Medical insurance affects fate. What should pharmaceutical companies do?

Source: from September to mid August 2015, Jiangsu's medical insurance payment reform plan flowed out, becoming the first province of medical insurance payment reform in the whole province, which attracted the attention of pharmaceutical companies! This year, the long-awaited drug price liberalization finally came into effect The drug price can be determined by the enterprise independently according to the market However, while the drug price liberalization, the shackles of drug price bidding are still in place At the same time, the medical insurance payment price has become the key factor determining the life and death of drug price According to the relevant government documents, the payment rules for medical insurance will be formulated by the end of September On July 22, Premier Li Keqiang presided over the executive meeting of the State Council to determine the full implementation of serious illness insurance for urban and rural residents It was decided at the meeting that by the end of 2015, the serious illness insurance should cover all the urban and rural residents' basic medical insurance participants, with the payment proportion reaching more than 50%, and the proportion will continue to increase in the future This is the latest policy instruction of the State Council to accelerate the promotion of serious illness medical insurance since the announcement of the new policy of serious illness medical insurance in August 2012 It is a new change in the pattern of medical insurance in China, which has a profound impact on the medical and pharmaceutical industry chain On May 18, the general office of the State Council issued the guiding opinions on the pilot comprehensive reform of urban public hospitals, which pointed out that the reform of medical insurance payment mode should be deepened We should give full play to the basic role of basic medical insurance, strengthen the budget of medical insurance fund revenue and expenditure, establish a composite payment mode, which mainly pays by disease, pays by head, pays by service unit and so on, and gradually reduce the payment by project Encourage the implementation of DRGs In 2015, the reform of medical insurance payment mode should cover all public hospitals in the region and gradually cover all medical services According to the proposal of promoting drug price reform, the payment standard of medical insurance should be established to guide the reasonable formation of market price We estimate that nearly 55% of medical expenses are paid by medical insurance, which is the price negotiator with the right to speak In the future, medical insurance payment price is expected to become the core of drug price system Medical insurance payment reform is imperative!! The notice on the designated rules (for Trial Implementation) for triggering the payment standard of basic insurance drugs (discussion draft) jointly researched and formulated by the Ministry of human resources and social security, the health and Family Planning Commission, the development and Reform Commission, the Ministry of industry and information technology, the Ministry of finance, the Ministry of Commerce, CFDA and other seven ministries and commissions pointed out that the payment standard should be formulated in accordance with the common name of drugs In the initial stage, the payment standards can be formulated according to the drugs produced by different enterprises With the reduction of the quality and price differences between the same drugs produced by different enterprises, the payment standards can be developed according to the general products This is no different from greatly increasing the cost of corporate public relations, different enterprises pay different prices, where are the opportunities for enterprises?? What kind of impact will it have on enterprises when the central government makes rules, provinces and cities make policies and administrative regions are responsible for implementation??? How do enterprises view the impact of uncertainty of "second bargaining" on business operation? After drug price liberalization, will the medical insurance department become the leading department of drug price? What is the inextricable relationship between medical insurance payment price, bidding price and drug purchase price? In addition to the second price negotiation and price reduction, have you ever thought that this will become the future trend of medical insurance payment reform? Is it to protect the interests of the people or for other political purposes? The second price negotiation enters the room Is the bidding price meaningful? What is the importance of bidding price? Will the bidding price of this pilot adjustment return to its former glory? Is the drug payment price the purchase price, the bid price or the retail price? Does the quality level still account for a proportion? According to the quality level, how to divide the quality level to encourage the high price generic drugs to the greatest extent? From the perspective of encouraging hospitals, how can the same group of drugs determine the medical insurance payment price to work? How will the direct owner of the balance directly affect the hospital and the whole drug market? Is it for the patients or the hospital to bear the part of the drug sales price exceeding the medical insurance payment price? What is the impact of different choices on enterprises?? What will happen if the medical insurance payment price really becomes the core of the drug price system? If the payment standard is set by each city, there is no doubt about the price trend of this pharmaceutical enterprise? After the further decentralization of medical insurance payment standard, what kind of payment standard will medical insurance give? In order to help enterprises understand the trend of medical insurance payment reform policy and rationally analyze the significant impact of medical insurance payment reform on enterprises, the seminar on medical insurance payment trend analysis and policy interpretation was held in Beijing on September 19 At this meeting, relevant leaders and experts from the Ministry of social security, the health and Family Planning Commission and the research center of medical insurance policy were invited to attend and make keynote speeches to answer questions and clarify doubts for enterprises and grasp the core of policies earlier to straighten out the strategic development of enterprises