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    Home > Active Ingredient News > Drugs Articles > The latest ultimatum of the health and Family Planning Commission: the proportion of drugs in 200 urban hospitals is reduced to 30%

    The latest ultimatum of the health and Family Planning Commission: the proportion of drugs in 200 urban hospitals is reduced to 30%

    • Last Update: 2017-04-24
    • Source: Internet
    • Author: User
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    Source: sabilan's medical reform policy affecting the fate of pharmaceutical companies on April 24, 2017 Here comes! ▍ the proportion of drugs in 200 cities has dropped to 30% for only 8 months The proportion of public hospital drugs in four batches of 200 pilot cities of medical reform in China will be cut to 30% On the afternoon of the 21st, the website of the health and Family Planning Commission released the notice on comprehensively promoting the comprehensive reform of public hospitals (gwsgf [2017] No 22) (hereinafter referred to as the notice), which clearly stated that "by the end of 2017, the proportion of public hospitals in the first four pilot cities (excluding Chinese herbal pieces) had declined to about 30% overall" This is also the first time since the guiding opinions of the general office of the State Council on comprehensive reform pilot of urban public hospitals in 2015 clearly proposed that the proportion of drugs in urban public hospitals should be controlled within 30% in 2017, and the national level has clearly defined the detailed schedule for the proportion of drugs And this also means that the pharmaceutical enterprises with drug sales in 200 cities across the country will face a big shock in their overall business from variety research and development to marketing Sabilan noted that the contents of the notice that directly affect drug (machinery) enterprises include: by the end of 2017, the proportion of drugs in the first four pilot cities' public hospitals (excluding Chinese herbal pieces) decreased to about 30%; the health materials consumed in the medical income of 100 yuan (excluding drug income) decreased to less than 20 yuan; and the number of diseases charged by disease was no less than 100 "Compulsory drugs account for less than 30%, which is a hard measure (binding force) to control drugs and reduce the use of simple drugs; payment by disease is a soft measure (both incentive and restriction) to control the use of drugs." Yesterday, some experts in the industry told cypress blue about the document, "it used to be called Wolf, with a clear timetable, it's the wolf that really comes!" ▍ the proportion of drugs for general lowering in China In fact, due to a series of problems and contradictions caused by the excessive dependence of Chinese public hospitals on drug sales, as early as in the guideline for hospital management evaluation (2008 version) issued by the Ministry of health, the standard of "proportion of drugs in top three hospitals" has been proposed as ≤ 45% "According to China Health and family planning statistical yearbook 2015, the cost of public medical treatment and hospitalization in China has been rising, from 6193.9 yuan in 2010 to 7832.3 yuan in 2014 Among the costs, the cost of outpatient and inpatient medicine accounts for half of the total Under the current national trend of emphasizing reducing burden and improving public medicine cost, the urgency of reducing the proportion of medicine can be seen In 2015, according to the implementation plan of sunshine medication project for medical services in Zhejiang health system, the requirements for the proportion of drugs are as follows: the proportion of drug revenue to medical Revenue: Level 3 hospitals ≤ 45%, level 2 hospitals ≤ 50% and the proportion of antibiotics to drug use: Level 3 class A hospitals ≤ 23%, level 3 class B hospitals ≤ 25%, level 2 class A hospitals ≤ 28%, and level 2 class B hospitals ≤ 30% In the published data, there are 121 tertiary hospitals, 17 of which account for more than 45% of the drugs, 7 of which account for more than 23% of the drug use, and the proportion of hospital drugs has been significantly reduced With the development of medical reform and medical reform, provinces have successively issued requirements for the proportion of drugs, such as Liaoning regulation of less than 40% (by the end of 2015), Anhui 40% (including consumables); Fujian: 35%, Sanming public data shows that it has decreased from 46.77% before medical reform to 27.36%; Jiangsu: 30% (2017), etc ▍ the earthquake impact of pharmaceutical enterprises and the reduction of the proportion of drugs have undoubtedly brought about earthquake like changes to pharmaceutical enterprises, especially the sales of prescription drugs, which are mainly in the public hospital market According to the data of China Health and family planning statistical yearbook 2015, the impact of reducing the proportion of drugs on different levels of hospitals is also very different: in 2014, inpatients need 3737.1 yuan each time to see a doctor in the first level hospital, and each time to see a doctor in the second level hospital increased to 5114.6 yuan, while in the third level hospital, it has more than doubled, reaching 12100.0 yuan, of which more than half is still the cost of drugs 。 It can be seen that once the proportion of drugs drops to 30%, how to make up for the huge holes will be a headache for hospitals and pharmaceutical enterprises Even some insiders predict that with the gradual deepening of the "drug proportion" policy, the market of prescription drugs in urban hospitals will decrease by 10% - 20% in the next two years However, in the grass-roots market where the industry has always believed that the proportion of drugs is under greater pressure, the notice clearly states that by the end of 2017, the comprehensive payment mode will be implemented, including payment by disease, payment by head, payment by bed, etc., to explore the payment mode in line with the characteristics of traditional Chinese medicine, and encourage the provision and use of Chinese medicine services; The per capita cost and total income of outpatients and inpatients in county-level public hospitals decreased, the proportion of medical service income (excluding drugs, consumables, inspection and laboratory test income) in business income increased, and the proportion of out of pocket medical expenses in total medical expenses decreased With the rapid development of the system of "pay by disease" as a combination of boxing and medicine, some general drugs with low clinical value will encounter more serious impact It's not only the homogenous and highly uncompetitive generic drugs, but also the well-known pharmaceutical companies' leaders have told Cyprian blue that under the policy of paying by disease and emphasizing the control of medical insurance payers, with the widespread application of evaluation indicators such as pharmacoeconomics, including some high priced innovative drugs will also encounter market challenges due to the pressure of medical insurance payment - those innovative drugs with high cost performance and characteristics It is likely to form new competitiveness and market At the same time, every step of the hospital's response to a series of policies will be quickly transmitted to drug companies and cause further impact According to the formula of drug proportion: drug proportion = drug / (drug income + drug proportion = drug / (drug income + medical income) * 100% In order to reduce the drug proportion, the hospital can not only reduce the molecular part, but also increase the denominator part Of course, it can also work together to reduce the molecular part and increase the denominator at the same time In other words, the hospital's second price negotiation will be more dynamic, and further price reduction can reduce the molecules in the formula of drug proportion; meanwhile, the increase of inspection cost will help to lower the drug proportion in the denominator part, and fill the deficit of the hospital due to the decrease of drug sales Public data shows that the average proportion of drugs in urban public hospitals in China is 40% - in 2015, the sales volume of drugs in urban public hospitals reached 735 billion yuan Based on the proportion of drugs, the annual income of urban public hospitals is about 1.84 trillion yuan According to the data of the national health and Family Planning Commission, the growth rate of the number of patients in public hospitals in the first five months of 2015 was 4.9%, taking this 4.9% as the growth rate, and assuming that the cost of single diagnosis and treatment remains the same, the revenue of urban public hospitals will increase to 2.02 trillion yuan in 2017 If the proportion of drugs is reduced from 40% to 30%, the drug sales of public hospitals in 2017 will be reduced from 735 billion yuan in 2015 to 606 billion yuan, down more than 120 billion yuan At present, public hospitals in most areas of the country still retain an average of 15% of the drug markup cost, which is about 90 billion yuan All of these have posed a comprehensive challenge to the R & D and marketing of pharmaceutical enterprises How to flow out the prescriptions outside the hospital, whether the trusteeship of pharmacies is reliable, what challenges to the sales model of pharmaceutical representatives, how to resolve them, and whether the academic model of cooperation between some key departments can be commercialized quickly The countdown has begun nationwide, with the time left for pharmaceutical companies and the last eight months.
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