liang Wannian: the national health and Health Commission is working with relevant departments to study the scheme of high-quality and efficient medical and health service system In order to better promote the construction of this system, we have done relevant work in the early stage: first, we have organized and carried out some basic research to clarify the connotation and extension of the high-quality and efficient medical and health service system, that is, the difference between this system and the existing medical and health service supply system, which of this system and the traditional system needs to be changed and which needs to be innovated On the whole, we should focus on the multi-level and diversified demands of the people in the new era to better meet and solve the unbalanced and inadequate development of the medical and health supply side system; secondly, we have organized and carried out some international relevant empirical research We should fully learn from some good international practices and combine our national reality to design and organize the implementation of a new system that conforms to China's characteristics and meets the needs of the people Third, in-depth summary of the practice of domestic parties, such as Zhejiang, Shanxi, Anhui and other places to explore the construction of this system, and summarize their practical experience and main path On this basis, we should focus on five aspects of innovation in system construction First, we will implement supply side structural reform, improve the service system, and enhance the capacity and accessibility of the whole system To make the system more complete; second, to make the system more oriented to the health needs of residents; Third, we should make full use of the Internet, big data, artificial intelligence and other modern information technologies on the basis of straightening out the external operation mechanism and internal management system of the system to improve the standardization, refinement and informatization management level of medical and health institutions and the whole system; Fourth, actively explore a variety of integrated service modes with family doctors' primary medical and health institutions and district and county hospitals as the health platform, so as to realize the effective combination of "medical" and "prevention" in this system, the effective combination of upper and lower level medical and health institutions, "medical" and "maintenance" and the effective combination of Chinese and Western medicine, which are very important; Fifth, through the construction of a refined management system, reasonable operation mechanism and perfect supervision mechanism, we can establish a policy environment of equal rights and responsibilities, fair and transparent, scientific and reasonable for the high-quality development of this system The adjustment of the new medical insurance catalogue pays more attention to the drug economy, National Radio and television station, National Radio and television reporter: in terms of reducing drug costs, especially what work has the medical insurance bureau carried out after its establishment, and what are its plans in 2019? thank you Xiong Xianjun: the false high price and high cost of some drugs are very important factors for the high cost of medical treatment In order to effectively reduce the drug cost and ease the drug burden of the common people, the National Health Insurance Bureau mainly carried out the following work in 2018: First, according to the adjustment of tax policies, 14 national negotiated payment standards for anticancer drugs were adjusted, with an average decrease of 4.86% Second, at the same time, special negotiations on the access of anti-cancer drugs to medical insurance were held, and 17 kinds of drugs were included in the medical insurance catalogue Local governments are required to implement new pricing and reimbursement policies by the end of November 2018 As of March this year, the total amount of anticancer drugs purchased by national medical institutions and pharmacies in 17 countries according to the negotiated price was about 6.28 million (tablets / piece), and the total purchase amount reached 2.234 billion yuan, which saved 3.181 billion yuan of purchase cost compared with the pre negotiation price Recently, we saw that some media reported that the anti-cancer drugs could not be bought or reported in the hospital after they entered the medical insurance We have noticed that the relevant data quoted in the article was in the middle of December last year Objectively speaking, there was a problem that the anticancer drugs could not be admitted to the hospital or reimbursed The Party group of our Bureau attached great importance to this issue In November last year, the Party group of our bureau together with the health and Health Commission issued the notice on doing a good job in the implementation of 17 national health insurance negotiations on anticancer drugs, requiring all regions to attach great importance to strengthening management, seriously do a good job in online procurement and medical insurance payment At the same time, it was clearly required that all regions should not take "total cost control", "drug proportion" and basic drug catalog of medical institutions as the reasons To negotiate the supply of anticancer drugs and rational drug demand Since 2019, we have strengthened dispatching and urged provinces to report progress on a monthly basis From the current situation reported by all regions, the progress of this work is relatively smooth As of the end of March, the total number of reimbursed people has reached 209400, and the reimbursement amount has reached 1.058 billion yuan Of course, there are imbalances in various regions Third, we carried out provincial-level special centralized procurement of anticancer drugs, with an average price drop of 10.21% Timely carry out the pilot drug centralized procurement In view of the outstanding problems in the field of centralized procurement, such as the decoupling of quantity and price, regional barriers, and the lack of "three medical linkage", focus on the public medical institutions in four municipalities directly under the central government and seven larger cities to adopt centralized procurement with quantity to realize the exchange of quantity for price In this pilot procurement, 25 drugs were successfully purchased, with an average decrease of 52% in purchase price The pilot load reduction and efficiency effect are significant, and it is expected to save 5.8 billion yuan in drug costs Among them, about 2.3 billion yuan was saved for patients In addition, we have also standardized the diagnosis and treatment and drug use behavior of grass-roots and social medical institutions through the special action against fraud and insurance, which has also played a positive role in reducing the drug burden of patients This year, we will do a good job in the following aspects in reducing drug costs: first, we will carry out the adjustment of the national medical insurance drug catalog in 2019, bring more drugs with high clinical value and good drug economy into the catalog, and better meet the needs of the insured