Medical network - July 21st July 19, 36 health human resources and social security ministry announced the negotiations successful drug list, and released in April this year early predecessors' club of 44 intends to negotiate drug list, compared to negotiate the success rate of 81.8%. Compared with the success rate of 60% of the negotiations in 2015, the number of medical insurance negotiations and the success rate of negotiations have increased.
Classification success rate
Chinese medicine injection is the lowest
Of the eight drugs that failed to negotiate, seven were injectable. The drug list has 25 injectables and 18 successful negotiations, with a success rate of 72 percent.
No negotiations successful drugs, there are three Chinese medicine injection, respectively in yunnan teng medicine Pharmaceutical Co., Ltd. Heart pulse lung fluids, Tianjin Chase Sun Pharmaceutical Co., Ltd. Will the blood of net injection and the arrogance of Tianjin tasly Pharmaceutical Co., Ltd. After injection for reasons of gas pulse (freeze). There are six Chinese medicine injections in the list of drugs to be negotiated, and the final three negotiations have been successful, with a success rate of 50%.
Three chemical medicine no negotiations success, respectively, of injection of cisco pharmaceutical co., LTD. Nanjing green leaves with paclitaxel liposome, biochemical pharmaceutical co., LTD. Of guangdong temple for injection yuri orlov kling and Patheon Inc., a wave of raw piece. The wave raw temple is to treat the WHO Ⅲ period and Ⅳ period of primary pulmonary hypertension patients of pulmonary hypertension, or pulmonary hypertension caused by scleroderma rare diseases. The drug list has five chemical injectables, and the three successful negotiations have a 60% success rate.
The two biological products that were not successfully negotiated were monoclonal antibodies, which were administered to Merck KgaA's situximab injection and Cilag AG injection with inviliximab (limited crohn's disease). There are eight monoclonal antibodies in the list of drugs to be negotiated, and the final six negotiations have been successful, with a success rate of 75%.
Three ways
If you want to negotiate success, you must lower your price
Health insurance payment standard price including fund of insurance of primary medical treatment and ginseng protect personnel to pay the full cost of the including patients' out-of-pocket expenses, which means that health care payment standard for the highest retail price. General office of the state council on perfecting public hospital drug centralized procurement guidelines "2015 no. 7 mentioned" part of patent medicine, the sole drug production, establish a transparent, participating mechanism of price negotiations. Negotiations result in national drug supply security integrated management information platform, hospital drug procurement according to the negotiation result ". Comprehensive zero-rate policy, the standard price of medical insurance payment can be regarded as the highest retail price, and the hospital direct purchase price.
In 2015, the price reduction of the three negotiating drugs in the commission of the commission was 67%, 54% and 55%, respectively, for the drug tenofovir, ekelinii and geirinib. According to people club department, compared with the average retail price of 2016, 36 negotiations drug average decline reached 44%, the highest reached 70%, most of the imported drugs after negotiation payment standard is lower than the surrounding international market price.
In the last two years, the bidding rules require that the pharmaceutical industry reduce prices by referring to the lowest price of the bidding in the provinces and the price adjustment of the lowest price. By combining the price of guangdong into the market in 2017 and the lowest price in the country in the past five years, we can get a general idea of the price reduction of the negotiation drugs by comparing the standard price of medical insurance paid by the ministry of social security.
Salty reach data V3.2 found that compared with the lowest price on the market at present, the treatment of locally advanced or metastatic non-small cell lung cancer of hydrochloric acid for it of roche medicare payment standard price reduction is the largest, is 65%. Hydrochloric acid for it's originally is one of the health development planning commission five talks drugs, but in the end no list released into the health development planning commission, the steep price is expected to refer to the final into development planning commission negotiation drug list of competing goods for ek, the treatment and the price for ek's final negotiation price is 66.62 yuan (125 mg/tablet), (for he is 235.8 yuan (250 mg/tablet).
Glaxosmithkline toluene sulfonic acid for lapa, chips and jiangsu hengrui pharmaceutical co., LTD mesylate path for piece of reduction were 42% and 37% respectively, the price is 70 yuan respectively (250 mg/tablet) and 250 yuan (250 mg/tablet). When tyrosine kinase inhibitors antitumor drugs will enter the age of 200 yuan ($200), the end market price war is about to begin.
Similar indications of competitive products, health care the price difference is not too big, such as novartis's licensed injection of medicare payment standard 5700 yuan/branch, chengdu yasuhiro miyata compaq heap eye ophthalmic injection of 5550 yuan /.
Compound Huang Dai piece before 2013 prices are below $4.8 per piece, started in 2014 to give drug policy, drug prices increase (to 13 yuan/piece above), if the reference price of 2013 years ago, medical insurance payment standard value and guangdong into the market/the lowest upside down will occur.
Table 1. Price reduction range of health insurance payment
(source of information: salty da data V3.2)
Routine 2 enter the negotiation directory to be limited?
Who planning commission three talks drug tenofovir two pyrazole cefuroxime ester of the limits of medical insurance for "limit has active hepatitis b diagnosis and inspection of evidence", the treatment for ek, and have been "limit of EGFR gene mutation sensitive advanced non-small cell lung cancer".
This successful drugs in 36 kinds of negotiations, only three products are not restrict the use of range, for shenzhen xinli tai o blood pressure medications, ester piece of sand, astrazeneca quetiapine for the treatment of schizophrenia zyban, glaxosmithkline paroxetine hydrochloride for the treatment of depression enteric relievers - piece.
The elloitinib hydrochloride tablet is "advanced non-small-cell lung cancer in the highly susceptible mutations of EGFR." Presence who planning commission talks eventually quit drug list base pharmaceutical drug lenalidomide capsule has entered the list of social medical insurance negotiations successful, reduction of 38%, its scope of coverage limit "limited has received at least one treatment of adult patients with multiple myeloma, and satisfy the following conditions: one is every 2 courses of treatment is required to provide effective evidence rear can continue to pay; the second is by tertiary hospital blood or blood specialist hospital physicians prescription; 3 it is used in combination with boron for m does not grant to pay".
Except indications and hospital level limit, 36 negotiations successful drug health care new restrictions are: 1) the patients age, such as a licensed injection and compaq heap eye ophthalmic injection were limited to wet age-related macular degeneration patients over 50 years of age; 2) the qualification of the prescribing physician, such as the use of borotizo for injection, must be prescribed by the blood specialist or the blood specialist hospital of the tertiary hospital; 3) payment amount limit, such as licensed injection and compaq heap eye ophthalmic injection every eye accumulated up to pay 9, annual pay at most four teams, each vial astragalus polysaccharides, ginkgo diterpene lactone meglumine injection and lactones ginkgo biloba injection single hospital pay 14 days at most. 4) the interconnection between competing products will not be reimbursed, as if it is limited to the treatment of polymyeloma and borotizolam, which is not payable if used jointly.
The standard price of the standard three insurance is the highest retail price, and the proportion of patients who pay is still to be made
Medicine health development planning commission three talks, or club 36 negotiations successful drugs, eventually brought into the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue (2017 edition) "(hereinafter referred to as drug directory) b range.
The proportion of medical insurance is not 100% reimbursement, according to different grade hospitals, patients pay different proportions. The human resources and social security ministry about 36 kinds of drugs should be brought into the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue b range of notice, fund of insurance of primary medical treatment and ginseng protect personnel allocation proportion determined by the region as a whole.
As of July 19, 2017, salty V3.2 reference data for payment after the Shanghai part of the drug centralized purchasing list of varieties and ego personal rating standards and in fujian province, the pharmaceutical joint limit sunlight procurement directory (first batch) and health care the highest selling price and payment settlement price ", the treatment of astrazeneca pharmaceutical tablets, 250 * 10 mg / 1 board/box, Shanghai conceit of 950 yuan, highest in fujian province for 1414.8 yuan reimbursement ratio (60%); There is a 125mg * 21 tablet/box, Shanghai self-payment 570 yuan, and fujian maximum reimbursement of 839.5 yuan (60% reimbursement); Fumaric tenofovir dipyride tablets 300mg * 30 tablets/bottle, Shanghai pay 200 yuan, fujian maximum reimbursement 294 yuan (reimbursement rate 60%). Thus, Shanghai and fujian have different standard, encountered in fujian province development planning commission three talks pays amount of the drug is in proportion, the patient pays 40%, reported in fujian province on March 7, medicare drug payment settlement price formulation principles of 50% 10% decline. The amount of out-of-pocket payment is fixed in Shanghai.
Salty data V3.2 found, beacizumab bead single ampoule and vial by bead sheet resistance to previously released in Shanghai pays an individual norm standards higher than people club department released the payment standard value, expected future related products will be adjusted correspondingly.
Table 2 standard comparison of medicare payment standard and Shanghai patients' conceit standard
(source of information: salty da data V3.2)
The health insurance payment standard of 36 successful medical insurance negotiations will be effective as of December 31, 2019, and will be adjusted according to the relevant provisions of the medical insurance payment standards after the expiry date. Within the validity period, if there is a listing of generic name drugs (generic drugs), the department will adjust the medical insurance payment standard of the drug with the price level of generic drugs; If the actual price of drug market is significantly lower than the current payment standard, the payment standard will be adjusted.
|
