On August 2, the ministry of health and family planning of guangdong province issued the notice on further clarifying the requirements of the basic drug system of our province. Have a bold statement: in the notice is no longer in our province to the medical institutions at all levels (including basic medical and health institutions, similarly hereinafter) equipped with use of national basic drugs (hereinafter generally referred to as the basic basic drugs, including provincial supplemented drugs) the product quantity and amount proportion for specific requirements. This means that guangdong province will no longer be required to use national essential medicines for primary medical institutions. This expression has caused a great deal of reaction among grassroots medical institutions and grass-roots medical personnel. That is good news for major drug companies.
The basic drug system led to the withdrawal of pharmaceutical companies
Reviewing the basic drug system currently implemented, a new round of medical reform has been implemented in the government-run urban community service institutions and county grass-roots medical and health institutions since 2009. System mainly includes: basic medicine full implementation of the national basic drugs directory (including provincial supplemented directory), the provincial focus, online public bidding procurement, unified distribution, drug base zero bad sales. And clear stipulation government-run grassroots medical institutions all equipped with and using the national essential drugs, other kinds of medical institutions will also basic drugs as the preferred and the use of reaches a certain proportion. Basic drugs are included in the basic drug insurance reimbursement directory and the reimbursement rate is significantly higher than that of non-essential drugs. The system can be summarized as: the provision of the basic drug use catalogue, the provincial unified bidding procurement, the zero differential sales, the inclusion of medical insurance reimbursement.
The implementation of the basic medicine has a great influence on the domestic primary medical institutions. Is generally believed that the benefits of basic medicine system, one is in grass-roots hospitals, clinics and community health service institutions of zero rate of sales, effectively reduce the drug prices (but in fact, some of the more expensive drug price is zero rate before). Second, the basic drugs are all covered by medical insurance, and reimbursed at a 100% rate of the class a, reducing the burden on the people and alleviating the expensive problems of the people. Third, can promote grading diagnosis, using only basic drugs at the grassroots level can't solve the disease can be transferred to the superior hospitals use drug treatment and technology essential medicines, so as to build a pilot path, avoid excessive use of good medicine, expensive medicine.
However, with the continuous improvement of living standards, the level of drug use has exceeded the institutional assumption. The result of the compulsory promotion of basic drugs is that some branded drugs and new drugs are being evacuated from the base. This has caused a lot of controversy.
The problems with basic medicines are very prominent
Compared with its advantages, the compulsory equipment and regulations of the basic drug system bring many inconveniences to the daily use of medical personnel of the general level. First, the primary drug use gap is larger. On the one hand is the drug dominance gap, mainly from the directory itself. The first edition of the national basic drug catalog contains only 307 varieties, which is too different from the actual drug use habit. If only national directory drugs were used, it would be difficult to use the grass roots. In this context, provinces have issued a provincial supplement. But even if there is a provincial supplement, many traditional medicines approved by ordinary people are still not included, such as xiaochai granule and gac, etc. On the other hand, the invisibility of drugs can harm the grass roots. Some basic drugs even enter the catalogue, often the situation that cannot supply online. And according to the regulations of the mandatory requirement, use requirements, grassroots medical institutions can't offline purchase, plus some branded disappear from grassroots, significantly affect the enthusiasm of the grassroots medical institutions to develop business.
Second, the level of primary care has declined. As time goes by, mandatory use medicine to show the shortcomings, grassroots medical institutions can medicine with county-level hospitals before the same, but the base medicine after the implementation of grassroots drugs are greatly constrained, and at the grass-roots level and grade hospital drug use level between was opened. In this way, the primary medical staff can not use the available medicines, the patients can not buy the medicines needed at the grass-roots level, the patients who could have stayed at the grass-roots level will be concentrated to the big hospital. The burden of patients is also overwhelming.
So primary-care medicine is in a vicious circle: the loss of drugs -- the loss of the patient -- the decline in business -- the decline in capacity -- and fewer patients, ultimately leading to a general decline in basic business capacity.
Guangdong is untied, the grass roots have hope
The base strongly calls for reform of the basic drug system. But before that is in the province around the supplemented directory, the respect such as chronic drug use to do some repair, did not involve system core, hard to change grassroots service ability and the plight of hierarchical diagnosis and treatment work. This time, the province bravely took the first step. The guangdong health and family planning commission has a clear response to the high demand for directory restrictions and mandatory equipment in the guangdong wai office [2017] no. 37.
Since July 1, 2017, our province to medical institutions at all levels (including basic medical and health institutions, similarly hereinafter) equipped with use of national basic drugs (hereinafter generally referred to as the basic basic drugs, including provincial supplemented drugs) the product quantity and amount proportion for specific requirements. Medical institutions at all levels can comprehensive clinical demand, curative effect and the price of drugs, from the new version of the basic medical insurance, inductrial injury insurance and maternity insurance in guangdong province the list of drugs to equipped with use, and implement zero rate of sales (except traditional Chinese medicine yinpian, similarly hereinafter). The centralized purchasing method and reimbursement policy of basic drugs are unchanged.
Since the beginning of 2017, the mandatory assessment indicators for the use of basic drugs will be adjusted to the encouraging assessment indicators in various assessment reviews and allocation of funds, such as health reform in our province.
The reform is not the basic drug system in guangdong, but further improve the system of basic drugs, sold on the reservation list of essential medicines, zero rate and recruitment forward, etc, on the basis of no longer forced equipped with and using the basic drugs at the grassroots level to take use of basic drugs at the grass-roots level government to corresponding money reward as an incentive. This relaxation of the guangdong province is undoubtedly a positive response to the grassroots appeal. It is a great opportunity for major drug companies to recover their lost ground.
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