With lower health spending, DRG and DIP will also bring about five major changes

, compared with some developed and developing countries in the world, China's health care expenditure has increased alarmingly in the past 20 years, not parallel to gdp growth per capita. At the same time, population aging, urbanization, westernization of life, health insurance coverage of the whole population, become "difficult to see a doctor" "expensive to see a doctor" pain point of the source.In June 2019, the State Health Insurance Administration, the Ministry of Finance, the National Health And Wellness Commission and the State Administration of Traditional Chinese Medicine jointly issued the Notice on the List of Pilot Cities Paying for Groups Related to Disease Diagnosis, identifying 30 cities in Beijing, Shanghai and Tianjin as pilot cities for paying for disease diagnosis-related subgroups, and requiring pilot cities to ensure the simulation operation in 2020 and the start of actual payment in 2021.

health insurance payments are paid for as aSimulation calculations show that China's vast geographical area, economic development is extremely unbalanced, manifested in the huge difference in health insurance income, the level of medical care at all levels of hospitals are far apart, even the same level of hospitals on the concept of disease treatment, methods, etc. are also very different, which is a challenge for DRG to roll out next year.In this context, on November 20, the State Health Insurance Administration published the "National Health Insurance Pay-as-You-Go (DIP) Technical Specifications" and "DIP Disease Directory Library (version 1.0)". This is the announcement of 71 pilot cities on November 3rd, the National Health Insurance Administration to promote DIP pay-per-disease points of another substantive initiative, as a supplement to the DRG landing.In the future, health insurance payments will implement the "pay-as-you-go" principle, which requires medical institutions to improve the cost-effective treatment, the diagnosis of diseases, treatment (non-drugs), drug treatment, hospital costs and so on into the overall consideration. Under China's current medical price system, treatment costs such as surgery costs, hospitalization costs are very low relative to other industries, the first-tier cities in the same location of the hotel costs than the triple-A hospital bed costs dozens of times higher.Therefore, the cost of diagnostic supplies, medical costs must be greatly reduced, especially the cost of drugs will be greatly compressed, performance in the safe and ineffective drugs will be out, drug use will be more reasonable, drug prices will be lower, collection and other price reduction measures will continue for a considerable period of time, for the therapeutic value of innovative drugs to make more room for medical insurance payment.

supplier market-orientedDRG and DIP implementation can be used as a market-oriented medical supplier, or form the following trends: 1, health insurance cataloghealth insurance catalog to a certain extent gradually diluted, in the future may be on the basis of the national drug catalog and local pharmaceutical catalog merger, and then the Class A directory and class B catalog merged. This can really use clinical efficacy and drug use cost-effective measurement to determine the health insurance catalog, reduce the human factors in the review of the health insurance catalog and the possible corruption factors of the evaluation process, simplify the selection process of the health insurance catalog.

2, patientThe implementation of DRG/DIP payment mechanism will also guide commercial insurance mechanism to intervene, make up for the shortage of general medical insurance, pay a wider range, multi-level medical insurance system will better meet the personalized needs of medical care.

3, pharmaceutical research andThe so-called "exclusive products" if it is still only safe and ineffective will be difficult to enter the market, the future exclusive products must be based on efficacy or safety in the sense of exclusive, new products require improved pharmaceutical economics indicators, such as the same efficacy, but can reduce dosage, or improve safety, can reduce the additional costs of dealing with side effects. To avoid pharmaceutical companies blindly pursue market hot spots, to prevent repeated waste of research and development resources.Research and development pipeline and product line portfolio strategy needs to be strengthened, DIP to pay for the value of disease, to research and development drugs, to encourage truly effective innovative drugs, special drugs is good, which will guide pharmaceutical companies to pay more attention to the field of disease treatment drugs and treatment points, so-called research and development close to the market, research and development close to treatment needs, in the end, the purpose and significance of research and development is this.

4, marketingFor many years, pharmaceutical companies have been concerned about sales data, DIP implementation, pharmaceutical companies sales model changed again. Because DIP is closely related to hospital performance, hospitals avoid the use of non-essential drugs and consumables. In the future, to improve the operational effectiveness of the marketing team, it is necessary to match the relevant drugs in the whole disease field to provide a package of effective solutions for a disease, which can save marketing input and reduce labor costs. At the same time, medical representatives have new requirements. Good promotion business personnel must first have good disease and product expertise, old imitations have no so-called "promotion lubricants", not only to promote product knowledge, but also to understand the value of pharmaceutical economics, may also carry out product pipeline portfolio promotion, focusing on treatment concepts and cost-effective.

5, retail channels   At present, enterprises that are not included in the collection are looking for ways to transfer from hospital channels to the pharmacy system, using the so-called "prescription outflow" strategy. After the implementation of DRG/DIP payment, hospitals may have new problems, especially inpatient care, and some hospitals allow patients to buy medicines at pharmacies to reduce the total cost of hospitalization. In response to these conditions, some provinces and cities issued new regulations, the cost of personal health insurance accounts into the region's "co-ordination pool" to limit the outflow of prescriptions, forming a vicious circle of multi-party game. The problems that may arise in the DRG pilot above need to be supplemented and perfected by DIP.   China's large population, into a well-off society, people's health has become a priority development of the national strategy. Overall, China's medical market is still a thriving hot market, its basic needs are 2030 healthy China, medical reform will be deep and breadth of the march, but the fundamentals of medical needs will not change, change is the supply chain product structure and competitive landscape. (
Medical Economics
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