The total budget of the regional point method and the payment by disease score have an impact on the geometry of pharmaceutical companies?

On October 19, 2020, the State Administration of Health Insurance issued the Pilot Work Programme on the Total Budget of the Regional Points Law and Paying by Disease, requiring provinces to organize the declaration of pilot cities and report them by October 20.
proposed:
1-2 years time, the overall regional health insurance budget and the point method combined to achieve hospitalization to pay according to the disease-based multi-composite payment method."
" gradually establish a system of payment for medical services based on diseases and results-oriented.
", the pilot scope is based on the city-level co-ordination zone, which covers all medical institutions within the jurisdiction.
"" to implement big data-based regulation.
" to strengthen the monitoring of key diseases to ensure the quality of medical care.
at first glance, none of them directly involved pharmaceutical companies.
carefully examined, each one has a profound meaning.
this paper, the author tries to explore the "regional points method total budget , pay by disease score , big data regulatory use" on the pharmaceutical companies what impact? From disease species to varieties, points reflect top-down changes in the regional points method covering the total budget, covering all medical institutions, and possibly almost all disease types, health insurance payment methods.
as an example of a single disease, all medical and medical services currently carried out around the disease, as long as it is paid, will cost a mark, will enter the big data pool.
to the clinical treatment of diabetes as an example, there are more than a dozen categories of drugs, in the past to choose different drug treatment options, of course, there are economic differences.
the future to observe the treatment drug treatment program, not only from the professional evaluation of technical, more convenient from the economic rationality of the evaluation.
means that not only is the prescription given by the doctor according to the individual conditions of the patient economical, but also the relevant enterprises, products reflect on how to price, price adjustment, actively adapt to the impulse of the love ratio.
from medical care to medical insurance, the value to prove bottom-up proposition in the past, related enterprises, products as long as the hospital access, clinical volume will do everything quickly.
After the pilot expansion of the "Regional Points Total Budget , Pay by Disease Score , and Big Data Supervision", any enterprise or product must have great ambition and determination to continue to nest in a few cooperative hospitals, apparently unable to withstand the test of big data cleaning problems.
endless competition enterprises and products without gold and quantity have a profound impact on the relevant track, attracting the regulatory authorities of comprehensive medical reform to do key monitoring.
Because the direction of reform is efficient and transparent, companies and product competitors are no longer just familiar peers, including prevention, treatment, rehabilitation services, including cross-category, intergenerational drug consumption, can bring competition in cost data.
Pay by disease, the pricing advantages and disadvantages of innovative drugs through anti-cancer drug negotiations, to solve a part of the market just need drugs to the medical insurance drug market penetration problems, at that time did not commit to agree on the purchase volume, or to the greatest extent adhere to the market principle.
is to believe that patients have needs, second, to believe that hospitals will support, third, to believe that competition needs to be perfected, and fourth, to believe that domestic alternatives.
Whether local or imported patented drugs, they are innovative only a few years before generics, similar drugs and the latest drugs are available, and they must have precise safety effects before they can be priced and adjusted more freely.
Pay according to the disease score, grasp the data, the innovative medicine is not good, and then the good things should be compared to the price, but also have the appropriate price;
to pay for the disease by disease, it is an unprecedented opportunity for the pharmaceutical industry to go wrong.
data analyzed data on the cost of treating diseases in thousands of co-ordination areas on the basis of big data.
any pharmaceutical company, the pharmaceutical business, it's very difficult to cover the whole country, all the pharmaceutical institutions, of course, the idea can be a goal.
, but at least one or two varieties, on the rules, adhere to this idea is extremely uneconconconconental, extremely unrealistic, extremely crazy imagination.
the method of paying according to the disease score, this limitation in pharmaceutical production and circulation is used for the comparison of big data differences.
as long as the timely direction of efforts, the pharmaceutical business can tell the disease treatment costs are abnormally high areas: you are lack of good materials.
we look forward to more data opening up to the industry.
predictable: pharmaceutical research and production will not be so crowded, will encourage differences.
The real cage for birds, from auxiliary drugs to serious diseases is well known, patients suffering from serious diseases prescription over-prescription of chemotherapy drugs is a financial disaster, prescription over-assisted drugs are also a financial disaster, but the nature of some light.
"Pay by disease score plus big data supervision" can not only compare the differences in the types and regulations of drugs used in and outside the region, but also compare the number and amount of complementary drugs.
, from the medical insurance payment performance, hospital management performance dimension, auxiliary drug use is the first, the need for standardized use, economic prescription.
the medical insurance resources and cost space freed up by the Government will unconditionally tilt towards the reimbursement of drugs for the treatment of serious and extreme diseases, focusing on alleviating the "difficult to see a doctor expensive".
medical insurance, medical treatment, drug consumption, patients and other data will form the ocean between the integrated areas of the pay-per-view mechanism operating level, like the four oceans interconnection.
several characteristics can be shown: First, sea level is actually not equally high, but the difference is not great.
is that the ocean floor terrain of each sea area is different, and the sea weather is different.
the third is that there will be rich and orderly currents, pulling the ocean around again and again.
thursday are frequent storms and waves that hit similar beaches around the world.
providers of medical and pharmaceutical services in this ecological environment: may crystallize like salt, reflect a certain value;
process may be extremely slow, similar to the cycle of fossil formation, but the direction has not changed.
there must be a boat at sea, likening the hospital to a ship, and medicine is placed on a small boat.
if the ship is crushed and old and heavy, there is a danger of capsized and sunk together.
DRGs can be hailed as a giant cruise fleet, offshore factories or breeding nets, from DRGs or any fine management was born to manage efficient medical insurance payment results, have the origin label, have confirmed the medical law and health assessment, will be passed on.
a small number of patients may be selected for entitlement observation, a small group, a small group of doctors may be hired as consultant doctors, time will be left to the end of the trigger.
"Regional points method total budget , pay by disease score , big data supervision" has a wealth of international comparative experience, from the national level to promote the provinces and cities to start the pilot, open bow no back arrow, will only "a thousand miles trip, starting from the foot."
's better than anything for a drug company that wants to be an officer and can make a business.
are worse than anything for companies and products that go the other way based on competence and ideas.
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