Medical network - April 18th April 14, the general office of human resources and social security ministry about 2017 national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue negotiations range of circular released, which means that access to health care medicine negotiation mechanism has been basically established. 

 

For new drug clinical required, thanks to the new mechanism, medicare drug drug pricing negotiations, can be directly hung net purchase, into the provinces into medical insurance directory will be no need to wait for more than 4 years of time. The author thinks drugs range analysis of this round of talks, good single drug-resistant, antitumor medicine and traditional Chinese medicine composition single medicine these three kinds of drugs. 

 

But, the risk and good coexistence. Degree of eventually positive question: one is to see negotiation price reduction, such as the first batch of less than 50% of the decline? Look into the provinces after hanging net, medicare pay what price? 

 

Health-care negotiation mechanism is difficult to establish 

 

Who planning commission to determine the first batch of drugs 

 

The establishment of the health care medicine negotiation mechanism lasted for more than two years. 

 

In February 2015 on the perfect public hospital drug centralized procurement guidelines "(countries do hair [2015] no. 7) for the first time put forward to some patent drugs, exclusive production of drugs, to establish open and transparent, participating mechanism of drug price negotiations. In October 2015, 16 ministries and commissions such as health development planning commission (bureau) organization has launched the first pilot work national drug price negotiations. According to China's major public health and disease prevention and control of medical needs, organize experts after sufficient demonstration, who planning commission selected price is high, the heavy burden of disease, patients benefit significantly in the treatment of hepatitis b, lung cancer and multiple myeloma pilot drug patent medicine as a negotiation. In the same year in late November, officially launched the national drug price negotiations. 

 

Rumors into development planning commission negotiation directory of drugs with five, but on May 20, 2016, the national health and family planning commission general office to release the results of our national drug price talks about notice only announced three drugs, respectively is glaxosmithkline (China) fumarate tenofovir two pyrazole cefuroxime ester, beida pharmaceutical ek hydrochloride for the treatment, astrazeneca. Fumaric acid tenofovir two pyrazole cefuroxime ester is the latest guidelines recommending a gleam of oral drugs for the treatment of chronic hepatitis b. The treatment for ek, is used for tumor is sensitive to the epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer molecular targeted drugs. 

 

Perform trouble around 

 

According to a notice health development planning commission, the three drugs in 2016, the completion of negotiations by the end of June and drug concentration netting and purchase cycle in 2016 ~ 2017, no longer separately organized bargaining negotiations. In the same year on July 22, who planning commission issued "the talks will be held across drugs into the progress of all kinds of the compliance costs of medical insurance", there are 14 provinces will negotiate drug into all kinds of the compliance costs of medical insurance. It 14 provinces into health care, however, is not entirely town worker is basic medical treatment insurance and basic medical insurance for urban residents, more is a new type of rural cooperative medical care or a serious illness insurance, in addition, only a few provinces recognized individual products are included in the compliance costs of medical insurance. Who planning commission to promote in trouble. 

 

People club department relay "name" 

 

Until February 21, 2017, the human resources and social security ministry about issued by the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue (2017 edition) notice to all three products into the medical insurance directory b, is the three drugs. In general, health b than hundred payment proportion of reimbursement, which means that the three drug prices more than 50% can only gain access to health insurance directory, medicare actually paid more discount. Fujian province in 2017 released by the health insurance payment standard sent the payment standard of the three drugs was 50%. In addition, the notice said, will explore establishing access to health care medicine negotiation mechanism. People club department determined via expert evaluation of negotiations negotiations drugs according to the rules, eligible drug into the medical insurance to pay limits, the list shall be issued separately. 

 

On February 23, 2017 people club department news center "people club department issued by the 2017 version of the catalogue of drugs mentioned in after from all provinces (autonomous regions and municipalities) of nearly 4000 clinical doctors, pharmacists, and healthcare management experts, preliminarily determines the 45 to negotiate drug, are of higher clinical value but relatively expensive, exclusive patent drugs. People club department after confirm whether enterprises have negotiations intention, publish to the society plans to negotiate drug list and group negotiation according to related procedure. On April 14, the published directory has 44, means one drug to determine not involved in the negotiations. 

 

44 negotiations drug positive analysis 

 

Good homebred class 1 chemical drugs 

 

44 negotiations in pharmaceutical chemical medicine or as the main categories, a total of 22. Import chemical medicine 15, domestic chemical medicine seven. In addition to the injection of paclitaxel liposome, the rest of the domestic chemical medicine is approved after 2010 class 1 new drug. Going into the directory of chemical medicine is given priority to with antitumor medicine. 

 

Biological products is given priority to with single resistance 

 

Biological products have 14 going into the directory, with imports accounted for nine, domestic five. In domestic biological products belong to the approved after 2010 has two, respectively is injection with urokinase of restructuring the original and compaq heap eye ophthalmic injection. Going into the directory of biological products is given priority to with single resistance. 

 

8 the commonness and analysis of Chinese traditional medicine 

 

Drug of the communist party of China has eight Chinese medicine 44 negotiations, six of them are traditional Chinese medicine injections, two is for oral administration. 8 2010 years in traditional Chinese medicine (TCM) is approved for lactones ginkgo biloba injection and ginkgo diterpene lactone meglumine injection, the rest from the fixed number of year of the approved in terms of how the "new" are out of the question. Just eight drugs in common, is the author thinks that the main effective component is relatively single. Indications, main is to improve the cancer patient's immune function and cardiovascular medicines. 

 

Most of TCM injections in 2017 version of health care use is limited, I wonder if after six TCM injections for negotiation price indications will be restricted or limited use hospital level. In addition, the traditional Chinese medicine injection current is also focused on the health insurance payment standard, fujian only willing to pay to enter the national essential drugs in traditional Chinese medicine injections, which means that the release of six TCM injections will not get reimbursement in fujian. 

 

Table 1 2017 national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue negotiations