Medical network - July 10 inside the hospital pharmacy can keep the bonus, at their own expense is not affected by the bidding price, imported drugs will become medical institutions for profitable products, and not included in the medicine of the inspection system, prescription impulse obviously enhanced, imported drugs in recent bucked up trend.
National drug zero bonus on July 1, the policy is considered to be medical separate important key measures, if translated at medicine accounted for 40%, drug addition to cancel, is expected to reduce the overall medical costs by 6%, drug costs decline will adjust the leaving space for other costs, that is, "vacate basket change a bird".
At zero rate + 2 votes + camp under the policy, such as addition, more and more hospitals "pharmacy trusteeship" approach, and to promote the hospital pharmacies and hospitals, pharmacy important step towards the society.
Drug zero bonus policy measures have to cancel the registration fee, raise diagnosis and treatment fees, fees, large-scale test equipment cost reduction, etc.
Recently, the author from the summary report of zero bonus practices in Beijing and guangzhou zero bonus pricing before the meeting to know two health city will implement a slightly different zero bonus supporting policies: Beijing area mainly concentrated in the doctor diagnosis and treatment cost price reduction space, mainly focusing on lower grade hospital MenZhenLiang promote patients shunt or family doctor to the hospital. Follow the general policy of guangdong province in guangzhou, in reducing the costs of drug at the same time, the doctor diagnosis and treatment and nursing cost slightly raised, to reduce the overall health care costs of patients in grade hospital.
In view of this, Beijing policy in guangzhou I think mainly because of different area that is affected by the two cities are different, need to coordinate with other health city, guangdong province, guangzhou area. From the provinces of the nation's economy development and form a complete set of medical practice, the author thinks that the pricing scheme of guangzhou more learning significance.
▍ situation of the implementation of the Beijing area
In the Beijing area after zero bonus medical service fee increases sharply
April 8, Beijing formally implement medical reform separately. This reform mainly cancelled the drug addition and the registration fee, the fee, set up the medical service charges, and specification of medical service prices. Tertiary hospital related fee will be adjusted to: ordinary outpatient medical service fee of 50 yuan, deputy director of the physician 60 yuan, 80 yuan, director of the physician, famous experts, 100 yuan, emergency medical service charge 70 yuan, was in the hospital medical service charge $100 per bed per day.
Impact: drop drop drop
Beijing area by sharply higher level hospital diagnosis and treatment cost expense can be reimbursed (part), grassroots medical price is changeless, medical institutions will be mild, slow patients shunt to grassroots medical institutions. Beijing also promoted the family doctor give medicine door-to-door service.
From the "full moon", according to the results of tertiary hospital door always fall of er visits the biggest, at 15.1%, fell by 7.2% in the er visits in secondary hospital door. At the same time, the level and community service center MenZhenLiang increased by 3.4%. By early June, the data has a new adjustment, er visits in tertiary hospital door fell by 12.6%, fell by 4.5% in the second class hospitals, primary MenZhenLiang increased by 7.6% and the community service center.
Clinic visits to reduce at the same time, per capita also reduce expenses for medicine, further reduce dose. Drug dosage negative. Beijing "full moon", according to drug sunlight procurement platform cumulative order amount more than $5.1 billion, the cumulative savings rate of 8.2%. Until June 7, drug procurement platform sunshine order cumulative amount more than $10.3 billion, the cumulative savings rate was 8.2%, and the total saving cost 840 million yuan.
"Full moon", according to the overall inspection fee is also down, CT, mri examination workload compared with before reform this year increased by 5.5% and 5.5%, but the cost is decreased by 45.5% and 24.4% respectively, saved 110 million yuan.
Implementation effect is the largest hospital revenue, revenue decline in hospital, the doctor? After pulse through medical health reform implementation in Beijing after a month in Beijing 95 doctors in different hospital research, 61.1% of doctors reflects his department income decreased.
The implementation of the ▍ in guangzhou area
The registration fee to cancel in guangzhou, fee slightly raised
On June 13, the national development and reform commission of guangdong province website published a notice, to revision of some medical services price project in our province, will be examined the registration fee into the fee, the charge air conditioning cooling and heating into beds at the same time. Number at the same time designated by the doctor in the hospital in diagnosis examined or take tests and various test results can not charge fees.
Doctors, for example, registration fees from 3 yuan, to rise to 10 yuan, rise in far more modest in the Beijing area. But the final diagnosis and treatment cost of guangzhou adjust temporarily not give specific files, and was scheduled on July 1, the provincial medical comprehensive full implementation of the reform of the time also changed to July 15.
Guangzhou zero bonus after the diagnosis and treatment cost adjustment scheme
Compared to Beijing, guangzhou medical expenses increase relatively limited. Guangzhou reform focus more attention in reducing comprehensive medical expenses, the control of a single prescription drug expenses shall not be higher than 50 yuan, essentially by medicine proportion decreased level hospital overall health care costs. Drop in drug costs will lead to more to grade hospital patients focus remains to be seen, but the classification of guangzhou diagnosis and treatment have been implemented, is expected to administrative measures under medicare patients need to go to class and community service center first option or shunt can cause patients.
▍ zero bonus after impact
1. Domestic/import drugs clinical selective
After the industry generally believe that with the imported drugs out, off the mark, imported drugs give up clinical channel, transferred to the society in an all-round way the pharmacy sales. But simply from the perspective of drug zero bonus policy on domestic drug, the influence of the imported drugs appeared two kinds of completely different:
1) hospital procurement of domestic drug most affected, whether through escrow at present each big hospital pharmacy or everything is in order to "rebates" bargaining model, drug profit fell sharply, but also the tax risk.
Imported drugs after the medicine proportion, is mostly into each big hospital self-built or internal pharmacy at their own expense in hospital, the implementation of the zero bonus will further accelerate the speed of imported drugs to the DTP pharmacy sales trend. At the pharmacy because of a lack of insurance reimbursement policy, has a certain impact on its sales. A recent policy suggests that drugs will do not take medicine of health talks, but the number belongs to health-care negotiation drugs is very few, most of the imported drugs or DTP pharmacy.
Inside the hospital pharmacy can keep the bonus, at their own expense is not affected by the bidding price, imported drugs will become medical institutions for profitable products, and not included in the medicine of the inspection system, prescription impulse obviously enhanced, imported drugs in recent bucked up trend. Now more restrictive import drugs is the national policy changes, compliance requirements, a medical representative shall not hang sales target and forbidden medicine promotion behavior.
2. Medical institutions and pharmacies selling price
After comprehensive factors such as drug reimbursement, zero bonus, medical institutions and pharmacies and drug prices down further. Patients with health insurance will be more inclined to see a doctor to buy medicine to medical institutions, community hospital after patients shunt in the short term there will be a difficult condition. Ordinary pharmacy after losing price sensitive customers, pressure on profits.
Drug zero bonus is supposed to reduce medical costs, cut public hospital business income linked to drugs, promote medicine separate big kill, its influence is far greater than two votes the reform of pharmaceutical intermediate. Zero bonus will be changed medical institutions sell drugs drug good motivation and preference, the same kind of policy and press disease to pay. Drug zero bonus to reshape the flow distribution of the patients. Pharmaceutical enterprises should pay attention to the policy change, marketing mode should be timely change. |
