Medical insurance payment standard or pharmaceutical manufacturers will face more pressure of price reduction by the end of this month

Source: China Securities News reported on December 6, 2016 that the long-standing medical insurance payment standard concerned by the industry is expected to be issued by the end of December Recently, the Ministry of human resources and social security, together with the health and Family Planning Commission, once again solicited opinions from the provincial departments on the revised guidance on the rules for the formulation of drug payment standards for basic medical insurance (Draft for comments) It is expected that the formal draft of medical insurance payment standards will be issued with the new version of the medical insurance drug catalog by the end of December this year Medical insurance payment standard is different from the previous proportional reimbursement method The biggest highlight is the price difference between medical insurance payment standard and hospital sales price, which allows hospitals to retain In this way, the hospital has sufficient power to suppress drug prices This policy will have a huge impact on the price of most drugs "Medical insurance payment standards will be published together with the medical insurance catalogue." Yu Mingde, President of China Pharmaceutical Enterprise Management Association, told reporters, "the Ministry of human resources and social security and other national ministries and commissions formulate rules, provincial governments formulate specific policies, and coordinate regions to formulate payment methods." According to Dr Gu Xuefei, the Research Center for health development of the national health and Family Planning Commission, the payment standard for Medicare drugs is also known as the "benchmark price", which some countries call "reference price" The payment standard of medical insurance is based on the equivalence of drugs in the treatment effect and the clinical substitutability, grouping the drugs with substitutability, and determining the medical insurance compensation level of each group of drugs according to a certain benchmark price "Strictly speaking, the medical insurance payment standard is not a pricing system, but a compensation mechanism It is a policy to control the drug cost by limiting the level of medical insurance compensation It can reduce the drug price involved in the reference pricing system by reducing the demand for high priced drugs (from the demander) and stimulating the drug producers to reduce the price of drugs (from the supplier) ”Gu Xuefei said It should be noted that there is a significant difference between "medical insurance payment standard" and "medical insurance payment price" Yu Mingde told China Securities News that the mistake of "medical insurance payment price" is that medical insurance payment directly determines the final price of drugs, which is not in line with the situation; in fact, the "medical insurance payment standard" has no direct relationship with the formation of the actual sales price of drugs "The mechanism of payment standard will guide medical institutions to actively reduce the price, and eventually medical institutions and drug suppliers will form drug prices that reflect the real demand of the market." Yu Mingde pointed out Duan Zhengming, director of the medical service management department of the social security center of the Ministry of human resources and social security, told China Securities News that if the payment standard of medical insurance is higher than the actual price of the hospital, the difference can be distributed to the hospital under the condition of financial coordination It can be seen that the biggest difference between medical insurance payment standard and past medical insurance payment regulations is that medical insurance payment standard makes medical institutions more motivated to actively lower the price of drugs, which can gradually relieve the payment pressure of medical insurance funds As the implementation of medical insurance payment standard makes medical institutions become the main body to reduce the price of drugs, pharmaceutical manufacturers will face more obvious pressure of price reduction than before Industry insiders told China Securities News that for innovative drugs with better curative effect or hard to replace, the pressure on price reduction will not be too great, while high-priced drugs with more substitutes will face great pressure on price reduction, such as imported original drugs that complete the conformity evaluation of generic drugs, Chinese patent drugs with more manufacturers, and even some Chinese herbal medicines with more competitive substitutes Varieties will face greater pressure of price reduction.