This weeks important drug message interpretation

Chenghui Shuangda

Cancel the drug ratio,Fine control fee assessment Kicked off

With the publication in January 2019 of the "Opinions of the General Office of the State Council on Strengthening the Performance Evaluation of Third Class Public Hospitals", the reform of indicators for third-level public hospitals was formally launched. The task of 2019 is to launch the performance evaluation work of third-level public hospitals throughout the country, establish a performance evaluation index system, a standardized support system, and a national and provincial performance evaluation information system, and explore the establishment of a performance evaluation mechanism. The goal is to basically establish a relatively complete three-level public hospital performance assessment system by 2020.

Graded diagnosis and treatment will be further advanced, chronic diseases(such as hypertension and diabetes) will be further reduced to primary care, and tertiary public hospitals will pay more attention to surgical patients, rare diseases and difficult diseases. This can be seen from the second level of functional positioning indicators under the first level of medical quality indicators of the third-level public hospitals. The third-level public hospitals pay more attention to hospitalized patients, and the third-level public hospitals must also turn to the second-level hospitals or grassroots medical institutions. Emergency and inpatient. The scale of outpatient medicine, especially chronic medicine, in tertiary public hospitals will likely gradually decrease, and the market size of chronic medicine(especially hypertension and diabetes) in primary medical institutions is expected to increase.

The "drug ratio" is replaced by old ones. The three-level public hospital does not have the three-level indicator of "the proportion of drugs outside the medical insurance catalogue", and its assessment standard is "the proportion of drugs outside the medical insurance catalogue decreased or remained stable in the previous year". The 2019 edition of the third-level public hospital indicator policy is more concerned with the proportion of auxiliary drug use income, that is, the proportion of auxiliary drug use income to the total drug income, auxiliary drug use will be based on the National unified regulations, and the scale of the auxiliary drug market will be further reduced in the future.

73 species auxiliary medication primary breed exposure

The Letter of Consultation on the Notice for Conducting Drug Use Monitoring and Clinical Comprehensive Evaluation(Consultation Draft) was circulated in the industry, and a table of 73 auxiliary medication primary breed drug types was released.

The State shall carry out comprehensive monitoring of all public hospitals to report on their equipment, production enterprises, quantity of use, purchase price, supply and distribution as required. At the same time, no fewer than 1,500 public hospitals at all levels throughout the country have been selected, and on the basis of comprehensive monitoring work, specific data related to drug use and disease prevention and follow-up have been monitored.

Starting from the "4 +7" quantity procurement policy, we can gradually see the rhythm of the national policy: the first result, and then the supporting policy. Not long ago, the National Health Care Commission issued the "National Basic Drug Catalogue" and proposed that the "Basic Drug Catalogue" will be dynamically adjusted. The so-called miracle drugs and auxiliary drugs that are costly and have no clear curative effect are the key points. This shows that Shiweijian has decided to raise the concept of "auxiliary drug use" to the national level. As health care reform enters the deep water zone, it is the future direction to use health insurance effectively, to return to the essence of drug treatment, and to promote drug research and development and innovation. At this time, the state's auxiliary drug use is a foot in the door, raising the auxiliary drug monitoring to the national level, and then pulling it down to the altar.

Fujian wants the province to follow up on "4 +7" quantity procurement

Recently, the relevant departments of the Fujian Provincial Government organized a symposium to follow up on the use of national collections to solicit opinions on the "Fujian Province's comprehensive implementation of the implementation plan(discussion draft) for the follow-up of the National Drug centralized procurement and use pilot work". According to the requirements of the National Medical Insurance Bureau, in the first quarter of 2019, the "4 +7" pilot cities need to implement the results of procurement negotiations. From the perspective of the Fujian program, Xiamen is expected to begin implementation on March 1, while Fujian Province will implement it on April 1.

Fujian has always been the "pioneer" of medical reform. It has made useful attempts in the work of the medical insurance bureau leading the centralized procurement of drugs and the two-vote system, which can be regarded as a vane for medical reform in the country. This time, Fujian Province took the lead in a province with 60 % of the market and entered the 4 +7 volume procurement pilot. This has important demonstration significance for the nationwide promotion of this procurement model and will accelerate the subversion of the industry. Prior to this, the industry analyzed that with the entry of Fujian Province, the price of related varieties may be further reduced.

21 Rare Disease Drugs Tax cut from March

On February 11, Premier Li Keqiang of the State Council presided over an executive meeting of the State Council to listen to the proposals made by the two national committees in 2018 for handling work reports, deploy measures to strengthen the early treatment of early cancer diagnosis and drug use, and decide to grant VAT concessions to rare diseases.

From March 1st onwards, for the first batch of 21 rare diseases drugs and 4 raw materials drugs, a value-added tax of 3 % will be levied on the import link with reference to anti-cancer drugs. The domestic link can choose to apply a 3 % simple method to collect value-added tax.

In recent years, China has continuously strengthened the management of rare diseases. In May 2018, the five ministries and commissions jointly issued the first list of rare diseases, which included 121 rare diseases. At the same time, we will formulate norms and guidelines for the diagnosis and treatment of rare diseases and carry out training for relevant medical personnel. The relevant person in charge of the National Weijian Commission stated that in the future, according to the principle of prevention, classification, and steady progress, measures will be taken to reduce the incidence of rare diseases and mobilize all forces to further care for and support patients with rare diseases.


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