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    Home > Active Ingredient News > Drugs Articles > The introduction of the heavy medical insurance documents is difficult for pharmaceutical companies to sell

    The introduction of the heavy medical insurance documents is difficult for pharmaceutical companies to sell

    • Last Update: 2021-06-17
    • Source: Internet
    • Author: User
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    1.
    The Guangxi version of the medical insurance balance retention policy is introduced

    1.
    The Guangxi version of the medical insurance balance retention policy is introduced

    Recently, the Guangxi Autonomous Region Medical Insurance Bureau and the Autonomous Region’s Department of Finance issued the "Implementation Opinions on the Retention of Chinese Medical Insurance Funds for the Centralized Purchase of Drugs by the State and the Autonomous Region
    .


    "

    According to the notice, these implementation opinions are applicable to various batches of centralized procurement of drug varieties carried out by the state, inter-provincial alliances, and autonomous regions, and all participating public medical institutions in the above-mentioned designated public medical institutions and medical institutions of the People’s Liberation Army and the Armed Police Forces in Guangxi.
    , And medical groups such as medical consortia and medical community with designated public medical institutions as the lead institutions are all included in the policy implementation of the policy on the retention of medical insurance funds for centralized drug purchases
    .

    The notice requires that medical insurance departments in various regions implement medical insurance fund budget management on an annual basis during the procurement cycle for drugs included in the centralized procurement within the total control indicators of the total medical insurance amount of the centralized procurement agency
    .


    After that, considering a variety of factors, calculate the amount of medical insurance expenditures for centralized procurement of generic drugs by centralized procurement agencies, and the part that is lower than the budget of centralized procurement of medical insurance funds is the basis for calculating the balance


    It is worth noting that, in order to encourage the use of selected products, the part of the agreed-upon medical institutions using the selected products in excess of the agreed purchase amount will not be included in the centralized procurement of generic medicines and medical insurance expenditures when calculating the basis of the approved balance
    .

    As for the proportion of the remaining balance, the agreed medical institutions that have completed the agreed procurement volume and passed the assessment will retain the centralized procurement drug medical insurance funds at a ratio of not more than 50% of the estimated balance base.
    The specific retention ratio will be determined by each region based on the evaluation results of the agreed medical institutions OK
    .


    Regarding the remaining funds, the notice mentioned that special funds should be used for special purpose and special budgets, which are mainly used for the performance of relevant medical staff, to encourage them to use drugs rationally and give priority to the use of selected products


    In addition, in order to prevent relevant personnel from arbitrarily opening centralized procurement of medicines in order to obtain surplus reserve funds, a document circulated in the industry in April this year entitled "Notice on Strengthening the Management of the Use of Medical Insurance Funds for Centralized Procurement of Medicines and Consumables by the State" pointed out , It is not allowed to directly link the retained funds for centralized procurement of medical insurance with the use of departments and personal incentives
    .

    2.
    Promote the implementation of quantity procurement

    The policy for the retention of medical insurance fund balances is simply that, according to a certain calculation method, the amount of medical insurance funds saved compared to before the centralized procurement will be approved according to a certain proportion, and the medical insurance department will allocate the amount to be completed in accordance with the signed national centralized procurement contract.
    The designated medical institutions with the task of selecting drugs in the procurement process are used to encourage the relevant personnel of the medical structure to use centralized procurement drugs, and to promote the further implementation of the mass procurement policy
    .

    It can be seen that the compensation mechanism for medical institutions based on the policy of retention of medical insurance funds in bulk purchases is directly linked to the use of selected drugs in bulk purchases
    .


    The more products are used, the more compensation incentives the hospital will receive.


    Although there is no indication that the unselected drugs cannot be used, the unselected drugs greatly affect the balance calculation base.
    If medical institutions want to obtain as much balance measurement base as possible, they need to reduce the purchase amount of the unselected products as much as possible
    .

    Moreover, hospitals have not been prevented from influencing the calculation base to change the unselected drugs into offline procurement.
    The state has long established regulations that in principle, offline procurement is not allowed.
    Therefore, even if the doctor personally wants to prescribe it, there is no path
    .


    Last year, the National Medical Insurance Administration and the Ministry of Finance issued the "Guiding Opinions on the Retention of Medical Insurance Surplus Funds in the Centralized Procurement of Drugs Organized by the State" which clearly mentioned this point


    These regulations guarantee and encourage the use of centralized procurement products, and also greatly reduce the living space of unselected drugs in hospitals, prompting relevant pharmaceutical companies to actively participate in centralized procurement
    .

    3.
    It is difficult for pharmaceutical companies to sell with gold

    Bulk purchases have compressed the water of falsely high drug prices, which also reduces the space and possibility for pharmaceutical companies to sell with money.
    However, high-priced drugs such as unselected drugs are restricted by the above regulations, and the living space in hospitals is reduced.
    Opportunities to sell with gold
    .


    Therefore, pharmaceutical companies that have relied on this way to obtain the market in the past will face certain challenges


    So far, Qinghai, Hunan, Anhui and other places have issued relevant notices on strengthening the management of the use of medical insurance funds in the centralized procurement of medicines and consumables organized by the state, and many places have implemented them
    .


    It is understood that in recent days, many places have issued transcripts of surplus funds for the purchase of medical insurance


    On May 31, the Anqing Municipal Medical Insurance Bureau announced the completion of the first batch of 25 kinds of national centralized procurement of medicines surplus reserve fund allocation work
    .


    The notice shows that 123 public hospitals in the city participated in the first batch of national centralized procurement and use of drugs.


    In addition, Shanwei City also recently issued the "Notice of Shanwei City on Fully Implementing the Policy for the Retention of TCM Insurance Funds for Centralized Drug Purchase by the State".
    The notice shows that 27 designated medical institutions in Shanwei City have passed the assessment.
    % Of the available balance of medical insurance funds is 1.
    747 million yuan, which will be allocated and cashed on May 30, 2021
    .

    With the successive implementation of policies, the demand for pharmaceutical companies to change their marketing models has become increasingly urgent
    .


    In addition to the policy of retaining the amount of purchase balance, there are many policies in the new medical reform that have the effect of restricting the sales of pharmaceutical companies
    .

    For example, under the payment of DRGs, medical staff takes into account the impact of hospital assessment, balance incentives and other aspects.
    Reasonable diagnosis and treatment, fewer prescriptions, and prescription of cost-effective drugs will bring benefits to the hospital compared to unreasonable drug use methods such as prescribing large prescriptions.
    Bigger
    .
    The model of selling with gold was naturally eliminated by the hospital market
    .

    All in all, in the context of the country's deepening of the medical reform, the mode of sales with gold for pharmaceutical companies is facing failure, which will have a revolutionary impact on the business behavior of pharmaceutical companies
    .
    To achieve good development, improve core competitiveness has become a path that pharmaceutical companies must choose
    .

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