The national collection variety payment standard has come

September 24th, 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 national organization of drug centralized procurement and use of the pilot expansion of related drugs of the medical insurance payment standards, around 25 drugs, Sichuan for different pharmaceutical companies, different product regulations of 503 drugs, one by one set the payment standards.In its circular, Sichuan noted that the payment criteria apply to 25 drugs, including selected and non-selected drugs, that have been expanded through the centralized procurement and use of drugs organized by the State. That is, whether it is the selected or non-selected varieties, you need to refer to this standard for medical insurance reimbursement.In 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 within the payment standard is shared between the patient and medicare as prescribed. Patients who use drugs that are below the payment standard are paid at the actual price.In addition to Sichuan Province, Zhejiang has also issued relevant notices on the payment standards of the country's harvest varieties. In this regard, Seberlan's contributing author, Code Wanxuan, told Seberan that the impact of health care payment standards is expected to be systematic and will be more extensive.Some people in the industry 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. 25 collection varieties will be adopted by then.After the normalization of collection, the establishment of payment standards is the key as early as September 30, 2019, the State Health Insurance Administration and other nine departments issued "on the centralized procurement and use of national organizations of drugs pilot expansion of regional implementation opinions" clearly stated that the exploration of centralized procurement of pharmaceutical medical insurance payment standards and procurement price synergy.“ For centralizedly purchased drugs, the medical insurance fund shall, in principle, settle the original research drugs under the same generic name, the compared preparations, and 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 use drugs higher than the payment standard, the part of the payment standard is paid by the patient, such as the patient's drug price and the selected drug centralized purchase 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 national organization of drug belt procurement.On 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.Up to now, the collection of drugs by the State organization 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;Drug payment standards have far-reaching implicationsindustry authorities have previously told Seberan that the exploration and development of payment standards is one of the important purposes of the national organization of drug collection. There is no doubt that 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 Dingchen Medical Management Consulting Center in Beijing, 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 affordability of medical insurance funds in each province, the determination of payment standards will also take into account the situation of the provinces.Back to the varieties collected by the state, according to the relevant policy requirements, the standard of payment for medical insurance should be set in accordance with the winning price of the collection, but at present, different drugs under the same generic name, the difference in tender prices in the provinces is still relatively large. With the harmonization of payment standards, this may push down the tender prices of these drugs further, so to speak, at least in the policy market, the prices of these varieties will face a downward.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 the national health insurance directory, will be affected by the standard of payment for health insurance. For affected pharmaceutical companies, entering retail pharmacies at their own expense may become an option for non-selected varieties. Code Wanyu further said to Cypress Blue, with the establishment of payment standards, non-selected enterprises are basically left with the following 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 their mentality is likely to change further; Unseeded drug companies can retain their existing market share by lowering the price of the internet in the affected areas, or consider overseas markets where policy is relatively quiet. Unlike relatively intuitive prices, the system of medical insurance payment standards has far-reaching implications that cannot be ignored. (Seber blue
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