The new health insurance catalog brings three opportunities for DTP pharmacies!

The results of the 2020 National Health Insurance Drug Price Negotiations were released by the National Health Insurance Administration on December 28, 2020 and will come into effect on March 1, 2021.
The current round of state talks is the fifth round of national drug price negotiations in China, 162 drugs were negotiated, the negotiations were successful 119 (of which 96 were added outside the catalogue, 23 were successfully negotiated or renewed in the catalogue), the overall success rate of 73.46 percent, an average price reduction of 50.64 percent.
The results of the first four rounds of national drug price negotiations can be found that through the national drug price negotiations, the scope of medical insurance payment has been expanded, including many anti-cancer drugs, rare disease drugs and other DTP pharmacies mainly suitable varieties, bringing better access to drugs, easing the pressure to pay.
More anti-cancer drugs, rare disease drugs and other special drugs successfully entered the medical insurance directory, for the DTP pharmacy already has the qualification of special drugs for major diseases is very good, the patient's payment pressure can be greatly alleviated.
, DTP pharmacies can use these drugs to provide professional health services to more patients, which is opportunity and value.
data show that from the patient burden situation, through negotiations to reduce prices and health insurance reimbursement, it is expected that by 2021 can be accumulated for patients to reduce the burden of about 28 billion yuan.
, it has been estimated that the price reduction of 14 anti-cancer drugs in this renewal negotiation is expected to save cancer patients more than 3 billion yuan by 2021.
, it can be seen that "quantity for price" has obtained a clear "cage for bird" effect.
, the health-care sector will also include more innovative therapeutic drugs for serious diseases, including anti-cancer drugs and rare disease medications, into the scope of Medicare payments.
of the 119 successfully negotiated varieties of drug use for rare diseases included 6 rare disease medications.
Previously, the 2019 National Health Insurance Drug Catalog included nine new rare disease drugs (six negotiated into category B), involving systemic sclerosis, multiple sclerosis, idiopathic pulmonary hypertension, idiopathic pulmonary fibrosis, Huntington's disease, amyotrophic lateral sclerosis (frozen human).
, there are 24 rare diseases in the new health insurance catalogue, which will be officially implemented on March 1, 2021, involving 55 drugs, of which 15 are Class A and 40 are Class B.
results are mostly brought about by national talks and can greatly meet the clinical drug needs of patients with rare diseases.
access to medicines for patients with rare diseases will gradually increase, and DTP pharmacies will have increasing opportunities to serve patients with rare diseases.
opportunity for the DTP pharmacy to implement the Medicare two-channel policy is the Medicare two-channel policy.
December 28, 2020, the Document of the State Administration of Health Care Security requires all departments to "innovate ways and means of working to promote the landing of the 2020 List of Medical Insurance Drugs by improving the policy of outpatient security, opening the channel of designated pharmacies for medical insurance, and rationally adjusting the total amount of control."
"national talk drug "two-channel" mode of the undertaker is the vast majority of cases around the DTP pharmacy.
this, DTP pharmacies, which already have the qualification of special drugs for medical insurance for major diseases, have increased the possibility of obtaining authorization from product manufacturers within the scope of the successful catalogue of national talks, and can obtain more products to operate.
There are incomplete statistics in the industry, as of October 2020, 216 of the country's 323 health insurance co-ordination areas of the relevant departments have issued a notice or landed to implement the national drug-related medical insurance special drugs landing two-channel policy, that is: for these countries to talk about drugs, patients in accordance with the relevant rules and procedures issued by the regional health insurance agencies, can be in the relevant hospital hospital treatment reimbursement, but also in the designated retail pharmacy DTP drug reimbursement.
Moremore, it is expected that with the improvement of the local medical insurance agencies Internet plus, big data and other technical means, its intelligent all-dimensional fee control capacity is getting stronger and stronger, there will certainly be more and more regional health insurance managers to liberalize the two-channel policy of special drug medical insurance, in order to land on the country to talk about the implementation of drug policy.
talk about unsuccessful drugs and non-medical insurance catalog of new drugs in addition, for this national talk of unsuccessful anti-cancer drugs, or non-national talk of innovative special drugs, DTP pharmacies also have great market opportunities.
The main channel of patient purchase is naturally outside the hospital, which is also the core point of view of the out-of-catalog market strategy of the vast majority of innovative special drug companies.
high-value drugs, such as innovative anti-cancer drugs or rare disease drugs, that are not on the health insurance list, and newly marketed drugs are opportunities that DTP pharmacy channels need to seize.
DTP pharmacies can professionally manage the drug purchase scenarios of such patients to help the market.
DTP pharmacies should be highly aware of the increasing number of innovative drugs on the market each year and the increasing demand.
statistics, in 2020, the State Drug Administration (NMPA) approved a total of 48 new drugs, of which 20 are domestic new drugs and 28 are imported.
, there were 16 oncology drugs, accounting for 34%, 8 rare disease drugs, all imported drugs, 6 did not enter the health insurance list, 8 clinical urgent needs of drugs, 3 did not enter the health insurance list.
for these DTP pharmacy-friendly products that do not enter the health insurance catalog, pharmacies can work in-depth with manufacturers to actively carry out charitable drug donation activities, or commercial health insurance products to improve the channels.
through the PAP charity drug donation activities, anti-cancer drugs, rare disease drugs and other related enterprise products can be actually sold and used, followed by hope in a new round through the national medical insurance drug catalog dynamic adjustment of access.
if there is no clinical practice, and if there is no positive feedback from clinicians on the efficacy of the product, it will be difficult for pharmaceutical companies to impress the health insurance bureau in future communication negotiations.
this year's PD-1 class of single-resistance negotiations before and after the drug company's strategy is this logic, so it has attracted attention from all walks of life.
From the results of the 2020 National Health Care Drug Negotiations, imports of PD-1 are completely wiped out, and those who fail to make the list of imported PD-1s are now working hard to adjust their strategies and modify the drug-giving program to reduce costs, thereby preserving patient stickiness.
before the negotiations, the cost of treatment after the import of PD-1 drug K drug gift is about 287,000 yuan / year, while the annual treatment cost of PD-1 patients after the success of domestic negotiations is only about 60,000 yuan.
In fact, before the negotiations, there are people in the industry on the PD-1 negotiations have a prejudgment that multinational pharmaceutical companies to defeat health insurance is a high probability event, because they need to maintain the global price system, so many times multinational pharmaceutical companies would rather choose the way to give drugs to reduce prices in disguise.
for the products that have been defeated in the health care negotiations, hospital access will be difficult, pharmaceutical companies need to open up DTP and other out-of-hospital markets to ensure that the urban market drug access.
is also an opportunity for DTP pharmacies to develop.
addition, because medical institutions have prescription control and medical insurance control fees, so long-term treatment of large amounts of medication or need to go to the out-of-hospital pharmacy to solve.
therefore, products that meet the areas of chronic, severe, and rare diseases, or where patients require long-term medication and tracking services, can be considered as the scope and opportunity of DTP's services.
conclusion, the national health insurance drug price negotiations can bring good opportunities for the development of DTP, but not "pie in the sky", the opportunity is not every DTP pharmacy can seize.
iron also need their own hard, DTP pharmacy to prepare in advance.
Stick to the original heart, around the patient in the medical institutions are not satisfied with the needs of health services, to provide patients with the needs of professional drugs and professional clinical medicine and pharmaceutical health services, it is best to truly establish a "medical risk detection" patient treatment value fusion platform, for patients, doctors, pharmaceutical companies, health insurance and other relevant parties to create value and recognition.