New version of medical insurance catalog, who wins in the Jianghu

It's a reminder of the times when we are in the Jianghu Emperor map overbearing talk and laugh, life is too drunk ——From day to night in the movie "the East is invincible in the Jianghu with a smile", the industry is full of anxiety At 5:00 p.m., the medical insurance catalog arrived slowly, which attracted cheers, shouts, frustrations and sighs But in fact, since the 2017 version of the national health insurance catalog, the industry has calmed down a lot The era of expecting to enter a catalog and achieve high growth has been far away However, in the context of cost control, living is winning has become the same idea But is getting into the Medicare catalog a good thing? The author makes a brief analysis from the following aspects You may as well have a taste together In such a medical Jianghu, who can win with pride 1、 "Fine fee control" determines the "gold content" of the medical insurance catalog "You are all tears in your life, and you have to suffer if you don't die The more you suffer, the more you pursue, the more miserable you are If you are tired when you are dying, it's better to sleep in bed." It was once said that the number of products has not increased since entering the medical insurance In fact, without the bed of "medical insurance", it is estimated that there is no qualification to sleep After the release of the new version of the medical insurance catalogue in 2017, under the premise of medical insurance cost control, the provinces began to be meticulous in the total amount of medical insurance costs, let alone at the national level At the beginning of this year, the opinions of the general office of the State Council on strengthening the performance appraisal of three-level public hospitals was officially released This performance appraisal replaced the single drug proportion index with the related indicators of rational drug use, and paid more attention to the rationality of prescription of medical staff and the quality and safety of patients' drug use With the strict constraints of public hospitals on medical insurance, financial budget and performance evaluation, the performance evaluation of public medical institutions is becoming increasingly strict, and the evaluation indicators are more detailed In the context of refined cost control, "broad access + strict control + dynamic adjustment" has become the biggest feature of the medical insurance catalog The diversification and innovation of cost control means further confirm that entering the medical insurance catalog is only a product of ten thousand li After the first step of the Long March, there is still a lot of work to be done before the market is truly launched 2、 "Gun warning" is issued in the medical insurance Catalogue: be careful about "large amount of abused" drugs According to the official statement, 150 varieties of drugs are transferred out in the adjustment of the medical insurance catalogue In addition to the drugs whose number has been revoked by the State Drug Administration, a total of 79 varieties have been transferred out The first batch of national key monitoring and rational use of drugs catalogues were all transferred out after expert argumentation In the regular access part, 148 new varieties were added, including 47 Western medicines and 101 Chinese patent medicines Meanwhile, 128 drugs were included in the list of medical insurance, including 109 Western medicines and 19 Chinese patent medicines All of them are exclusive products with high clinical value but relatively expensive price, while the total number of drugs successfully negotiated in the first three batches is only 56 It's surprising that all the 20 national key monitoring drugs for rational drug use have been transferred out: at the beginning, the word "rational drug use" has replaced the word "auxiliary drug use", which once left many drug companies with stones on the ground Moreover, according to the requirements of the national health and Health Commission, the clinical application requirements of the drugs in the key monitoring catalogue have been relatively strict: not only drug use guidelines or technical regulations should be formulated Fan, clearly stipulate the conditions and principles of clinical application, and carry out prescription review and comment on all drugs included in the catalogue, and take measures such as ranking notification, rectification within a time limit, clearing out the drug supply catalogue of the agency, etc to ensure the rational use of drugs Unexpectedly, the health care Commission's heavy blow came to the medical insurance bureau, but it was used by "borrowing" like "four or two thousand catties" Finally, all the "unloading" was put down, and all the "tea delivery" in the medical insurance catalog was sent off The advantage of cage swapping is that all the saved resource space is put into the products with high clinical value At the same time, a strong warning signal is sent out again by the way of catalog access: "products with low clinical value, obvious abuse and better substitution" must be cautious! Without the products of pharmacoeconomics, we will not go far 3、 How to pass the three-year transition period of medical insurance catalog in different regions? For pharmaceutical enterprises, especially for those who have not entered the medical insurance catalog (the provincial government has not entered the national version, and the original national version has been eliminated), the most critical requirement now is to trade time for space The first task is to carefully sort out the supplement of medical insurance in relevant provinces and fully activate the existing resources According to the analysis of Yilian's recruitment and procurement, after the 2017 version of the medical insurance catalog was published, there are still 17 provinces in China that have issued the provincial supplementary medical insurance catalog (see the table below) Therefore, how to keep the stock of the provincial supplementary catalogs of these 17 provinces within a limited time has become a top priority According to the current trend, after the introduction of the national medical insurance catalogue, local medical security bureaus, as the leading departments of bidding and purchasing, will move according to the trend The author speculates that there will be the following situations in the drug procurement of each province: 1 Hold still The provincial standard will not be carried out in a large scale, but the products of the new medical insurance catalogue will be included through dynamic adjustment Among them, with Fujian as the representative, through the way of sunshine dynamic online hanging, the enterprises voluntarily declare online, on the basis of conforming to the price reduction, incorporate it into Fujian sunshine procurement catalogue and realize the transaction 2 Take a small walk Take the dynamic adjustment of drug prices between provinces or at provincial level as an example, take the lowest prices of three or five provinces in China, reduce the prices of products in the existing purchase catalogue again, and allow the new version of the national medical insurance catalogue to be declared by enterprises As long as the original provincial supplement products meet the linkage requirements, they can still be sold online 3 Be bold The provincial medical insurance bureau takes the lead in organizing a new round of centralized drug procurement, and the procurement catalogue is formulated in strict accordance with the new national medical insurance catalogue For enterprises, they should focus on the provinces that have not been supplemented after 2017 In addition, we should pay attention to the relevant issues of the payment standard of drug medical insurance when we enter the new version of the medical insurance catalog According to the continuity policy, in addition to the national negotiation and the national centralized joint procurement of varieties, the medical insurance payment standard for drugs with approximate rate will still be formulated at the provincial level, especially for class B drugs, the self payment proportion will still be determined by the overall planning area The new feast of medical insurance catalog has been opened, but if you want to be really proud of the medical Jianghu, you have to cultivate your internal skills Because all kinds of catalogues are not omnipotent Only oneself can really control and control one's own destiny The medical insurance directory query database of Yaozhi has been launched to 2019 version of medical insurance directory, welcome to use, visit the website: https://db.yaozh.com/yibao statement: this point of view only represents the author, not the position of yaozhi.com, welcome to exchange and supplement in the message area; if you need to reprint, please be sure to indicate the author and source of the article.