The first clear definition of the circulation difference rate is based on the compensation for the cost of logistics distribution. The argument that the price of medicines entering the basic drug list will be uniformly reduced by 15% is inaccurate.

In the future, in addition to medical insurance drugs and some special drugs (such as vaccines), included in the government's key management will also include basic drug list drugs. At the same time, the National Development and Reform Commission will also increase the monitoring of high-priced drugs and promptly reduce their prices.

Also, the spread between individual-priced drugs and uniformly-priced drugs will gradually shrink.

The "Medicine Economics" reporter recently learned from the Price Division of the National Development and Reform Commission that the National Development and Reform Commission has drafted "Opinions on Reforming the Mechanism for Pricing Drugs and Medical Services" (hereinafter referred to as "opinions"). Its core ideas have been finalized and several internal comments have been completed and are currently in the final revision before release.

It is reported that the "Opinions" will be released as one of the 21 supporting documents for the new medical reform program, but the exact time has not yet been determined.

Reducing the level of fare increase in circulation, the difference in hospital drug prices

Reporters learned that the "Opinions" adjusted the central and local price management authority. In addition to formulating non-prescription drugs for basic medical insurance drugs, local supplemented varieties, and non-profit medical institutions, the local government also increased the pricing authority for Chinese Herbal Medicines in the Essential Drug List.

It is reported that this will be another large-scale adjustment after July 2005. At present, there are 2,400 kinds of medicines that are priced by the state, including 1018 kinds of prescription medicines for Western medicine, 532 prescription medicines for Chinese patent medicines, and over 300 kinds of special medicines such as blood products, narcotic drugs, and a class of psychoactive drugs.

Preliminary thoughts have also been given on how to price the drugs included in the basic drug list with high external concern. After the basic drug list is formally announced, the NDRC will approve and publish the retail drug guide price for essential drugs as soon as possible. According to reports, the retail guide price will be set according to the common name.

Previously, the industry widely circulated that "entering the basic drug list will implement a uniform price reduction, the price reduction may reach 15%" argument. In response, an official from the Development and Reform Commission's Price Department said that this statement is not accurate. "Some drugs must be reduced in price, but there are also price increases."

And for the difference rate of circulation, "Opinion" for the first time that will be in accordance with the cost of compensation logistics distribution to be approved. "Control of drug price difference in circulation, gradually reduce the level of price increase in circulation, promote the merger and reorganization of circulation, reduce circulation, the increase in the flow of essential drugs is part of the increase in the cost of distribution." The price of the Development and Reform Commission said.

In the retail sector, the "Opinions" will reform the hospital's drug addition policy, gradually reduce the hospital's drug price increase rate, and implement the difference without exceeding the current 15% markup rate. The price increase policy means that hospitals perform differential price increase according to the purchase price of drugs, and the rate of increase of drugs with high purchase price is lower, and the rate of increase of drugs with low purchase price can be higher. In the basic medical institutions, the zero rate is implemented, that is, the drugs are leveled out and flattened, without any price increase.

"Implementation of differential mark-ups is to make hospitals receive less income from drug spreads and reduce dependence on drug spreads," said the person in the price division of the National Development and Reform Commission.

It has been revealed that the reform of the pharmaceutical price management mechanism will also be carried out in the aspects of improving the management of medical service prices, trial-based charge of disease, and the implementation of "one-day fee schedule" for medical services. reform.

The spread between single-priced drugs and unified-priced drugs will gradually shrink

Afterwards, the National Development and Reform Commission issued the "Notice on Conducting a Price Survey of Pharmaceuticals," requiring all provinces and municipalities to organize pharmaceutical companies and medical institutions to fill in the medical cost and price questionnaires. Listed in the National Basic Medical Insurance and Industrial Injury Insurance Drug List. The official from the Price Division of the National Development and Reform Commission said frankly: "At present, the country's method for conducting drug cost investigation and verification is not yet complete. Some unreasonable expenses are difficult to exclude from existing pricing." The official pointed out that for the same drug, the production costs of enterprises of different sizes are different. Disparity, so the average cost is difficult to determine.

The degree of responsibility for price formation also makes the NDRC face difficulties in the price review process. "The current price of drugs contains more or less gray income for hospitals and doctors. Lowering the price of medicines and compressing the promotion costs in circulation will cause the sales volume of medicines to drop substantially. If prices are measured at the true cost, medicines will be There is no promotional space and the market is lost or even disappeared."

Therefore, in order to promote a scientific and rational drug price formation mechanism, the "opinion" will encourage and support drug innovation on the one hand, evaluate pharmacoeconomics before pricing of new drugs, and use price levers to encourage The production and management of essential medicines will, on the other hand, gradually reduce the spread between individually priced drugs and uniformly priced drugs.

The officials of the Development and Reform Commission's price department pointed out that in accordance with the new medical reform opinion, enterprises should be encouraged to innovate in the production of pharmaceuticals, and the patent medicine must be evaluated before the pricing of pharmacoeconomics, allowing innovative drugs to have The higher interval cost and profit level will maintain the relative stability of the price during the protection period and allow the company's innovative behaviors to be rewarded; the low-level construction will be curbed, and the implementation of the first generic drug price favorably and the latter listed drug price lower policy.

In terms of pricing method, we insist on the principle of combining cost pricing with effect pricing. On the one hand, we continue to adhere to the principle of original compensation cost and maintenance quality, and on the other hand, Consider the clinical value of drugs, compare the efficacy and price of clinically substitutable drugs with the pricing of generic drugs, and evaluate the pricing of new drugs by pharmacoeconomics."

The officials of the Development and Reform Commission's Price Division also revealed that the current price gap between domestic and foreign-funded companies' medicines is gradually widening. "While some of the original research medicines produced by foreign-funded enterprises have passed the patent period, due to their quality and efficacy, as well as physician preference, these research drugs are still expensive and the actual production costs are also high. Most of them are generic drugs, and the price difference between them and the original research drug is very large, and the actual ex-factory price is even lower.This situation resulted in the bidding price of generic companies and the price of foreign pharmaceuticals in the actual tendering and fierce market competition. There is a huge spread in prices, and the trend is still increasing."

Accordingly, in the "Opinions", although there are differences in the pricing of patented drugs and original research drugs originally used for differential pricing (separate pricing), they should be gradually reduced in the future. The difference between a differentially priced drug and a uniformly priced drug.