97 big varieties of winning ways

On December 18, the document No 73 issued by the state health insurance bureau and the health and Health Commission officially promoted the sustainable development of the pharmaceutical industry at the national level, with clear objectives, "to promote the implementation of national health insurance negotiation drugs in 2019 as soon as possible, so as to ensure that the majority of insured patients can enjoy the relevant treatment as scheduled" This measure will catalyse 97 large varieties of medical insurance negotiation and reshape the pattern of clinical medication Yesterday, the people's network issued another document "to promote the implementation of national health insurance negotiation drugs as soon as possible", according to the 2020 health insurance directory implementation still has 12 days Large varieties will be redefined on the premise of high quality and low price for the benefit of the common people 1 The past clinical large varieties, mainly cardiovascular and cerebrovascular clinical large varieties in China, have remained basically stable There has been no qualitative change in the past decade They are all affiliated to several large pharmaceutical enterprises, such as Pfizer, Yangzi River, Sanofi, AstraZeneca, etc Pfizer is the most eye-catching of the top ten, occupying two seats The threshold of the top ten clubs has been raised to 5 billion yuan According to the data, the terminal sales of salvianolic acid salt for injection of the 10th Shanghai Green Valley Pharmaceutical Co., Ltd in 2017 totaled 4.89 billion yuan The top ten clinical varieties come from five treatment fields, namely, cardio cerebrovascular, analgesia, anti infection, respiration and tumor Among them, six places were taken away from cardiovascular and cerebrovascular products, more than half of them According to the calculation of 5 billion yuan, the sales volume of cardiovascular and cerebrovascular products accounts for more than 60%, which is contrary to the emphasis of clinical rational drug use The characteristics of these large varieties: for many years, the company has maintained billions of sales and covered many hospitals with favorable policies For example, with the help of more than 12900 AstraZeneca standard atomizing rooms, the company has successfully pushed the company to the first-line treatment Not only in large hospitals, but also in many community hospitals as the first choice treatment plan 2 For the current large varieties, it is not possible to implement the high-quality and low-cost medical insurance According to the three implementation evaluations of the medical insurance negotiation catalogue of 31 provinces and cities, only 7 provinces and cities have achieved good implementation, while others are good, poor and poor Among them, the health and Health Commission issued two documents requiring hospitals not to influence the supply guarantee and rational drug demand of negotiated drugs on the grounds of total control of medical expenses, total control of medical insurance expenses, "drug proportion" and limit of drug varieties; only four provinces and cities issued documents and negotiated drugs did not account for total control of expenses, and 22 provinces and cities issued documents did not include drug proportion Therefore, it is particularly important for the negotiation drugs to benefit the people 97 negotiation varieties entered the national medical insurance catalog through substantial price reduction, and the Bureau / Commission Document No 73 guaranteed their growth From the perspective of the health insurance negotiation, the key evaluation varieties include more than 10 clinical treatment fields including cancer, rare disease, hepatitis, diabetes, multi drug resistant tuberculosis, rheumatism immunity, cardio cerebrovascular disease, digestion, and other major domestic innovative varieties These varieties cover more fields and are also clinically necessary 97 negotiation catalogue products, basically with low price, exclusive and historical mission, make people have the characteristics of sense of gain 3 In the future, large varieties should be innovated and conform to the national medical reform strategy With the strong return of China's pharmaceutical research and development, China's innovative drugs will affect the global pharmaceutical research and development in the future After 2013, 250000 R & D talents in China's pharmaceutical field will flow back, greatly ensuring the construction of talent ladder in China's R & D Lingteng pharmaceutical was established in 2017 Recently, it submitted the clinical application of cardosol double anti drug, becoming the first double anti drug in the world Even innovative drugs need to have Chinese characteristics and conform to the national medical reform strategy There is a "patent cliff" in the foreign pharmaceutical industry, that is, the price of drugs remains high within the patent period, helping pharmaceutical companies recover high R & D costs Once the patent expires, the price "precipice" falls This is different in China During the patent period, price reduction is also needed, only for the benefit of the people For example, "4.4 is too bad" dagliejing experienced the experience that the lowest price in the world continues to be cut Relying on national endorsement to achieve a large variety of Chinese characteristics will become the first national centralized procurement and the first national health insurance negotiation, which will promote the completion of China's medical reform The shortlisted varieties mean getting national endorsement The national negotiation of 97 major varieties also lays the foundation for the continuous expansion of the medical insurance catalogue with Chinese characteristics 1 Large varieties shoulder the national mission to help solve the problem of expensive medical treatment The average price reduction of large varieties is more than 60%, which is the first large-scale collective price reduction of national medical insurance catalog products These large varieties are timely landed, which will save the treatment cost for patients to a certain extent, and help the medical reform to solve the overall goal of "expensive medical treatment" 2 The growth of large varieties promotes the clinical rational use of 97 medical insurance negotiation large varieties, all of which are clinically necessary products with good efficacy and safety The rapid growth and development of these products will change the clinical drug use structure to a certain extent, promote the rational use of therapeutic drugs, and reduce the use proportion of auxiliary drugs 3 During the patent period, there is also a price reduction This is a medical insurance reimbursement system with Chinese characteristics The unique feature of this medical insurance negotiation is the price reduction of patented products, which is different from the medical insurance and medical reimbursement models of most countries in the world Most European and American countries are "patent cliff", and the price level of products within the patent period remains high In China, not only the "patent cliff" is promoted through national centralized procurement, but also the "price reduction of products within the patent period" reflects the medical insurance reimbursement system with Chinese characteristics During the patent period, price reduction will explore a new way for the future medical reform, and carry out top-level design from the perspective of the benefits of the state, enterprises and patients, so as to achieve a win-win situation among the three parties The way to win for a large variety of products is to hang the net, enter the hospital and replace them Liu Qian said that speed is everything No matter how fast you hang the net, enter the court or replace it, it's only 730 days from the beginning to the end of the game 1 97 large varieties of national empowering drugs are directly linked to the network on the provincial drug centralized purchase platform according to the time limit stipulated by the Ministry of human resources and social security of the State Health Insurance Bureau on the inclusion of negotiation drugs in 2019 (medical insurance Fa [2019] No 65) This means that the country saves time for varieties to enter the clinical practice, which can be implemented on January 1, 2020 According to the Beijing Sunshine procurement platform, Pfizer's tofacib, a new negotiating product, was admitted to three hospitals in Beijing at the price of medical insurance 2 The people's network of 97 large varieties directly entered the hospital issued a document today "to promote the implementation of national medical insurance negotiation drugs as soon as possible" The second point is to promote the timely entry of negotiation drugs into designated medical institutions Local medical insurance, health and other departments shall, according to their duties, put forward specific requirements for the allocation and use of negotiated drugs, and guide designated medical institutions to allocate and use drugs in a timely and reasonable manner according to their functional orientation, clinical needs and diagnosis and treatment capabilities From the documents issued by the medical insurance bureau and the health care commission to the interpretation of the people's website documents, it is once again clear that the state's further management of the drug directory of medical institutions is reflected in "timely access" at the same time Beijing medical institutions have been at the forefront in responding to the implementation of national policies It is reported that several top three hospitals in Beijing have started preparations for pharmaceutical conferences, will complete the bill of lading in December, and a number of foreign medical insurance negotiation products have submitted the drug demand list to the pharmaceutical Committee of the hospital Another hospital with a long history in the core area of Beijing has adopted the policy of "one entry, one withdrawal", that is, an enterprise needs to apply for a variety to withdraw from the drug catalog of the hospital With the implementation of the negotiation catalog, the hospital opens a "green channel" for the negotiation drugs 3 According to document No 73 of 97 large varieties directly replaced by state authorized energy, measures can be taken to encourage alternative use of drugs that have higher cost performance and can be completely replaced compared with the original drugs in the medical insurance catalogue before the negotiation In this way, the products with high clinical price and similar benefits for patients will be replaced to promote the implementation of the results of medical insurance negotiation and benefit patients Only by directly hanging on the Internet can we save time for reform; only by ensuring access to the hospital, can we promote the effective implementation of reform; only by replacing, can we benefit the people with the reform dividend Only by reflecting the speed can we become a big variety in the future We will wait and see 37 statement: This article only represents the author and does not represent the position of yaozhi.com You are welcome to communicate and supplement in the message area If you need to reprint, please be sure to indicate the author and source of the article.