Shanghai version of the basic drug list covers the widest coverage and financial subsidies key

On December 13th, the Shanghai version of the Essential Drugs Catalogue and Shanghai's pilot scheme for the implementation of the National Essential Drug System were formally released. 688 kinds of drugs were listed in the Shanghai Basic Medication Catalog. This has made Shanghai the most extensive provincial-level administrative unit in the “Basic Medication Directory” across the country.

“As long as financial conditions permit and grassroots service capabilities are available, they will have the ability to increase the basic medical directory. Since the implementation of the basic pharmaceutical system by the state, as far as I know, all regions have increased this list. Li Changming, executive vice president of the Chinese Health Economics Association, told reporters.

In fact, before Shanghai, there were 24 provinces in the country that had issued the Basic Medicine Catalogue for 2010. As a general practice, more than one hundred kinds of supplements have been added to the catalogue. However, since the implementation of the directory in 2009, there are still two major issues that need to be resolved.

The first is the coverage rate. 60% of the community health service agencies and county-level primary health care institutions mentioned at the beginning of the year have to implement the basic medicine catalog. This task is not simple; in addition, related to the coverage rate, how is the financial subsidy in place? The fundamental guarantee of the above switching.

Since the primary income of primary-level medical institutions comes from the sales of medicines, the elimination of the 15% increase in medicines will make the survival of primary-level medical institutions a crisis. “From the perspective of the implementation effect of the primary hospitals in many places, after the implementation of the basic medical directory, where is this part of the money for patient insurance coming from, it is still difficult to solve. Therefore, from the current point of view, the operation status of primary medical institutions is generally difficult. Hu Dayang, director of the Jiangsu Provincial Medical Insurance Center, told reporters.

“Shanghai is one of the most economically developed regions in the country. Expanding the content of the catalogue will help improve the ability of basic medicine lists to meet patient requirements and guide residents to visit primary medical institutions. Currently, the medicines in the Shanghai Basic Medical Directory are already More than 95% of medicines in primary medical institutions can be covered, and after the full implementation of the basic medical directory system, the service level of Shanghai primary medical institutions will not have a major impact, said Hu Shanlian, director of the Shanghai Municipal Health Development Research Center.

According to the Shanghai Municipal Government's pilot scheme for the implementation of the National Essential Drug System, the basic medical and health institutions organized by the Shanghai Municipal Government are expected to implement uniform sales of essential drugs in the first half of next year after the city completes the centralized drug procurement.

The subsidy work for basic medical institutions has also been put on the agenda, and the State Council executive meeting convened a few days ago has researched and deployed policies and measures for establishing and improving the compensation mechanism for primary health care institutions. In the future, through the government’s purchase of services, etc., reasonable subsidies will be given to public health services undertaken by non-government primary health care institutions, and qualified institutions will be included in the designated scope of medical insurance, and the same medical insurance payment as the government’s primary health care institutions will be implemented. And reimbursement policies.

In the future, Shanghai Essential Drugs will follow the principles of openness, fairness, and fairness, and implement centralized online open procurement through the city's unified pharmaceutical centralized procurement and trading platform, and the pharmaceutical production enterprises and pharmaceutical logistics companies with modern logistics capabilities that are selected by tendering will have the necessary conditions. The other companies unified delivery.

Shanghai will soon publish a tender notice. The bidding and procurement of essential medicines will adhere to the principle of giving priority to quality and reasonable prices. It will explore ways to centralize purchases of basic medicines provided by the government for basic medical and health institutions by linking volume to price, that is, to certain essential drugs. , From a number of companies participating in bidding, choose a company with quality assurance, reasonable price, and sufficient supply. From its production, negotiate separately to minimize procurement costs and thus reduce drug prices.

Drug revenue is the “big head” of community health care service revenues. Completely canceling the 15% increase in essential drugs means that the hospital has zero or even negative income in the medicines, because the medicines generally take up about 3% loss in the hospital. Changes such as compensation mechanisms.

Since 2008, Shanghai has instituted a zero-sum drug reform, and in October of that year, he will be entitled to basic drug purchase discounts in the village clinic. In 2009, the city's community health service center fully implemented the “Zero-difference Rate” western (central) medicine list of the Shanghai Community Health Service Center, with a total of 166 medicines.

In addition to the basis for the reform of the zero-difference rate of drugs in the previous period, the two reforms of income and expenditure that Shanghai has promoted in various districts and counties have created favorable conditions for the initiation of the basic drug system work.

Professor Liu Jun, deputy chairman of the Chinese Medical Association, pointed out: “The basic reform of the basic drug system must be based on the reform of the basic fund-raising and security system. In addition to the implementation of the list, it is more important to establish a special channel for the development, production, circulation, and use of essential drugs.”

"Although from the perspective of the use of drugs, due to the different types of supplements in the provinces and cities, regional imbalances in medical insurance have been formed. However, in the long run, with the advancement of the basic medical directory system and the advancement of medical reform, this kind of regional imbalance Still will be solved slowly." Hu Shanlian said.