The national collection variety payment standard has come.

On September 24, the Sichuan Medical Insurance Bureau issued a public consultation on the issuance of a notice (draft for comments) on the issuance of the national organization's centralized procurement and use of drugs to expand the relevant drug medical insurance payment standards.
In the annex section, Sichuan Province announced the state-organized centralized procurement and use of drugs to expand the relevant drug health insurance payment standards, around 25 drugs, Sichuan for different pharmaceutical companies, different product regulations of 503 drugs, one by one set payment standards.
, Sichuan stated in the circular that the payment criteria applied to the centralized procurement and use of the pilot expansion of 25 drugs by national organizations, including selected and non-selected drugs.
, whether it is a selected or non-selected variety, you need to refer to this standard for health insurance reimbursement.
addition, patients use drugs that cost more than the payment standard, the portion that exceeds the payment standard is paid by the patient, and the portion of the payment standard is shared between the patient and medicare according to the regulations.
patients who use drugs that are below the standard of payment are paid at the actual price.
addition to Sichuan Province, Zhejiang also issued a relevant notice on the payment standards of the national collection varieties.
, Seberlan's contributing author, Wan Yu, told Seberan that the impact of health care payment standards is expected to be systemic and more widespread.
There are industry insiders to Cypress Blue said that the collection of varieties to pay the standard according to the common name, and reference to the purchase price of the selected varieties, the greatest impact may be the relatively high price of the original research drugs, with the implementation of payment standards, generic drug replacement effect may be strengthened.
, according to the draft opinion, the above notice will be implemented from 15 November 2020, i.e. by that time, 25 varieties will have adopted the new payment standard. After the normalization of
collection, the payment standard is established as early as September 30, 2019, the State Health Insurance Administration and other nine departments issued "on the national organization of drug centralized procurement and use of pilot expansion of regional implementation opinion" clearly pointed out that the exploration of centralized procurement of drug medical insurance payment standards and procurement price synergy.
" For centralizedly procured drugs, the medical insurance fund shall, in principle, settle the original research drugs under the same generic name, the evaluation of generic drugs, and the generic drugs evaluated by consistency, with the centralized purchase price as the standard of payment for medical insurance within the scope of the medical insurance catalogue.
Patients using drugs higher than the payment standard, beyond the payment standard part of the patient's own payment, such as the patient's use of the drug price and the selected drug centralized procurement price difference is large, can gradually adjust the payment standard, in 2-3 years to adjust in place."
According to Seber blue inquiry, the National Health Insurance Administration in the response to the relevant recommendations, said that according to the central institutional reform program, the health care sector officially became the competent department of drug prices, after which the State Health Insurance Administration began to actively carry out the state-organized drug belt procurement.
January 1, 2019, the General Office of the State Council issued the Notice on the Piloting of the Central Procurement and Use of Drugs organized by the State, and organized 11 cities, including Beijing, Tianjin, Shanghai and Chongqing, to carry out volume procurement for 25 varieties.
, the collection of drugs organized by the State has been carried out in the third batch, involving a total of 113 varieties.
Follow-up, on the one hand, is the normalization of the collection of national organizations to carry out - collection of products and collection of the main body continue to expand;
the impact of drug payment standards more far-reaching, some industry authorities told Seberan that the exploration and development of payment standards is one of the important purposes of the national organization of drug collection.
once the payment standards are formally introduced, this will have an impact on the use of drugs in selected varieties, non-selected varieties, hospitals and retail pharmacies.
Shi Lichen, founder of the Beijing Dingchen Medical Management Consulting Center, told SaibaiLan today that according to the policy orientation of the National Health Insurance Administration, the national health insurance catalogue and medical insurance payment standards will gradually be unified, but considering the different capacity of the provinces to pay for medical insurance funds, the determination of the payment standards will also take into account the situation of the provinces comprehensive formulation.
return to the national collection of varieties, according to the relevant policy requirements, medical insurance payment standards should be set in accordance with the winning price, but at present the same generic name under the different drugs, in the provinces of the tender price difference is still relatively large.
with the harmonization of payment standards, this could push down the tender prices for these drugs further, arguably at least in the policy market, and the prices of these varieties will face a downward decline.
as the price of the winning variety spreads to the level of payment standards, non-selected drugs will be affected, and in some ways, payment standards are developed to expand the impact of volume procurement.
further, as the standard of payment for varieties collected and even more in health insurance falls, as long as they are included in the National Health Insurance Directory, they will be affected by the standard of payment for health insurance.
for affected drug companies, entering retail pharmacies at their own expense may become an option for non-selected varieties.
yards wanyu further said to Cypress Blue, with the establishment of payment standards, non-selecting enterprises basically only have the following few options: First, Mo fist rub, waiting for the next collection in the full fight for the election.
drug companies that have not yet been selected have suffered a new blow on the unseeded circuit, and the mentality is likely to change further;
drug companies could retain their existing market share by lowering the price of the internet in the affected areas, or consider overseas markets with relatively calm policies.
relatively intuitive price, the system of medical insurance payment standards has far-reaching implications and cannot be ignored.
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