Pay by disease gradually and comprehensively push away

, the centralized procurement of drugs organized by the state to the third batch, the trend of normalization of collection appears. According to the relevant government documents, the next stage, health care payment method reform or become a key content.On the evening of March 5, the Central Committee of the Communist Party of China and the State Council issued the Opinions on Deepening the Reform of the Health Care System, which has made it clear that the reform of the payment method for medical insurance will continue to be promoted."To vigorously promote the application of big data, the implementation of a multi-composite medical insurance payment method based on disease-based payment, the promotion of disease diagnosis-related group payment, medical rehabilitation, chronic mental illness and other long-term hospitalization pay by bed, outpatient special chronic diseases pay by head."Some industry experts today said that the effect of the national organization of drug collection is mainly generic drugs to reduce prices significantly, to achieve the original drug replacement, improve the concentration of the pharmaceutical industry, squeeze out the drug belt gold sales space, promote the transformation and upgrading of enterprises, save medical insurance funds.The reform of the payment method of medical insurance based on the payment by disease is mainly changed from the post-payment system to the prepaid system, through the way of prepaid package according to the disease, according to the different payment standards determined by different diseases, the implementation of the policy of savings and retention, overspending and reasonable sharing, forcing hospitals and doctors to use drugs rationally, reasonable diagnosis and treatment, save medical resources, improve the quality of medical services and so on.

pay by disease, and gradually and comprehensively push theOn July 15th, the Shanghai Health and Health Commission released the Shanghai Key Action Plan for Deepening Medical Reform (2020-2022), which plans the focus of Shanghai's health reform in the next two years.Shanghai, as the city that hosts the centralized procurement of medicines organized by the state, said it would encourage public medical institutions to conduct centralized bargaining procurement of drugs with volume and budget in the form of medical complexes, monos or voluntary procurement alliances for medicines not included in centralized belt procurement.Another clear part of the Action Plan is the steady implementation of the big data disease-based medicare pay-per-DRG pilot, and the orderly expansion of the pilot scope. By 2022, on the basis of the Shanghai pilot, the "four-in-one" (DRG, big data diseases, pay-per-bed, pay-per-person) multi-composite health insurance payment model under the total budget framework will be fully implemented.A few days ago, Hebei Health Anding Committee in a notice to deepen medical reform also made it clear that it will vigorously promote pay-per-disease, and actively promote pay-per-bed, start simulation operation in 2020, start actual payment in 2021.According to the "three-step" step arrangement of the DRG paid national pilot work: 2019 is the DRG top-level design phase, 2020 is the simulation operation phase, 2021 is the actual payment phase.Overall, the two years to come in 2021 and 2022 will be an important time for the overhaul of medicare payment methods, and for pharmaceutical companies, the impact of health care payment reform should also be anticipated.

prescriptions, overdosing, or becoming a historicalFujian Sanming, as a model city of national medical reform stars, from 2016 to date, began to implement medical insurance package payment as the starting point, the construction of regional health care organizations, and strive to provide the masses with a full range of full-cycle health and health services.Before the reform of the payment method of health insurance, Sanming went through two stages: the treatment of chaos, the blocking of waste (2012.2-2013.1) and the establishment of the constitution and the establishment of the system (2013.2-2016.8).In the first stage, Sanming implemented the key drug monitoring, control the circulation of drug prices, regulate medical behavior and other measures, in the second stage, Sanming began to break the rules and regulations, straighten out the government management system, establish the "three-doctor linkage", "two-vote system", "annual salary system", "three insurance in one" and other reforms of the "four pillars and eight pillars."In June 2017, the Office of the former State Health and Planning Commission issued a Notice on the Implementation of the Pilot Work on Pay-for-Pay Reform by Group Related to Disease Diagnosis, announcing that the C-DRG Pay-To-Pay Reform Pilot Work was officially launched in Shenzhen, Sanming and Kramay.Sanming's C-DRG fee-for-access reform will enter its official operational phase on January 1, 2018. Up to now, Sanming's reform of the payment method of health insurance has achieved remarkable results.Sanming City Health Reform Leading Group Secretariat Deputy Director, Sanming City Health Care Commission four-level researcher Zhou Xianxuan said, different from the original pay-per-project, income and the number of services linked, hospitals in pursuit of economic benefits, easy to cause overuse of medical services, in the total cost control, and pay by disease-based multi-health insurance payment method reform, the cost of medicine significantly decreased, hospital revenue increased, unreasonable drug use and treatment significantly reduced.The above-mentioned person said to SaiBaiLan, Sanming to implement the reform of medical insurance payment methods has a better basis for reform - first, through the integration of the "three insurance", joint price-limiting procurement and other series of measures to reduce the price of drugs (supplies) to a certain level;In the exchange with Seberan, the above-mentioned people further said that in the process of implementing the medical reform policy, the effective implementation of policies such as lowering drug prices is an important prerequisite for the reform of the payment method of medical insurance based on the payment of diseases.In addition, before paying by disease, it is necessary to determine the payment standards for major diseases, change the concept from leadership to medical personnel, train medical personnel to master relevant knowledge, code drug supplies and medical service projects, rebuild the home page of hospital medical records, medical insurance payment system, electronic medical record system, etc., to provide information system support for the formal implementation of DRG.In the process of paying by disease, the examination, examination, medicine and hygiene materials (including high-value consumables and low-value consumables) used by inpatients need to be included in the pricing by disease group, in the process, drugs that do not conform to clinical pathways and do not have clear clinical value and efficacy will undoubtedly be excluded from packaging.Practice shows that the implementation of DRG is conducive to higher-level hospitals to take the initiative to transfer common diseases to the grass-roots level, to achieve graded diagnosis and treatment;Further, the implementation of DRG can effectively regulate the behavior of diagnosis and treatment services - breaking by medicine, excessive medical behavior, strengthen the use of drugs and consumables, strengthen "reasonable drug use, reasonable examination, reasonable treatment", urge doctors to regulate the behavior of diagnosis and treatment, change the use of drugs in doctors disorderly "order", the cost of others "pay" (i.e., patients and medical insurance funds) chaos, reduce the risk of clean and honest medicine.In general, under this payment method, based on value of medical treatment, to pay for the value of the traditional "to supplement medicine, to supplement medicine, to supplement medicine" era is gone. (Cypress Blue)