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    Home > Medical News > Medical World News > Medical insurance payment settlement price limit forced to withdraw the original research drug? Fujian Health Insurance Office: You can talk about it again

    Medical insurance payment settlement price limit forced to withdraw the original research drug? Fujian Health Insurance Office: You can talk about it again

    • Last Update: 2020-05-12
    • Source: Internet
    • Author: User
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    these two days, the medical circle on the Fujianmedicineprocurement of new policies or will force the original research drug talk. On March 6, Fujian ProvinceMedical InsuranceOffice issued a letter through the provincial drug joint price limit sunshine procurement network, the country's firstmedical insuranceto pay settlement price based on thedrugjoint price limit procurement landing. At the heart of the attempt ishealth insurancedetermine directly how muchtohospitals are paid based on the affordability of the fund, the distinction between the treatment or auxiliary or nutritional effects ofdrugs, and the price ofdrug. The settlement price is seen as a unilateral decision by thehealth insurance, which is widely seen in the industry asmedicarethe settlement price of drugs- especially the settlement price of the original drug is low. A pharmaceutical industry consultant analysis, down the original research drughealth insurancesettlement price, directly leading to patients because of excessive out-of-pocket ratio to abandon the original research drug, the market share of the original research drug in Fujian will shrink sharply until exiting the market. On the 10th, a person in charge of the Fujian's Medical InsuranceOffice responded to questions in response to questions about the 21st century economic report, saying that the low settlement price of themedical insuranceof the original drug does not mean that it will inevitably exit the market. The above-mentioned person-in-charge said that thedrugdemand is based on the patient's individual ability to pay, for the original drug, although theof health insurancereimbursement ratio greatly reduced, but there is demand and the ability to pay patients can still use. The person in charge also said thatpharmaceutical joint price limit procurement is ultimately a market negotiation procurement mechanism If the original pharmaceutical manufacturers are willing to fight for the market, you can negotiate with the medical insurance , if it can lower the price, the health insurance can also raise the settlement price accordingly. Encourage hospitals
    to negotiate a joint price reduction Fujian Medical Insurance Office to provide 21st century economic report ingress, one of the characteristics of this reform attempt is to medical insurance payment settlement price and drug procurement closely linked, so that the past separate bidding, procurement, use, settlement links into one. the bridge between the settlement of payment health insurance and the purchase of medicines is the of hospitals According to Fujian regulations, it is the negotiations between the of hospitals and the manufacturers of medicines that really determine the purchase price of
    medicines The new rules give hospitals sufficient incentive to negotiate price cuts. For hospitals, drugs that are reimbursed 100 percent by Medicare , because health insurance pay the settlement price, their income is determined According to Fujian's new rules, the medical insurance 100% reimbursement of medicines
    a total of 13,010 products, accounting for 80%. The 20 percent of drugs that are not fully reimbursed health insurance are , and the income of the hospital is determined because of the 's health insurance the maximum price of sales. Under such circumstances, Fujian stipulates that hospitals can negotiate with pharmaceutical production enterprises to determine the purchase price of drugs , the difference is self-determined This practice is not new, drug joint band price limit procurement is based on the "difference." The focus of Fujian's new rules is to adjust the reimbursement ratio of 20% of drug that are not fully reimbursed. The above-mentioned health insurance office head told reporters that the remaining 20% of the drug originally did not enter the scope of reimbursement, which means that the burden of patients has not changed. The main impact occurred in the health insurance can not be fully reimbursed 10% of the drug Under Fujian's new rules, the reimbursement rates for these drug range from 0 to 90% Fujian's new rules on some drugs to increase the out-of-pocket ratio, to guide patients to make drug choices. This mechanism is summarized by the Fujian Medical Insurance Office as "to the of medical insurance payment settlement price leverage, to promote the 'drug, price, insurance' linkage Controversial: will it force the withdrawal of the original drug? The biggest impact of the New Deal was part of the original drug The above-mentioned pharmaceutical industry consultantcomb found that some of the original research drugs after the original drug, compared with the generic drug, the medical insurance settlement price is only 1.5 times higher, with the past reimbursement ratio has a large gap. Some medical reform experts believe that the national generic drug quality and efficacy consistency evaluation work before the end, such pricing is not fair to the original drug. The above-mentioned pharmaceutical industry consultant analysis, reduce the proportion of original drug reimbursement will inevitably lead to the original research drug market shrink If the pharmaceutical companies want to continue to occupy the market, they must give in on price But price concessions in Fujian will affect its national price system, which will eventually lead to its withdrawal from the Fujian market. "Some drugs are much more expensive in China than in foreign countries, but our per capita income is not as high as those of these countries, " said the head of the Fujian health reform office, adding that some of the original drugs were overpriced at home and needed to be forced to lower prices. In addition, the person in charge also said that he had not received a protest from the original pharmaceutical companies, nor had he heard of any enterprises that offered to withdraw from Fujian. The above-mentioned medical reform experts criticized the health insurance to determine the drug settlement price is administrative one-size-fits-all, contrary to the market law There is also concern that forcing patients to use low-cost generics that are not yet recognized by consistency of the national generics will pose a safety risk until the national evaluation of the quality and efficacy of generics is completed. In response to this, the above-mentioned person-in-charge to the 21st century economic report said that the settlement price of medical insurance drug is based on the of medical insurance the maximum price for the sale of drugs , comprehensive the ability of medical insurance funds to pay, the use of drugs And medical insurance the maximum price of drug sales is a comprehensive drug port price, minimum purchase price, factory agreement price, and most importantly, the manufacturer's own quotation was finally determined. "It's not just an administrative one-size-fits-all, it's the market behavior of the of health care as a buyer." "
    the head of the health insurance office told reporters. For generics consistency evaluation has not been completed on the introduction of policy, the above-mentioned person explained that the national consistency evaluation only for chemical drugs generic oral solid preparations, and this work started last year by the end of 2018 may be completed. For those varieties that need to carry out clinical effectiveness trials and special circumstances, the consistency evaluation should be completed by the end of 2021; During the two sessions, the reporter also learned that the representative committee on the drug consistency evaluation raised the high cost of clinical trials, difficult to operate and many other issues. "
    drug price adjustment to wait for the consistency evaluation to be completed, it is really too late The above-mentioned person in charge said that for the quality of Chinese generic drugs control, the State Food and Drug Administration every year has strict inspection For medicines entered the procurement catalogue, no quality defects have been found. Source: economic reporting in the 21st century
    Original title: medical insurance payment settlement price limit forced to withdraw the original research drug? Fujian Health Insurance Office: You can talk about it again
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