The "986 policy" of basic medicine will force a large number of "Shenyao" enterprises to die again!

On October 11, the general office of the State Council issued the "GBF [2019] No 47" and issued the so-called "986 policy" （6） We will give priority to the use and rational use of essential drugs By strengthening the supervision and assessment of drug use, guiding and urging medical institutions to optimize the drug use catalogue and drug prescription set, we will promote the priority of the allocation and use of essential drugs, increase the proportion of the use of essential drugs, and timely adjust the national essential drugs catalogue, so as to gradually realize the proportion of the number of essential drugs in primary medical and health institutions run by the government, secondary public hospitals and tertiary public hospitals At least 90%, 80% and 60% respectively, to promote medical institutions at all levels to form a "1 + X" (1 is the national catalogue of basic drugs, "X" is non basic drugs, determined by each region according to the actual situation) drug use mode, optimize and standardize the drug use structure We will strengthen the whole process management of drug catalog selection, purchase and use in medical institutions, promote the implementation of the requirements of "no intramuscular injection for oral administration, no infusion for intramuscular injection", and promote scientific and rational drug use (in charge of the National Health Commission and the State Administration of traditional Chinese Medicine) 1 = basic drugs: 90%, 80%, 60% As we all know, the drugs in the basic drug list are the basis for the use of drugs in medical institutions, and the main characteristics are to adapt to the basic medical and health needs, the dosage form is appropriate, the price is reasonable, the supply can be guaranteed, and the public can get the drugs fairly X = therapeutic drugs + auxiliary drugs + partial rebate drugs ("Shenyao", traditional Chinese medicine injection, etc.): 10%, 20%, 40% Before that, the local competent departments also had restrictions on the use of the proportion of base drugs, such as: Beijing: 50% of primary medical institutions, 30% of secondary hospitals and 25% of tertiary hospitals; Henan: 70% of primary medical institutions, 50% of secondary hospitals and 30% of tertiary hospitals; Guangxi: 70% of primary medical institutions, 40% of secondary hospitals and 30% of tertiary hospitals; This time, the national "986 policy" and "1 + X" drug use mode further reduced the use of drugs other than base drugs to 124 In other words, the proportion of drugs other than basic drugs used by hospitals is less than 40% in tertiary hospitals, less than 20% in secondary hospitals and less than 10% in primary medical institutions In the process of disease treatment, in addition to the basic drugs, there are some other therapeutic drugs besides the catalogue, which have important effects on disease treatment But in addition to basic drugs and therapeutic drugs, doctors may also issue some "kickback drugs", mainly Chinese patent medicine, traditional Chinese medicine injection, auxiliary drugs, etc these drugs are characterized by no therapeutic effect, neither good nor bad eating, but the price is very high In the future, the total proportion of these therapeutic drugs and rebate drugs will be reduced to at least 10%, 20% and 40% However, the clinical treatment of patients, not just income, so in fact, compressed is the space of kickback medicine! If you stack DRGs, they will collapse completely! 1 Lay a foundation for the centralized procurement of national drugs, and ensure the procurement and use of basic drugs 2 Further promote DRGs and clinical pathway DRGs requires more patients with the lowest price to achieve the best treatment effect The basic drugs and therapeutic drugs with low price, good effect and high cost performance will be the most popular, while the safe and ineffective, expensive and inefficient auxiliary traditional Chinese medicine, traditional Chinese medicine injection and other products will be actively abandoned by hospitals and doctors 3 By limiting the high proportion of base drug use rate, some Shenyao kickbacks are directly squeezed out of the patients' prescription list If the proportion of basic drugs is too low, doctors have greater discretion, and they can often use high rebate traditional Chinese medicine injection, auxiliary drugs, etc After the "986 policy", in order to ensure that the proportion is up to the standard, and to be able to treat patients at the same time, doctors must prescribe therapeutic drugs in the remaining small proportion of non base drugs In this way, the "magic medicine" will be driven away In the future, a large number of "magic medicine" enterprises will be very uncomfortable Generally speaking, the grade hospitals have gradually started to clean up these auxiliary drugs and drug varieties, especially the national general hospitals have already started to do so, which was the case several years ago!