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    Home > Active Ingredient News > Drugs Articles > Drug zero plus this year nationwide coverage! How do you get through three passes?

    Drug zero plus this year nationwide coverage! How do you get through three passes?

    • Last Update: 2017-01-09
    • Source: Internet
    • Author: User
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    Source: Xinhua news agency, outlook, 21st century economic report 2017-01-09 all drug mark ups in public hospitals in 2017 were cancelled! Li Bin, director of the national health and Family Planning Commission, said at the national health and family planning work conference, which closed on June 6, that this year's reform of public hospitals will be rolled out in all cities, all drug mark ups will be cancelled, and smooth transformation of the old and new operating mechanisms will be promoted According to the information from the meeting, at present, more than 1560 public hospitals in cities across the country have cancelled drug mark ups and broken the mechanism of supplementing medicine with drugs The income structure of public hospitals continued to be optimized, and the growth of medical expenses was effectively controlled This year, China will combine efforts to squeeze the space for drug prices, adjust the prices of medical services, reform the payment methods of medical insurance and the implementation of compensation policies by the government Li Bin stressed that in 2017, we should continue to deepen medical reform, promote the construction of hierarchical diagnosis and treatment system, actively promote the construction of medical consortia, medical community and specialized alliance, develop remote medical cooperation network, and improve the coverage of family doctors' contracted services In addition, she pointed out that in the year, the direct settlement of hospital and hospital expenses in different places in line with referral regulations will be realized, and the "two ticket system" for drug procurement in public medical institutions will be promoted We will strengthen the supervision of the whole industry, accelerate the formation of the framework of the basic medical and health system, further take the initiative to optimize and control the distribution of medical resources, deepen the implementation of health poverty alleviation projects, continue to implement actions to improve medical services, and enhance people's sense of health This means that the zero mark up of drugs previously landed in the local area, and the "two vote system" to be announced, since then, the overall speed has been increased, and the countdown sprint has entered the runway With the series of challenges brought by the cancellation of drug mark up, are pharmaceutical companies, hospitals and circulation channels really ready? ▍ challenge 1: how big is the hospital gap? According to the document spirit of the State Council, after the implementation of "zero drug difference rate", the income gap of public hospitals will be "filled" by three parts, that is, to increase the price of medical services, government subsidies and hospital self digestion - these three parts are apportioned according to the proportion of "811": financial subsidies 10%, hospital self digestion 10%, 80% Compensation by raising the price of medical services But Xiangya Hospital of Central South University, known as "central Concord", has recently been revealed that its annual income has been reduced by 200 million yuan after the cancellation of drug markup, and 5000 yuan has to be stopped this year, the 21st century economic report reported Before that, Jiang Pengcheng, vice president of Zhenjiang first people's Hospital, said in an interview that after the zero margin reform of drugs, the hospital lost about 15 million yuan in drug sales every year According to other data, in 2013, the estimated loss of five pilot hospitals in Zhangqiu City, Shandong Province was 76 million, but the financial subsidy was only 40 million; during the two sessions in 2013, Wang Jianfei, vice president of Xianju County People's Hospital in Zhejiang Province, said that the income gap after zero plus of the hospital was 120 million, while the government's 10% compensation was basically not obtained In 2015, Hainan Qionghai people's Hospital's income increased by adjusting the price of medical services only accounted for 39.5% of the cancellation of drug mark up, with a loss of 1.757 million yuan in August September alone; Beijing once carried out cost accounting for the medical projects of eight public hospitals, all of which were in a serious loss state, and nearly half of them were policy losses breaking“ In the business model of "medicine for medical care", the "fuse" of driving benefits of hospitals was dismantled Facing the sudden sharp decrease in income, many hospitals seemed to be caught off guard "Outlook" Newsweek survey found that, compared with general hospitals, traditional Chinese medicine hospitals with high proportion of medicine are difficult to adjust the gap by increasing the service fee of medicine Zengcheng District Hospital of traditional Chinese medicine is a second-class hospital, accounting for nearly 50% of the total "Traditional Chinese medicine hospital has more drugs, less surgery and less hospitalization, so it is difficult to compensate by increasing the price of medical services For us, the more outpatient services, the greater the loss " Liu Weidong, vice president of Zengcheng District Hospital of traditional Chinese medicine, said that since the pilot project, the total medical income of the hospital has been declining year by year, with an annual reduction of about 10 million yuan, plus more than 2.6 million yuan of government subsidies, and an annual loss of more than 7 million yuan "The lower price of medical service does not match the operation mechanism of self financing of the hospital The hospital can only make up for the lack of medical service income by issuing more checklists This kind of situation does exist The fundamental problem of profit seeking in public hospitals cannot be solved only by canceling the drug mark up " Hu Bingjie, deputy director of Guangzhou health and Family Planning Commission, said ▍ Challenge 2: pharmaceutical companies become "matchmakers"? In this context, the hospital in a strong position to drug companies to default fees and ask for rebate or even donation has become unspeakable pain for drug companies According to public reports, since the beginning of 2016, only 20 public hospitals, such as Hunan Xiangya Hospital, Hunan people's Hospital, and Hunan children's Hospital, have defaulted more than 10 billion yuan in drug payments to more than 40 drug dealers in Changsha In order to maintain the normal supply of drugs, even some druggists have to borrow money from private institutions at high interest rates, and the loss of this piece alone is up to 200000 yuan per month On December 20, Jiangsu Provincial Price Bureau held a press conference to announce the relevant situation of the province's cost reduction and burden reduction and the inspection of enterprise related charges Among them, Nanjing health and Family Planning Commission collects "fund occupation compensation and scale preferential income" from drug enterprises in the name of donation without approval in the process of drug centralized bidding and purchase According to subsequent reports, the "donation" fee is basically charged at 1% - 5% of the purchase amount, and the amount is relatively large For the purpose of the money, Nanjing health and Family Planning Commission said that it is "used for medical cause" ▍ challenge 3: can't the pharmacy be entrusted? There has been analysis before that after the cancellation of drug mark up in public hospitals, the hospital pharmacy is no longer a profit-making department In addition, the "two ticket system" that will be fully implemented in the near future will lead to the public hospital or the pharmacy trusteeship, which also brings the opportunity of Pharmacy Trusteeship to circulation enterprises There are already pharmaceutical companies in China, including Kangmei pharmaceutical, Sinopharm holding, China Resources pharmaceutical and Sanjiu group, which have undertaken the custody of pharmacies However, Liao Xinbo, the inspector of Guangdong health and Family Planning Commission at that time, said publicly that the trusteeship of pharmacies was sheep love wolf, which did not squeeze the unreasonable price water in the circulation field, but made the interest chain longer and water more In addition, the hospital trusteeship pharmacy needs to collect the trusteeship fee In order to pay for the trusteeship fee, the trusteeship side will further reduce the purchase price of drugs When the price is lower than the product cost, the clinically urgently needed drugs may also be out of stock According to the public data, China Hospital Association has been entrusted by the Department of system reform of the national health and Family Planning Commission to carry out a special study on the advantages and disadvantages and potential risks of pharmacy trusteeship, and published a paper entitled "analysis of the current situation of pharmacy trusteeship in China" in May 2015 in China Hospital magazine The paper, jointly signed by the China Hospital Association and the national health and Family Planning Commission, said: "can pharmacy trusteeship have the function of preventing commercial bribery like some people think?"? 54.13% of the participants believed that this did not help to prevent commercial bribery Up to 97.02% of the participants believed that there was a potential risk in pharmacy custody In the suggestion column of the questionnaire, many people directly expressed their opposition to the custody of the pharmacy "
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