Chinese medicine: "13th Five-Year" status quo and "14th Five-Year" point of view

Medicine Network January 7th, 2020 National Health Insurance Negotiations before the official.
with the repeal of the local health-care catalog, this may be the last year for many Chinese-made pharmaceutical companies that rely on local health-care catalogs to gain access to the health-care catalog.
Previously, the State Health Insurance Administration on the issue of Chinese medicine collection, said: the state-organized drug collection carried out to the third batch of remarkable results, at the same time, the State Health Insurance Administration also guides and promotes local drug collection exploration for Chinese medicine and other drugs.
At present, Qinghai Province, Zhejiang Jinhua, Henan Puyang and other places, for some of the large demand, high amount of chinese medicine species, actively carry out collection and exploration, achieved significant price reduction results, reform results benefit more people.
These local explorations involve the collection of varieties such as clear-cut ginseng particles, ginseng injections, steady heart particles, Kangai injections and puddy blue anti-inflammatory oral solution, magpie injections, injection blood plugs (freeze-dried), injections with dansin polyphenols, sputum hydrochloride injections, sodium sepsis, glutamate and Sichuan pyridosis injections, etc.
can be said that as long as the purchase of large amounts of high-value products, whether chemical drugs, or biological drugs, Chinese medicine, are within the scope of national procurement.
the "13th Five-Year" and "14th Five-Year" intersection, the collection of chinese medicine close to the development prospects of the Chinese medicine industry to what impact? What other policies affect the future of Chinese medicine? 01, "13th Five-Year Plan" summary of the status quo in recent years, with the tightening of health insurance fee control policy, the Chinese medicine industry is facing policy and public opinion pressure.
1. New regulations for the clinical use of Chinese medicine.
2017 edition of the National List of Essential Medical Insurance, Industrial Injury Insurance and Maternity Insurance Drugs, many Chinese medicine adaptation disorders are restricted.
After 2019, restrictions on the clinical application of Chinese medicine have increased, in addition to limiting adaptive disorders, but also further clarified the restrictions on the hospital level, physician level, that is, some Chinese medicine limited to the second and above medical institutions, some restrictions can only be used by the deputy director of physicians and above physicians.
many policy measures, the number of Chinese medicines in medical institutions gradually decreased.
2. Standardize the prescription rights of Chinese medicine practitioners.
2019, the National Health and Safety Commission issued the first batch of national key monitoring of rational drug use drug catalogue (chemical and biological products) notice, listing 20 super-large varieties. The
notice also calls for "strengthening the prescription management of drugs outside the catalogue", and for Chinese medicine, Chinese medicine practitioners should issue prescriptions for Chinese medicine in accordance with the Guidelines for the Clinical Application of Traditional Chinese Medicine, the Regulations on the Management of Chinese Medicine Tablets in Hospitals, etc., and in accordance with the principle of dialectical treatment of Chinese medicine clinically.
Other categories of physicians, after not less than 1 year of systematic study of Chinese medicine expertise and assessment of qualified, in accordance with the basic principle of dialectical treatment of Chinese medicine, can issue prescriptions for traditional Chinese medicine, thus bringing about some impact on the prescription rights of Western medicine.
3. Chinese medicine may be included in the collection.
has carried out three batches since december 2018, when the country announced the results of the first volume purchases.
prominent feature of drug collection in the united States is the reduction of prices.
can be seen, if Chinese medicine into the collection will certainly be significantly reduced prices, and the results of the collection, may lead to a shock in the Chinese medicine market, to the Chinese medicine market brings a lot of uncertainty.
4. Health insurance flight inspection frequency increased.
addition to the medical insurance catalogue, control fees, prescription rights restrictions, collection, medical insurance flight inspection has also brought a certain impact on the application of Chinese medicine in hospitals.
in some places, medical institutions using Chinese medicine is often identified by the inspection team as "over-range drug use."
For example, a chinese medicine, the drug instructions on the treatment of diseases and medical insurance directory provisions are inconsistent, doctors in accordance with the instructions used and medical insurance examination in accordance with the medical insurance drug catalog set out in the "treatment scope", all beyond the scope of treatment prescribed in the medical insurance drug catalog, it is easy to be identified as medical personnel of medical institutions over-range medication.
reform of the medical insurance payment system has been further advanced, and the uncertainty of the Chinese medicine market has increased.
with the deepening of the reform of the medical insurance payment system, there are some unknowns about the future of the Chinese medicine market.
health-care reforms have been in full swing in recent years, there are not many places where they have actually been implemented.
health care payment systems such as DRG and DIP are still being piloted, limited to some cities, so strategic purchases of health insurance are only a long-term goal.
can be expected that when the new health-care payment system hits the market, Chinese medicines that have no evidence of their efficacy may be withdrawn from the market.
02, "14th Five-Year" prospects according to the above analysis, it is not difficult to see the development direction of Chinese medicine "14th Five-Year".
and as things stand, there will be no major change in the direction of these policies.
is that the adjustment of the medical insurance drug catalogue remains normal.
the adjustment of the list of medical insurance drugs has the interim measures for the administration of basic medical insurance drugs.
document stipulates that the main tonic drugs; alcohol preparations, tea preparations; medicines containing national precious and endangered wildlife herbs; health care drugs and other 10 categories of drugs are not included in the medical insurance list, which contains some Chinese medicine.
considering clinical value, adverse reactions, drug economy and other factors, drugs assessed as risks greater than benefits will be directly transferred out of the health insurance directory.
In the same therapeutic field, the price or cost is obviously high and there is no reasonable reason for the drug, the clinical value is not accurate, can be better replaced by the drug, other drugs that do not meet the conditions of safety, effectiveness, economy and other three categories of drugs, although it is now in the list of medical insurance drugs, but as long as one of the above-mentioned conditions, after expert review and the corresponding procedures, can be transferred out of the list of medical insurance drugs.
, the prospect of Chinese medicine in the list of health insurance drugs is also unpredictable.
is that the reform of the health insurance payment system will continue to deepen.
strategic purchase is the established direction, which was made clear in the State Council's opinion on deepening the reform of the health care system in March this year.
the reform of the medical insurance payment system, in fact, the Guidance on Further Deepening the Reform of basic medical insurance payment methods issued by the General Office of the State Council in 2017 has determined that the multi-composite medical insurance payment method, which is based on the payment by disease, should be fully implemented.
According to the plan, in December 2018, the National Health Insurance Administration launched a pilot city declaration by diagnosis-related groupings (Diagnosis Related Groups, DRG), and in May 2019 identified 30 co-ordination areas, in accordance with the "top-level design, simulation testing, actual payment" three-step approach to carry out DRG pilot.
specific requirement is to run the simulation in 2020 and start paying in 2021.
third is the collection of drugs and consumables continue to advance.
the implementation of the national drug centralized belt procurement on pharmaceutical enterprises unprecedented impact, traditional Chinese medicine will inevitably be affected.
Not long ago, the Cpc Central Committee adopted the Fifth Plenary Session of the 19th Central Committee of the Communist Party of China on the formulation of the 14th Five-Year Plan for National Economic and Social Development and the 2035 Vision, which explicitly called for the continued promotion of the reform of the centralized procurement and use of medicines and consumables organized by the State.
is the normalization of flight inspection to combat fraud.
Recently Anhui Tai and by the media exposed a number of hospitals collective fraud insurance incident of a bad nature, and is in the country's high-pressure concentrated action against fraud insurance nearly two years, more deeply the relevant departments of the fraud against the importance of the fight, which indicates that the flight inspection to combat fraud insurance will be normal.
The Executive Meeting of the State Council recently adopted the Regulations on the Supervision and Administration of the Use of Medical Security Fund (Draft), which is the first regulation in the field of medical security in China, marking the re-strengthening of the supervision of medical insurance funds and further the legalization of the track.
03, recommendations based on the above analysis, "14th Five-Year Plan" period of Chinese medicine enterprises and medical institutions how to regulate and healthy development? First, we look forward to the better implementation of the Chinese Medicine Law.
For example, to carry out the evaluation, evaluation and appraisal activities related to Chinese medicine as prescribed by laws and administrative regulations, to set up a special organization for the evaluation, evaluation and appraisal of Chinese medicine, and to invite experts in the field of Chinese medicine to participate, but it is not appropriate to adopt the same method as Western medicine.
is to improve the level of medical insurance supervision, in the reform of the medical insurance payment system to be able to achieve the same treatment of Chinese and Western medicine.
third is that Chinese medicine to come up with more hard strength, hard evidence that the efficacy is reliable.
At the same time, it is hoped that clinicians will strictly abide by the Guidelines for the Clinical Application of Traditional Chinese Medicine formulated by the State Administration of Traditional Chinese Medicine and issue prescriptions for Traditional Chinese medicine in accordance with the basic principles of dialectical treatment of Traditional Chinese medicine, so as to effectively reduce the clinical adverse reactions of traditional Chinese medicine caused by indiscriminate use.
fourth is to actively implement the transformation and upgrading of enterprises, including cooperation with Chinese medicine medical institutions to launch the production of Traditional Chinese medicine preparations.
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