How to understand the health insurance negotiation correctly?

On November 13, 2019, the national health insurance negotiation will be finished, which means that the 2019 version of the national health insurance catalog will be finally completed It is an important node in the period of building a comprehensive medical insurance system with Chinese characteristics and promoting the high-quality development of China's health insurance Because of the importance of the new medical insurance catalogue, medical insurance and medical insurance negotiation have become the hottest topic in the medical industry this week or even for quite a long time, because it is not only the establishment of a new medical insurance system with Chinese characteristics leading, but also the treatment choice of tens of millions of patients Access process of national health insurance negotiation in 2019: This on-site negotiation belongs to the fourth stage of medical insurance negotiation access process: The medical insurance party and the enterprise party carry out on-site negotiation, leave the site to determine the negotiation results, and conduct the negotiation in several groups The negotiation group randomly selects the negotiation varieties In principle, the competitive products are negotiated in one group, each of which has 30 minutes and two quotation opportunities 1 Negotiation duration From November 11 to November 13, 2019, this is a huge test for both the medical insurance bureau and the negotiation expert group, which needs to be completed in a strict and orderly manner for up to three days 2 The negotiation involves a large range of experts Because there are many kinds of medical insurance negotiations and they are in the implementation node of the new medical insurance system, the level and scope of medical insurance experts are increased In addition to clinical, pharmaceutical and pharmacoeconomics experts, there are also measurement experts and local health care negotiators to promote the scientific demonstration of health care 3 Relatively strict process From the perspective of organizational process, combined with previous organizational experience, the medical insurance bureau is also relatively strict and confidential in the organizational process of this negotiation; Zhu multimedia didn't even know that the medical insurance negotiation had started on the same day of the medical insurance negotiation This negotiation not only affects the heartstrings of practitioners in the medical industry, but also attracts the attention of hundreds of millions of Chinese people In the era of information explosion, we encounter a lot of information, and also have some questions Let's interpret it from a relatively objective perspective: 1 5% reduction for some and 50% reduction for others, with different price reduction scales In this negotiation, there are varieties classification, continuation and new contract varieties First of all, the varieties to be discussed are the ones that have been reduced in the last round of medical insurance negotiation In this negotiation, if you want to enter the new medical insurance catalog, you need to further determine the intended payment price Because these products have experienced a large price drop, the price reduction ratio is relatively low Secondly, the newly signed varieties are of high clinical value and price This time, the price drop will be relatively large Meanwhile, we should also refer to the prices of surrounding countries and the lowest prices in the world As a potential pharmaceutical market, we hope China will get the lowest price treatment 2 A certain enterprise negotiates varieties and several manufacturers On August 20, 2019, the state health insurance bureau said at a briefing that some of the varieties to be included in the negotiation are exclusive patent varieties with high clinical value but high price or great fund impact It is emphasized that one of the entry barriers for negotiation is exclusive or patent varieties, which means that all negotiation varieties should be exclusive varieties There are several manufacturers of a certain variety in the media report, which is worth considering for readers Even if the health insurance bureau includes non exclusive varieties, there are great challenges in implementation and bidding access We will wait for the official results of the health insurance bureau to be published 3 Increase varieties to 150 There are media reports that the current variety has increased to 150 According to the latest official release, the number of negotiations is 128, with a difference of 22 According to the release of pharmaceutical economic news, in 2017-2018, according to the common name, a total of 128 new drugs will be listed, 10 of which have been approved for negotiation of special anticancer drugs in 2018, 18 of which have added the regular catalogue in 2019, 70 of which will enter this round of negotiation, and 30 of which will not be approved During this period, the official health insurance bureau has not updated the number of negotiated varieties, which may not be true information, or the expert group may temporarily increase the access negotiation of innovative drugs So the question is, what are the admission criteria and selection principles for new varieties? 4 The decrease rate of traditional Chinese medicine injection in a company in Tianjin is about 28% Similarly, the media reported the specific price reduction range and amount of the enterprise According to the process of signing the confidentiality agreement by the medical insurance bureau, only after the official information is released by the medical insurance bureau, the enterprise can release it to the public If it is released in advance, the medical insurance access qualification will be cancelled How this information comes from is worth pondering It is the most important strategy for pharmaceutical companies to get into the medical insurance reimbursement catalog by breaking through the dark clouds Selecting good varieties with clinical value is the way for enterprises to enter into the catalog, while promoting the clinical urgent varieties to enter the reimbursement catalog requires multi factor integration 1 Increase the value of access team With the increasing importance of access strategy, enterprises need to strengthen the layout of access strategy from the perspective of structure Especially for patent drug enterprises, several patent drugs are about to be listed, so the research rules, strategies and methods are very important For example, in a multinational pharmaceutical enterprise, the vice president of access strategy has access strategy department, access customer department, central access department, local access department and price team The system structure will support the long-term success of the enterprise access strategy.