In 2020, we will work together with our motherland to help China's pharmaceutical industry become a pioneer in reform

President Xi said in his new year's message, "2020 is a year of milestone significance and decisive victory in poverty alleviation." The national medical security work conference pointed out that we should make every effort to promote the medical insurance to get rid of poverty and promote the rural poor to achieve the goal of "guarantee to the best" Poverty alleviation through medicine will continue, and the relationship between medicine and poverty alleviation will definitely further and thoroughly promote the reform of China's medicine pattern In 2020, it is bound to be an extraordinary year for medical people, and China's medical pattern will be accelerated and optimized First of all, in 2020, the new dynamic adjustment of medical insurance will be introduced into the adjustment of medical insurance catalogue for the first time, which involves the most varieties, the widest negotiation scope and the strongest price reduction Secondly, DRG payment will continue to be promoted The DRG payment national pilot technical guidance group of the National Medical Security Bureau launched the DRG group clinical demonstration work in Beijing, and the health care Commission released 224 disease clinical paths (2019 version) This may be a highlight of the work of the health insurance bureau in 2020 Thirdly, the normalization of national centralized purchase requires comprehensively deepening the reform of centralized purchase and use of drugs, establishing a standardized and normalized mode of centralized with volume purchase of drugs, launching the second round of national centralized purchase, marking the ultimatum for non patent drugs Finally, multi pronged, focus on monitoring the implementation of drug catalog for one year, with remarkable results; two disease outpatient, long prescription to solve the basic treatment needs of patients, improve the efficiency of medical diagnosis and treatment; formulation and implementation of basic drug catalog To achieve the basic functions of medical insurance and meet the basic treatment needs of patients, all these will force China's pharmaceutical industry to become the leader of China's reform and give full play to the basic functions of medical insurance Poverty Alleviation Policies It should be guaranteed to show the superiority of the system with Chinese characteristics On January 10, the working conference of the national medical certificate system pointed out that the national medical insurance system should continue to "keep in mind the original intention, keep in mind the mission" theme of educational achievements, adhere to comprehensive coverage, basic protection and sustainability, and organize and strengthen the national medical insurance network 1 Comprehensive coverage and basic protection The basic requirements of the medical insurance system with Chinese characteristics are comprehensive coverage, especially for the poor China's medical insurance coverage exceeds 1.35 billion, making it the largest medical insurance coverage system in the world It is the superiority of China's medical insurance and socialist system to include the poor in the coverage of basic medical insurance, serious illness insurance and medical assistance system, and strive for a sustainable development Sex Innovative assessment of basic treatment needs The characteristics of this round of medical insurance catalog are to quickly include new drugs and innovative drugs within the patent period into the catalog, and to achieve substantial price reduction It is different from foreign countries that the patent varieties with treatment needs of patients are entered into the catalogue through medical insurance negotiation to ensure that the global innovative drugs can meet the treatment needs of Chinese people at a lower price in the first time Daglernet 4.36 yuan, the lowest price in the world is a good example, I believe that in the future, more innovative patent drugs will enter the medical insurance catalog through the lowest price in the world 2 With the change of population age structure, China has stepped into an aging society, and the demand for medical insurance has increased, which puts forward new requirements for the sustainable development of medical insurance expenditure On the one hand, we should be alert to the high welfare operation risks in developed countries, abandon the idea that health insurance is the overall burden of the country, all the burden and all the burden, and ignore the scientific and sustainable nature of the health insurance system The therapeutic drugs, patented and innovative varieties, varieties that can save the national health insurance fund, and varieties that people really need are included in the catalog On the other hand, in the dynamic adjustment of new medical insurance, we should continue to optimize the directory, monitor the irrational drugs in the directory at any time, and play a role in the process of dynamic adjustment For example, if we transfer out the varieties of the key monitoring catalogue, transfer in the medical insurance negotiation, transfer in the varieties that will be willing to reduce prices and be consistent with the national interests, so that the country, patients and enterprises can benefit, we can ensure the sustainable development of the medical insurance fund operation On July 1, 2019, the key monitoring catalogue was released, and the first batch of 20 national key monitoring varieties were released In August, the national medical insurance catalog was linked, and priority was given to adjusting the national medical insurance catalog for key monitored varieties 1 The monitoring results will significantly reflect that according to the public data, the sales volume of 20 major varieties in the national monitoring catalogue is 65.2 billion in 2018, and the maximum sales volume is 6.6 billion in oracetan, which are respectively three major manufacturers, of which 40% is made up of Sinopharm, and the sales volume is 2.6 billion According to the sales database of pharmaceutical intelligence hospital, by the end of the third quarter of 2019, the sales volume of domestic sample hospital of oxiracetam has reached 1.504 billion yuan In 2020, with the transfer out of "442" of medical insurance catalogue in some provinces, the monitoring effect will be further reflected In 2018, the sales volume of Changchun Xiting in the national medical insurance catalog was 4.2 billion With the implementation of the new medical insurance on January 1, 2020, it means that all provinces will not be reimbursed, and the varieties similar to it will fall precipitously The new dynamic adjustment is about to start 2 Dynamic adjustment with the publication of the principle of dynamic adjustment of medical insurance catalogue in 2019, the scientific nature of this round of national catalogue adjustment is reflected in dynamic adjustment With the migration of disease spectrum, the blowout of new drugs and the change of national economic situation, the dynamic adjustment of the catalog is not only reflected in the economic relevance, but also in the needs of people's livelihood for the pharmaceutical industry involving the national economy and people's livelihood It is essential to include the real urgently needed drugs and affordable varieties into the catalog In order to control the total amount of medical insurance fund, we need to adjust and optimize the catalogue scientifically and dynamically On July 1, 2019, the first batch of national key monitoring and rational drug use catalogue was released In the last sentence of the document, "the national health and Health Commission will make dynamic adjustment to the catalogue with the State Administration of traditional Chinese medicine" According to the publication of the catalogue for one year, it is believed that the second batch of key monitoring catalogue will be further released For the second batch of directories, whether to add monitoring varieties to the first batch of directories, or to dynamically transfer in and out of the first batch of directories, it is worthy of attention In general, the goal of regulation and control is to make the structure of drugs more reasonable, not to eliminate them as a whole According to the latest clinical evidence, fund calculation report and clinical needs, the dynamic transfer in and out of the new catalogue should be more scientific The normalization of national centralized purchase and the establishment of the mode of national centralized purchase of non patent drugs with Chinese characteristics will further form the mode of non patent drugs with Chinese characteristics From 4 + 7, to 4 + 7 expansion, to the formation of the second round of national centralized mining, the operation mode of China's generic drugs has been preliminarily outlined The generic drug models in developed countries can be used for reference: 1 Keep reducing costs to ensure competitive advantage The U.S generic drug price implements the "patent cliff" The price of generic drugs drops sharply, and the proportion of used drugs reaches 80% The competitive advantage can be realized by constantly reducing costs 2 In the approval process, FDA regulates the strategic layout of non patent drug approval, accelerates the speed of non patent drug approval, increases the batch of non patent drug approval, and promotes full competition in the field of non patent drugs In 2018, the U.S FDA approved more than 780 generic drugs, and since 2014, the number of such drugs has increased by more than 90% 3 Under the background of promoting the full competition of non patent pharmaceutical companies, it has become a consensus that the price will drop again and again Once the enterprise is unable to make profits, it will give up the variety In general, the U.S enterprises make technological transformation of generic drugs to ensure their commercial value and realize the upgrading revolution of generic drugs In addition to learning from foreign models, Chinese non patent drugs also need to shoulder the mission of China's medical reform The second round of the publication of the catalogue of centralized mining is different from the initial announcement of the national centralized mining policy Some enterprises have started to release celebration posters for entering the centralized mining, proud of entering the centralized mining, breathing with the country, sharing the same fate, and making a modest effort on the road of poverty alleviation in China Chinese enterprises gradually realize that profit is not fundamental It is very important to fulfill the role of corporate social citizen on the basis of commercial operation In the past, the social citizenship role of enterprises was often realized through charitable activities or public donations In the face of national natural disasters, pharmaceutical enterprises are obliged to donate drugs Today, in line with the national strategy, lowering the drug price and ensuring that Chinese patients no longer worry about the burden of drug costs are the optimal embodiment of China's medical system On January 16, the state issued the notice on carrying out the second batch of centralized procurement and use of drugs organized by the state In the last paragraph, it was clearly pointed out that the notice required "all localities and departments to improve their political positions, improve the leadership mechanism, strengthen the implementation of responsibilities, establish a working mechanism, carefully organize the implementation, strengthen the publicity and guidance of reform, and strengthen risk prevention." It is the first time to upgrade the national centralized purchase to the "political position and leadership mechanism", which also reflects the determination and confidence of the state in the centralized purchase of non patent drugs After the completion of the second round of centralized purchase in 2020, there will be the third round and the fourth round The list of generic reference preparations has been released to the 26th batch; the dynamic adjustment of medical insurance will also be launched, and the key monitoring directory has been one year There is still a long way to go Every pharmaceutical person should be aware of the situation Only when the strategy of pharmaceutical enterprises is closely combined with the national strategy, can they gain permanent benefits and keep their basic industries green 37 statement: This article only represents the author and does not represent the position of yaozhi.com You are welcome to communicate and supplement in the message area If you need to reprint, please be sure to indicate the author and source of the article.