[one week king] healthy China travel, put forward four areas of concern; 4 + 7 national spread, innovative medicine is the future of enterprises; Zhejiang province implements DGRs points method

The four major diseases of Health China action are concerned by the State Administration, but they are reflected in "prevention" Recently, the general office of the State Council issued the "opinions of the State Council on the implementation of Health China action" (hereinafter referred to as the "opinions") and announced the establishment of the health China action Promotion Committee to promote the implementation of the health China strategy With the acceleration of industrialization, urbanization and population aging, the production and life style and disease spectrum of Chinese residents are constantly changing Cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes and other chronic non infectious diseases accounted for 88% of the total deaths, resulting in disease burden accounting for more than 70% of the total burden of the disease And with the prevalence of unreasonable diet and unhealthy lifestyle, the problem of disease is increasingly prominent The situation of prevention and control of major infectious diseases, such as hepatitis, tuberculosis and AIDS, is still serious Problems in mental health, occupational health and endemic diseases cannot be ignored In order to insist on prevention first, the outline of "healthy China 2030" plan is implemented in detail, which involves four kinds of chronic diseases including cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes and infectious diseases 1 Carry out prevention and treatment of cardiovascular and cerebrovascular diseases To guide and master the knowledge and skills of self rescue and mutual rescue; to guide the life style of high-risk groups and patients; to implement the first diagnosis blood pressure system; to strengthen the standardized management of "three highs" has become the primary prevention goal; at the same time, to improve the emergency response ability of pre hospital first aid, intravenous thrombolysis, arterial thrombectomy, etc 2 Implement cancer prevention and control actions We should advocate actively preventing cancer, promote early screening, early diagnosis and early treatment, reduce the incidence rate and mortality of cancer, and improve the quality of life of patients We will expand cancer screening in an orderly manner Promote the application of common cancer diagnosis and treatment norms We will improve cancer diagnosis and treatment capacity in the central and western regions and at the grassroots level We will strengthen research in cancer prevention and treatment Accelerate the clinical urgent need for drug review and approval 3 Carry out the prevention and treatment of chronic respiratory diseases To guide the key population to find diseases in the early stage, control risk factors and prevent the occurrence and development of diseases To explore the first diagnosis and measurement of pulmonary function in high-risk population, to strengthen the health management of patients with COPD, and to improve the ability of pulmonary function examination in basic medical and health institutions 4 Carry out diabetes prevention and treatment actions We should pay attention to the blood glucose level, guide the diabetic population to reduce the risk of disease, strengthen health management, delay or prevent the occurrence and development of diabetes, and promote the standardization of screening and diagnosis and treatment of diabetes and complications at the grass-roots level 5 Carry out prevention and control actions for infectious and endemic diseases Improve self-awareness of prevention, pay attention to personal hygiene and disease prevention Fully understand the important role of vaccines in disease prevention We should encourage high-risk groups to be vaccinated against influenza We will strengthen the prevention and control of major infectious diseases such as AIDS, viral hepatitis and tuberculosis, and strive to control and reduce the prevalence of infectious diseases We will strengthen the prevention and control of parasitic diseases, drinking coal-fired fluorosis, Kashin Beck disease, fluorosis and other endemic diseases, and control and eliminate key endemic diseases Nowadays, whether the implementation of prevention means the decline of the total number of patients, the number of people being treated, and the demand for treatment drugs Although the state does focus on these four kinds of diseases, the core force is in the prevention work 4 + 7 centralized procurement nationwide? Recently, a small-scale 4 + 7 drug centralized procurement symposium organized by the medical insurance bureau was circulated in the industry It is planned to fine tune the bidding and procurement mechanism, push the first batch of centralized procurement from 4 + 7 cities to the whole country, and carry out the second batch of centralized procurement under the new mechanism next year The key contents are widely concerned: 1 All enterprises take the 4 + 7 bid price as the ceiling quotation, and many enterprises win the bid and share the market equally; the enterprises with the lowest quotation are directly selected, and the other enterprises decide whether to accept the lowest quotation in turn until the number of selected enterprises reaches three; and according to the quotation level, enterprises alternately choose provinces (1,2,3,1,2,3...) , the total quantity of the selected province reports is the quantity agreed by the enterprise; 2 Scope of drugs: 25 common names selected in the first batch; 3 Regions: all provinces and regions except 4 + 7 cities and Fujian and Hebei provinces; 4 Scope of enterprises: all original research and generic drug manufacturers that passed the consistency evaluation before the bid opening; 5 Agreed amount: the reported amount of public hospitals, designated private hospitals and military hospitals in all regions shall be taken as the agreed amount in a certain proportion The exclusive bid winner will enjoy 50% of the national market, 60% for two and 70% for three; 6 Cycle: 1 year for 2 bid winners and 2-3 years for 3 (or more than 3) bid winners; 7 Schedule: documents will be issued before October this year, bidding will be conducted at the end of the year, and implementation will start next year In fact, it's also expected that the centralized purchase will be carried out in an all-round way Nowadays, the medical industry has changed greatly, and the shuffling activities continue In fact, powerful pharmaceutical companies have seen through There is no future for generic drugs Even if the profits of generic drugs are good now, since the country has started the first step, it will never stop The past era of generic drugs has come to an end With the increasingly fierce competition, no matter how low the cost is, many enterprises cannot compete Even some enterprises have shifted from the generic market to the layout of the innovative drug market The production of generic drugs meets the needs of the society, and the innovative drugs are the main keynote of future market competition; such boldness is the key to success Industry is the first province in China! Anhui Province high value consumables volume purchasing document officially released Recently, Anhui medicine centralized purchase network published the implementation plan of negotiation and negotiation (pilot) for high value medical consumables centralized purchase in public medical institutions affiliated to Anhui Province, which became the first place to implement the pilot work of centralized purchase of medical consumables As a pilot work in the early stage, the selection scope of high value consumables has limitations At present, the procurement scope covers orthopedic implant (spine) and Ophthalmology (intraocular lens) The shortlisted price of consumables is discussed by experts selected by Anhui Medical Insurance Bureau The negotiation price is based on three aspects: 1 The lowest price of provincial bidding price or price limit since 2016; 2 The median price, average price and lowest price of the actual purchase price of provincial public medical institutions in 2018; 3 The first price of "two vote system" The implementation plan requires that the distribution must conform to the "two ticket system", and at the same time, it stipulates that the provincial public medical institutions, as the first person responsible for the payment settlement, shall settle with the enterprise in time according to the contract, pay the payment within 90 days, and reduce the transaction cost of the enterprise Shandong Province said: "if the price of anticancer drugs is not reduced, the Internet will be removed." On July 17, Shandong provincial drug centralized purchase network published an important document notice on the withdrawal of some of the original online products In this adjustment of the directory of anti cancer drugs, 51 anti-cancer drugs from 32 manufacturing enterprises were removed from the network for the simple and crude purpose of controlling the price of anti-cancer drugs and directly removing the network for enterprises without price reduction In addition to Shandong Province, Heilongjiang, Liaoning, Hainan and other provinces have adopted the operation method of suspending the network without price reduction Once there is no active price reduction and no justifiable reason, it will be removed from the suspension of Internet connection and lose the qualification of sales in the hospital As a result, drug companies can only be put on the Internet again after they lose the hospital market and submit the price reduction application again For example, the notice on restoring the qualification of online transaction of some provincial alliance imported anticancer drugs published by Guangxi Province is the same Zhejiang province promotes "point method" medical insurance payment and vows to set a precedent for the whole country Yesterday, Zhejiang medical security bureau published the opinions on promoting the reform of basic medical insurance payment mode of county medical community in Zhejiang Province, focusing on the implementation of compound medical insurance payment mode, the comprehensive implementation of total budget management, the implementation of disease group point method, Outpatient Head contract payment mode, and efforts to eliminate the impulse of hospital relying on resource consumption and profit, and guide the medical community to connect By improving medical behaviors, improving medical quality, controlling costs and reducing expenses, we can increase the net income of hospitals and medical staff, improve the performance of medical insurance fund, and help solve the problem that the masses generally reflect that medical treatment is expensive There are several points worthy of attention in the opinion: 1 Carry out the total budget management in the whole province Based on the results of the final accounts of the income and expenditure of the medical insurance fund in the previous year, and taking into account the income budget, major policy adjustments, and the quantity, quality, ability and other factors of medical services in the next year, the administrative departments of medical insurance in each overall planning area, together with the departments of Finance and health, shall organize the medical insurance agencies, medical communities and other medical institutions to determine the income and expenditure of the overall planning area in the next year through negotiation Total budget of medical insurance fund 2 For inpatient medical services, DRGs is the main method of payment, and incentive mechanism is strengthened The goal is to control the total amount of medical insurance Multi compound medical insurance payment method: points are distributed as a new way to get medical insurance payment method found in the reform of medical insurance payment method in different regions The scientific name is "pay by disease points" On the basis of total amount control, it gives each disease a corresponding score At the end of the year, it calculates the cost of medical insurance payment through the total score obtained by the hospital and the total budget amount of medical insurance DRG disease payment is relatively simple, does not need a lot of technical support, local medical insurance is enough to support, but also can promote the competition mechanism between hospitals The same CD-10 disease classification, the same disease points, the less medication, the shorter hospital stay, the more successful surgery, the fewer corresponding points, so compared with the basic score, the more subsidy can be obtained from the medical insurance bureau, and vice versa 3 For long-term and chronic inpatient medical services, pay per bed per day will be gradually implemented Drg-s points method is applied to long-term and chronic diseases For stable diseases, the length of stay determines the cost of medical resources, and the length of holding time, daily average cost and curative effect are used to shorten the waste of medical resources in inpatient department caused by chronic diseases 4 For outpatient medical services, explore the combination of family doctor signing services, and implement capitation Similar to area division, it is divided according to the household registration of the insured and the location of the unit's employees The out-patient expenses incurred by the insured personnel in their in-vitro medical treatment are counted in the budget of their medical community In recent days, Jiangxi Provincial Health and Health Commission issued a notice, announcing the first batch of key monitoring drug catalogue in Jiangxi Province There are 35 kinds of key monitoring drugs published this time, among which nervous system drugs, cardiovascular system drugs and anti infective drugs account for more than 70% of the total The 35 list of key monitoring drugs released this time is just based on the national Version (20), plus 20 varieties in the provincial version of Jiangxi Province in March Since the publication of the national version of the catalogue, up to now, Qingdao, Inner Mongolia, Jiangxi and Weihai have successively released the catalogue of key monitoring drugs In terms of the catalogues issued by different regions, the 20 varieties of the key monitored drug catalogues are not immutable, and the provincial catalogues have certain adjustability and space to move The "fuse" effect is also continuously amplified In the future, with the implementation of key monitoring directories in various regions and hospitals, there may be unexpected policies that will affect the industry's nerves However, the adjustment of the medical insurance catalogue that is about to be implemented will further exclude or restrict these key monitoring varieties, and the trend of "strong control of fees" has been determined Enterprise information: the market value of dong'a-jiao has shrunk by 2.5 billion, which is the biggest decline since it went public! After the opening of the stock market on July 15, the share price of dong'a-jiao fell and stopped