Policies are frequent, and the new model of "prescription outflow, medical insurance settlement" is accelerating

The new medical insurance payment policy is here, and this market is about to explode

This market is about to explode

On April 1, "Ningxia Hui Autonomous Region "Internet +" Medical Services Medical Insurance Payment Management Measures" was formally implemented, opening a new model of prescription outflow and medical insurance settlement.

It is understood that the main purpose of the "Measures" is to further expand the coverage of "Internet +" medical services in Ningxia.

That is to say, under this policy, retail pharmacies can join the closed loop of medical care to medical insurance, which can realize direct settlement of medical insurance in retail pharmacies, and at the same time further promote the outflow of hospital prescriptions, which is greatly beneficial to the development of the retail market.

According to the Frost & Sullivan report, it is estimated that 87.

For this forecast, some analysts believe that only by leveraging the leverage of medical insurance, allowing medical insurance to be fully integrated into retail pharmacies, and forming a competitive relationship between retail pharmacies and medical structures, can the market for 100 billion prescription drugs be truly leveraged.

For now, it is still difficult for most retail pharmacies to enjoy the bonus of prescription outflow from hospitals.

It can be seen that the new medical insurance policy implemented by Ningxia this time will solve the problem of retail pharmacy medical insurance coordination through "Internet +", which will fundamentally solve the bottleneck of prescription outflow and truly promote the development of the retail market.

Localities gradually clarify the Internet medical insurance payment policy

In fact, not only Ningxia, but also all parts of the country are currently exploring the "Internet +" medical insurance payment model.

During the 2020 new crown pneumonia epidemic, the state intensively introduced policies to encourage the development of online consultation and purchase of medicines.

Table 1: Internet follow-up visits and medical insurance policies in various regions

In the short term, clear regulations on the scope of online follow-up visits and medical insurance payment policies in various regions are expected to fully promote the outflow of prescriptions; in the long term, in the context of my country's shortage of medical resources and severely uneven distribution, Internet medical care is the general trend, and the solution of online sales of prescription drugs The problem of medical insurance docking is obstructive and long, but the future can be expected.

The country has successively introduced policies to promote the outflow of prescriptions

In recent years, as the reform of the national medical and health system continues to advance, new policies in the pharmaceutical industry have frequently emerged.

Table 2: Policy documents related to the promotion of prescription outflow at the national level in recent years

Not only at the national level, but in recent years all parts of the country have also accelerated the outflow of prescriptions.

Since the General Office of the State Council issued the "Opinions on Promoting the Development of "Internet + Medical Health"" in April 2018, building a prescription circulation platform has become the mainstream.

In addition, the "Hospital Smart Service Classification and Evaluation Standard System (Trial)" issued by the General Office of the National Health Commission on March 18, 2019, clarified that the function of hospitals to provide smart services to patients and the effects felt by patients will be implemented.

At a recent press conference held by the National Health Commission in Beijing, Xiong Xianjun, Director of the Medical Service Management Department of the National Medical Insurance Administration, introduced the "Internet + medical service" medical insurance payment situation and said that during the epidemic, all parts of the country have increased the "Internet +" The supply of medical services has made a positive contribution to the fight against the epidemic.

He said that the next step is to improve the medical insurance payment policy for "Internet +" medical insurance services.

It can be seen that under the promotion of a series of policies, the "Internet + medical service" medical insurance payment will continue to advance, and the circulation of electronic prescriptions will also be piloted or explored in more regions.
The prescription outflow market is expected to usher in a blowout.
How to better obtain outflow prescriptions and occupy the prescription outflow market has become the key to the next step of the layout of many pharmaceutical companies.