Limit self-harvesting, personal account purchaser insurance medical insurance drug accelerated reconstruction

September 1, a number of new health care policies will have a deep impact on the future pattern and direction of the pharmaceutical industry.this date, the Interim Measures for the Administration of Drug Use in Basic Medical Insurance have been put into effect, and eight categories of drugs will no longer be included in the List of Essential Medical Insurance Drugs in the future. That is to say, drugs that mainly play a tonic role; medicines containing national precious and endangered wildlife herbs; health care drugs; drugs that mainly enhance sexual function, treat hair loss, weight loss, beauty, quit smoking, alcohol withdrawal and other drugs that are very common in these hospitals and pharmacies exit the medical insurance reimbursement system.also on this day, Zhejiang Province has taken a new step: "Zhejiang Province to enhance the centralized procurement platform function to promote the health insurance drug payment standards full coverage reform program" began to land. Of particular concern is that, after clarifying the mechanism for drug access and withdrawal, the document innovatively proposes to "explore the self-procurement system of public medical institutions" throughout Zhejiang Province. A reporter from the Medical Economics Journal noted that the new initiative, while small in size, conveys a lot of information.Allow 1% self-harvesting behind the windZhejiang this document shows that for clinical needs and the platform does not have online trading products or can not be purchased according to the established price within the platform, allowing public medical institutions in the previous year's drug settlement amount of 1% limit, with enterprises in accordance with the principle of fairness to determine the procurement price, through the provincial drug procurement platform to purchase their own.industry was surprised not by the simple figure of 1 per cent, but by the "taste" of some drugs liberalization in terms of market access and prices at the health-care level. The explanation given by The Zhejiang Provincial Health Insurance Bureau is very clear: the new adjustment of medical insurance should serve five purposes, namely, to improve the access mechanism of the drug recruitment platform. The medical insurance catalogue drugs, state-based drugs, 1 new drugs and other drugs to check for deficiencies, all included in the scope of online trading platform; To encourage competition among drugs of different varieties to form more favorable prices and to implement uniform standards for payment of medical insurance. The standards of medical insurance drugs sold by fixed-point medical institutions and fixed-point retail pharmacies in the province are consistent, and private medical institutions and retail pharmacies are encouraged to purchase drugs voluntarily on the provincial drug recruitment platform; The same standard of payment for medical insurance is implemented in public and private medical institutions of the same rank.In order to try first, Zhejiang Province also has pre-conditions: officials said that the provincial drug procurement center will regularly announce the situation of self-purchased products, focusing on monitoring the high unit price, large purchase amount and medical institutions to purchase more products. Note that from this perspective, tender procurement is no longer the only threshold for market access, but self-procurement is not covered by health insurance payments. If contact with Zhejiang is the first province in the country to start the implementation of DRG payment reform, then, there is reason to believe that when a disease reimbursement quota is determined, drugs, supplies, etc. will become hospital operating costs, in order to improve the level of profitability, hospitals will take the initiative to reduce the cost of drugs, supplies and so on, this is the hospital's concern, as to whether self-harvesting or collection, are based on this purpose.industry believes, "This requires enterprises to pay close attention to, research local health insurance policies to do a good job of variety layout, the future will be more and more testing the ability of enterprises to find opportunities, which is as important as product power." " will it take to buy commercial insurance from a personal account?"addition to Zhejiang, Shenzhen Health Insurance Bureau also has innovative action. According to the relevant person in charge of the bureau, Shenzhen Medical Insurance Bureau will launch a personal account to purchase commercial exclusive medical insurance policy, to further improve the level of serious illness and multi-medical needs protection. At the same time, expand the use of personal accounts, allowing families to help each other use, pay for their own and family members of the vaccine medical examination costs.health care treatment in Shenzhen is the highest in the country. It accelerates the establishment of a multi-level long-term nursing insurance system with health-oriented government-led and market-oriented operation, which brings a new way of thinking. It is reported that at present, 240 communities in Shenzhen can run health insurance business. In 2019, the number of permanent residents was 13.4388 million, and in July this year, there were 1.5697 million insured people, which means that the number of people insured is greater than that of the resident population.recently, many people are concerned about where the money from the workers' health insurance fund will go. On August 26th the State Administration of Health Insurance issued the Guidance on establishing and improving the mechanism for the protection of basic medical insurance outpatient co-payments for workers (draft for comments), in which the accounts of medical insurance individuals with much attention have been accounted for significantly. Analysts believe that "retail pharmacies, especially those with a focus on health insurance, urgently need to be re-planned." For hospitals, it can greatly promote graded diagnosis and treatment, keep minor and common diseases in outpatient clinics, reduce hospitalization rate, and reduce the waste of medical insurance funds. Datashow that the hospitalization rate in our country was less than 9% in 2008 and will increase to 19% by 2019. In 2019, 472.4 billion yuan will be spent on individual accounts for employee health insurance. It can be predicted that the reform of personal accounts will lead to the use of drugs for serious and chronic diseases, rather than the eggs, health care products and so on in the past.if it were to extend a little further, the money freed up for health care could go to the grass-roots level. The Wuhan Municipal Health Insurance Bureau recently made a move to answer this view. In Wuhan City, the latest batch of medical institutions were added to the list of fixed-point units of medical insurance, 249 medical institutions for primary services, accounting for 89.2% of the total number of new, it is particularly noteworthy, of which 216 social-run medical institutions, accounting for 77.4% of the new. There is a view that "clinics and out-patient clinics will receive more attention from health insurance, while oral clinics, women's and children's clinics and Chinese medicine clinics will account for a larger proportion." In , health care, as the payer, will bring about a re-structure of the drug market with every little change and innovation.
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Medical Economics Journal)
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