Who is behind the health care negotiations?

In fact, the health insurance negotiations have also lasted for a long time, and behind the negotiations, our experts have been trying to negotiate for us, and we should thank the experts and all the workers.

At present, the resources of medical insurance are limited, but China's population is very large, so this is a world problem, and it also tests the courage and determination of our medical insurance people. In this bargaining scene of medical insurance negotiations, the Internet is all supportive, and experts can use their professional knowledge to win the greatest benefit for us. In the course of this negotiation, our relevant economists can reveal in every sentence of dialogue that the people are supreme, and the negotiation process is also based on the people's choice and touches the people's hearts, after all, there are many people involved.

The success of this negotiation also brings a glimmer of hope to our patients because we have no money to see a doctor every year, resulting in a poor recovery in the end.

At the negotiation site, in order to negotiate the expected drug reserve price, the skills and strategies of on-site negotiation are particularly important, and they cannot be interfered with by other factors, so as to obtain the greatest benefit for us. After three days, from morning to night of high-intensity negotiations, really test physical strength and brain power, then after three days of hard work by our experts, we also did our best to harvest the protection rights and interests of 119 kinds of drugs for our people, with an average price reduction of 50%, which solved a big problem for us in the future in terms of medical treatment.

Because at present, China's population base is relatively large, basically every family has social security, but the current per capita payment amount is not very high, to be able to negotiate this condition, it is really a very big benefit for us. We should also thank all the experts and the workers who have worked quietly behind the scenes, thank them for their efforts to allow us to enjoy such a good policy, as the so-called do not give up, do not abandon anyone. Finally, I wish each of us a better and better life!

The negotiators are generally composed of representatives of the medical insurance department and relevant experts, who are responsible for on-site negotiation and bidding with relevant drug companies. Of course, the success of the negotiation is not only due to the negotiators at the negotiating table, but also pharmacoeconomics experts and estimators. Before the negotiation, the medical insurance department will randomly select pharmacoeconomics experts and experts from the expert database to make professional calculations, so as to determine the negotiated reserve price of each drug.

This reserve price has also become a "hole card" in the hands of negotiators.

First of all, it must be inseparable from the country's attention and attention to people's health, and secondly, it is also inseparable from every bargaining of relevant personnel in the negotiation process.

It is inseparable from the efforts of our scientific researchers, the efforts of negotiators, the efforts of medical insurance staff, the efforts of the state, and the efforts of the medical insurance department, so we can obtain a lower rate.

It is inseparable from experts, as well as staff who have paid silently, or medical staff, employees of the unit, and relevant responsible persons, who have made a lot of efforts for this.

Hello, because medical insurance negotiation refers to the negotiation between experts from the National Health Insurance Administration and pharmaceutical companies to negotiate the drug **, so that the drug ** can be lowered and the patient's economic pressure will be reduced. In China, basic medical insurance is the most important payer for medicines and medical services. Only enter the medical insurance list.

can only be reimbursed by medical insurance. Therefore, the timely inclusion of newly marketed good drugs in the catalogue is directly related to the accessibility of drugs and medical insurance for patients.

affordability and returns on industrial innovation. The medical insurance negotiation is for the access system of exclusive varieties.

For exclusive varieties, since both the buyer (medical insurance) and the seller (enterprise) are exclusive, there is a lack of market pricing game between multiple buyers and sellers. Therefore, it is necessary to pass comprehensive information disclosure.

and evidence-based negotiation to maximize the display of drug-related information, reduce the information asymmetry between the two sides, and then form a reasonable situation, and achieve a win-win situation for patients, enterprises and medical insurance. Therefore, the National Medical Insurance Catalogue can be said to be "a must to talk about" for exclusive varieties, which not only needs to scientifically review the comprehensive value of drugs, but also to measure the reasonableness of drugs.

Extended Material: What is Medicare?

1.Medicare refers to social insurance through national legislation and in accordance with the compulsory.

principles. Employers and individual employees shall pay the basic medical insurance on time and in full.

Fee. If they fail to pay in full and on time, their personal accounts will not be calculated, and the basic medical insurance co-ordination will not pay their medical expenses. Take the proportion of medical insurance contributions in Beijing as an example:

The employer pays 10% of the total payment base every month, and the employee pays 2% of the salary + 120 yuan for serious illness.

2.Medical insurance is a type of insurance that compensates for medical expenses incurred due to illness. Social insurance for the society or enterprises to provide necessary medical services or material assistance when an employee is sick, injured or gives birth. For example, China's publicly-funded health care.

and labor insurance and medical care. The medical expenses of Chinese employees are jointly borne by the state, units and individuals, reducing the burden on enterprises and avoiding waste. In the event of an insurance liability accident, the insurance premium shall be paid proportionately.

In November 2019, the National Health Insurance Administration launched the national medical insurance electronic voucher system, which was piloted in some cities such as Hebei, Jilin, Heilongjiang, Shanghai, Fujian, Shandong, and Guangdong. In 2020, 10,000 people will participate in China's basic medical insurance, and the participation rate will remain stable at more than 95%.

1.To a certain extent, it leads to the inability of enterprises to set prices independently, which reduces the revenue of enterprises, but because the research funds will eventually be recovered, but due to the increase in time, the time for pharmaceutical companies to invest in R&D will increase, resulting in the slowdown of new drug R&D progress.

2.After the negotiation of medical insurance and through negotiation, it will expand the sales market of pharmaceutical companies and increase the visibility of pharmaceutical companies.

Extended information: 1. For enterprises, innovative drugs have huge R&D capabilities.

For the sake of cost, businesses have their own considerations. According to the affordability of medical insurance funds and the cost-effectiveness of drugs, the medical insurance bureau should also make professional judgments. National Health Security Administration.

Huang Xinyu, deputy director of the medical service management department, said: "The core of the negotiation is to purchase the right ** and let it enter the medical insurance list.

It can take into account the burden on patients, the affordability of funds, and the willingness of the business. The business is willing and has a reasonable profit. ”

2. As the largest purchaser, the National Health Insurance Bureau communicates face-to-face with pharmaceutical companies with negotiation qualifications, and the enterprises should remain in the national medical insurance before entering the negotiation process.

Within 15% of the fluctuation of the bureau prediction period**. With generics.

With the expansion of the scope of purchase of varieties and quantities and the standardization of medical insurance negotiations for innovative drugs, the domestic pharmaceutical market pattern has undergone great changes in recent years, especially the drug market pattern in hospitals has been reshaped. So far, the state has carried out 5 rounds (6 times) of intensive collection, involving nearly 400 varieties, focusing on the collection of chronic diseases.

Oncology, anti-infection and other fields. From the perspective of the hospital market, the performance of each ward and whether it is included in centralized procurement.

There is no obvious correlation.

3. If the final correct and successful negotiation, the drug produced by the enterprise can be included in the medical insurance; If it is not right, it will automatically withdraw and the negotiation fails. The withdrawal of the drug means that the companies behind it will lose hundreds of millions of dollars in sales. As a result, pharmaceutical companies will lower ** in exchange for "getting" health insurance.

Only in this way will the medical insurance management department commit to the purchase volume of pharmaceutical companies, so that pharmaceutical companies can arrange production and reduce production and circulation costs. With the help of medical insurance, innovative drugs can be sold quickly and on a large scale, and innovative drug companies can focus more on drug research and development rather than on sales. This not only reduces the drug **, but also shares the market risk of pharmaceutical companies.

It's the best of both worlds.

In general, because different drug varieties have different positions in the market, companies face different situations. For the landing performance of listed varieties, we need to consider more situations, so as to judge their future trends relatively more accurately and reduce the dual impact on enterprises and people.

Health care negotiations are all about finding the best balance between the affordability of health care and the encouragement of innovation. The success of medical insurance negotiations is inseparable from the combination of effective market and promising model. The construction of a healthy China is not completed, but only in progress.

Extended information: 1. The process of adjusting the medical insurance catalog is divided into three steps:

Step 2: Professional ** calculation;

Step 3: Drug access negotiations.

Throughout the process, the NHSA is responsible for formulating the rules, and each stage of implementation is carried out by experts in the field of rock erosion mitigation. According to the rules, each expert corresponds to the drug one by one, and none of the experts intersects in the three stages, realizing the decentralization of the whole process from the system design, and at the same time, each stage is also specially set up to communicate and interact with pharmaceutical companies, so as to achieve the best objectivity as much as possible.

The negotiation of access to the medical insurance drug list is relevant to each of us, because it is related to what drugs can be covered by medical insurance and what the price of the drug is. We know that the high cost of medical treatment has a lot to do with the inflated price of drugs, and only by squeezing out the water of drug prices and letting the drugs come down can we reduce the burden on patients.

2. From the standpoint of enterprises, medical insurance negotiations certainly bring important opportunities to enterprises. After the drug is included in the medical insurance, the demand will be greatly released. Although the price of drugs has been greatly reduced, the sales volume has also increased significantly, which helps the company to develop steadily on a benign track of expanding market share.

On the other hand, for pharmaceutical companies, R&D is undoubtedly the key to high-quality development, and it requires a huge amount of money. Therefore, maintaining an appropriate profit margin for drugs, especially new drugs, is also conducive to the sustainable development of enterprises driven by innovation. Health care negotiations are all about finding the best balance between the affordability of health care and the encouragement of innovation.

3. It is worth noting that among the 67 types of exclusive drugs that have been successfully negotiated, 66 are drugs that have been marketed since 2020, and the new drug inclusion rate is nearly 99%, which also releases a strong signal to support more new drugs to enter the medical insurance and encourage innovation. In fact, from 2017, when foreign companies' products accounted for most of the medical insurance negotiations, to this year's medical insurance negotiations, China's new drugs occupied the mainstream position, and the changes in the period also reflect the innovation and development process and achievements of China's pharmaceutical companies in recent years.

4. The success of medical insurance negotiations is just another new beginning. Let 2,860 kinds of drugs benefit the masses, inseparable from the joint efforts of all parties in society, there are **, there are pharmaceutical companies, hospitals, and pharmacies. What is certain is that the construction of a healthy China is not completed, but only in progress.

1. Medical insurance negotiation refers to the negotiation between experts from the National Medical Insurance Bureau and pharmaceutical companies to negotiate drugs, so as to reduce drugs and reduce the economic pressure of patients.

2. Since its establishment in 2018, the National Health Insurance Administration has conducted many negotiations. On September 15, 2018, 17 of the 18 varieties negotiated in the special negotiation of anticancer drugs were successful, and the overall reduction rate of drugs was. It can be seen that the health insurance bureau has a strong bargaining power.

3. In the negotiation, the pharmaceutical company wants to talk about the economic interests of the fan, and the purpose of the state is to reduce the economic pressure of patients, so how do the two be coordinated?

4. In the negotiation process, "price for quantity" is the general policy of medical insurance negotiation, that is, to promote a significant drop in drug prices through volume procurement. The so-called volume procurement is to commit to the purchase quantity during the centralized procurement negotiation, which is convenient for pharmaceutical companies to arrange production to reduce production and circulation costs, thereby reducing drug prices, thereby reducing the market risk of pharmaceutical companies, and achieving a "win-win".

In short, as long as the production capacity is sufficient and it is not sold at a loss, the increase in sales can fully cover the diluted profits, and the negotiation is also widely accepted by pharmaceutical companies.

The negotiation of the medical insurance loss chain refers to the negotiation between the experts of the National Health Insurance Administration and the pharmaceutical company to negotiate the drug **, so as to reduce the drug ** and reduce the economic pressure of the patient. Medical knowledge is medical insurance.

This year is a very difficult year for the national medical insurance, but the National Health Insurance Bureau still has the courage to negotiate medical insurance, which is worthy of everyone's praise.

There are several reasons why this negotiation has received so much attention:

First, the negotiation of medical insurance is of positive significance to both enterprises and the public. On the one hand, the negotiation of medical insurance has brought important opportunities to enterprises, after the inclusion of drugs in medical insurance, although the price of drugs has been greatly reduced, the sales volume has also increased significantly, which will help enterprises continue to expand their market share, and then develop steadily. On the other hand, more drugs can enter the medical insurance with a more reasonable **, which will help reduce the burden of medical treatment for the masses and improve people's livelihood and well-being.

The second is the great love of the Qing family behind the skills of "sister of medical insurance negotiation". In the negotiation process, words such as "every small group should not be abandoned" embody the concept of people first, which moved the majority of netizens and sparked social resonance.

But health care negotiations have their limitations. It can only squeeze out the unreasonable premium and moisture of drugs from R&D to sales, and in principle, it does not affect the manufacturing costs and reasonable profits of enterprises. If the "price cut" exceeds the range that pharmaceutical companies can afford, resulting in the inability to enter the medical insurance or affect the quality of drugs, the most harmful is actually the interests of patients.

First, pharmaceutical companies should assume corresponding social responsibilities. On the one hand, strengthen school-enterprise cooperation, introduce more high-quality talents, increase independent research and development of pharmaceuticals, and give more people the opportunity to recover their health. On the other hand, it is also necessary to compress the drug circulation link, improve the operational efficiency of pharmaceutical enterprises, and reduce unnecessary expenditures, so as to reduce the heavy burden of drug prices on buyers.

Second, policy assistance should be strengthened. For example, for enterprises with large investment in R&D drugs, tax exemptions and exemptions can be provided to improve the efficiency of drug approval, so as to enhance the R&D enthusiasm of pharmaceutical companies and accelerate the technical breakthrough of drugs for rare diseases.

The National Health Care Negotiation Process

According to the information on the negotiation site released by CCTV, it can be seen that the negotiators representing the National Health Insurance Bureau sat opposite the representatives of the enterprise, and an envelope opened at the scene contained the reserve price of the negotiated drug, which is called the "envelope price" in the industry. This "envelope price" is calculated by medical insurance experts and health economics experts in the early stage**, which is the most secret part of medical insurance negotiations.

Only when the medical insurance expert opens the sealed envelope can he know the ** and the medical insurance reserve price to be negotiated on the spot on the same day. After the enterprise representative enters the negotiation site, if it falls at 115% of the "envelope price" for the first time, it can be shortlisted and enter the negotiation between the two parties.

The representative of the enterprise does not know the expected price paid by the Medical Insurance Bureau, and should be cautious about **; Medical insurance experts can not disclose the "hole cards" in their hands, but also try their best to guide enterprises to report in line with expectations. At this time, there will be a famous scene of "soul bargaining".