Wei Jian Strictly Controlled Hospital Drug Use: 20 Kinds Of Divine Drugs, 18 High-Value Consumables Accounted For The Proportion Of Refined Assessment.

Recently, the National Health Council has requested that all three level public hospitals should complete the performance appraisal data collection in August 5th by -6, 19 and two hospitals in June 12, 2020.

From the two level and three grade hospitals' public hospitals performance evaluation manual (2020 Edition) issued by the National Health Protection Committee, they all referred to the requirements of the proportion of drug income, including the key monitoring of the proportion of high-value medical consumables, the proportion of key monitoring drugs and the proportion of auxiliary drugs, and the proportion of high value medical consumables accounted for the new assessment content. In the manual, the National Health Council has named 20 kinds of national key monitoring and rational drug use and 18 kinds of key national high value medical consumables.

"Drug proportion assessment and strict control of supplementary drugs are the use of medical insurance expenses at the end of the hospital. This kind of policy is from the first step to the present classification and detailed management, which shows that the management of the management department is gradually deepened and refined. When the management is mature, it is natural to extend the management of high value consumables. In June 10th, Wang Ying, CEO, told the reporter of twenty-first Century economic report that the state's medical reform policy is a set of sophisticated combination boxing, which takes the "three medical linkage" as the core and interacts with each other step by step.

Based on the above background, Wang Ying analysis said that in order to make the medical products return to the treatment attribute, enterprises must redefine the marketing system, and the gold sales mode will collapse completely. We must restructure the marketing system around the government procurement, and the R & D and innovation capability will become the main ability of the enterprise to grow or expand.

The proportion of divine drugs and high value consumables

The national two level public hospital performance appraisal operation manual (2020 Edition) requires that two hospitals should make statistics on "the proportion of key monitoring drug revenues"; "national three level public hospitals performance appraisal operation manual (2020 Edition)" requires three hospitals to count the proportion of auxiliary drug income.

The contents of the two level hospital statistics are the provincial key monitoring and rational drug use list based on the first batch of national key monitoring and rational drug list. The three grade hospitals are required to inform the first batch of national key surveillance drugs list of rational drug use, and all levels of health and health administrative departments, Chinese medicine authorities and medical institutions should establish and perfect the monitoring system for drug clinical use and supernormal warning system, and strengthen the monitoring and performance appraisal of clinical use of drugs.

In July 2019, the first batch of the first batch of national key surveillance drugs for rational use of drugs was issued in 20 varieties, many of which are called "magic drugs". According to the rice network database, the sales volume of these 20 varieties in China's public hospitals in 2018 totaled 65 billion 280 million yuan. Gangliosides, oxygen, alprostadil, edaravone are over 5 billion varieties.

It is worth noting that in the performance evaluation of the two or three tier hospitals, the state also added the assessment of the proportion of high value medical consumables, and monitored the 18 varieties of the first batch of national key medical consumables list.

In fact, for a long time, the phenomenon of abusing the heart support and the cost of Department of orthopedics consumables has always been criticized. These areas have also become the key areas to increase the medical burden of the masses and waste the medical insurance fund. According to data, in 2018, the market scale of cardiovascular and cerebrovascular intervention consumables was as high as 53 billion 590 million yuan. In recent years, the market scale growth rate was over 18%. The scale of Department of orthopedics implant market in China increased from 11 billion 700 million yuan in 2013 to 25 billion 800 million yuan in 2018, and the annual compound growth rate was 17.14%.

Wang Ying pointed out to the twenty-first Century economic report reporter that the proportion of high value medical consumable drugs is actually a matter of course. In recent years, the state has gradually strengthened the supervision of high value medical consumables. In July 31, 2019, the State Council issued the reform plan to control high value medical consumables. It pointed out that we should focus on the key problems of high value medical consumables such as high price, excessive use and so on. The main measures are to improve the price formation mechanism, reduce the high price of high value medical consumables, regulate the medical services, strictly control the unreasonable use of high value medical consumables, and improve the supervision and management mechanism. To investigate and punish illegal activities.

In June 8th, the National Health Protection Commission also issued the "Provisional Regulations on the management of medical consumables for basic medical insurance (Draft)" for public consultation. At the same time, high value medical consumables are being purchased everywhere. At the beginning of May, Hu Jinglin, director of the state health insurance bureau, attended the open information conference on high-value medical consumables in nine provinces of Tianjin, including Tianjin.

Products return to essence of treatment

From the operation manual, the proportion of the drug has also made clear the specific algorithm.

In fact, last year, the opinions of the general office of the State Council on strengthening the performance appraisal of the three level public hospitals eliminated the hospital assessment indicators such as the proportion of single medicine, consumption ratio and so on. Zhang Zongjiu, director of the state health and Health Commission, director of the medical and Political Bureau, said that the performance appraisal used the relevant indicators of rational drug use instead of the single drug proportion index, paying more attention to the rationality of the prescription of the medical staff and the quality and safety of the patients. This indicates that the performance appraisal of public hospitals has opened a prelude to fine control fees.

"Meticulous management and control of the proportion of drugs will better control the cost of medical insurance." The chairman of Baiyang pharmaceutical group told reporters on twenty-first Century economic report.

For example, the Interim Measures for the management of medical consumables in basic medical insurance (Draft for solicitation) also put forward that this method is aimed at standardizing and strengthening medical consumables medical insurance access and payment management, deepening the reform of high value medical consumables, improving the utilization efficiency of medical insurance funds, improving the level of medical consumables for basic medical insurance, and safeguarding the health rights and interests of the masses. Strengthening the management of clinical application of supplementary drugs is also an effective way to deepen the reform of the medical and health system, control the unreasonable increase of medical expenses in public hospitals, and reduce the burden of patients seeking medical treatment.

From the previous results, after monitoring the above 20 categories, although there is no statistical impact on sales volume, these drugs involve more than 20 listed companies such as tetracyclic medicine, fosstar medicine, Li Zhu group, Kunming Pharmaceutical Group, Sai Sheng pharmaceutical company and step pharmaceutical company.

After being included in the national key monitoring catalogue, the above drugs were hit by the medical insurance catalogue, and the sales volume dropped sharply. For example, there are 7 drugs in the Fourth Ring Road medicine. In the 2019 annual report, tetracycline pointed out that the revenue of cardiovascular and cerebrovascular products decreased by 12.8% to about 2 billion 343 million yuan during the year, accounting for 81.1% of the group's total revenue. The decrease in sales was mainly due to the monitoring of drug catalogues.

In this regard, Wang Ying believes that enterprise products should return to the nature of treatment. The definition of unrealistic treatment of medicine is all in the essence of product treatment, and the fancy function of equipment consumables will all return to the nature of treatment or adjuvant therapy. At the same time, enterprises must redefine the marketing system. The customers of enterprise marketing become the government. The marketing system must be re built around the government procurement.

Zhao Ning, deputy chief pharmacist of No.1 Hospital of Peking University, told the economic news reporters in twenty-first Century, "in fact, more efforts are needed at the national level to promote rational drug use. In this regard, the role of clinical pharmacists is great. However, under the operation system of hospitals, clinical pharmacists need to carry out various statistics and calculate various proportions to doctors' medication. Many doctors will think that they are being "managed" and opposed to clinical pharmacists instead of working together to better treat patients. Zhao Ning pointed out.

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