Policies related to pharmaceutical price reform
1. Opinions of the Central Government and the State Council on Deepening the Reform of the Pharmaceutical and Healthcare System
Promote the separation of medicines, and actively explore a variety of effective ways to gradually reform the mechanism of compensating for the costs of medical treatment with medicines. Through the implementation of differential markups in the purchase and sale of medicines, the establishment of pharmaceutical service fees and other ways to gradually reform or cancel the drug markup policy, while taking appropriate adjustment of the price of medical services, increasing government investment, reforming the payment method and other measures to improve the compensation mechanism of public hospitals.
2. The former Ministry of Health, the Central Editorial Office, the National Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security "on the issuance of public hospital reform pilot guidance notice"
Promoting the separation of medicine, reforming the mechanism of medicines to compensate for the medical system, and gradually changing the compensation of public hospitals from fee-for-service, income from drug markups and government subsidies to two channels: fee-for-service and government subsidies. Charges for services and government subsidies by localities in accordance with the relevant provisions of the State, taking into account the hospital's functional positioning, the affordability of the medical insurance fund, local financial capacity, urban and rural residents' income levels and affordability of price adjustments and other factors reasonably determined. (State Health Reform and Development [2014] No. 12 stipulates that: county-level public hospitals undertake the diagnosis and treatment of common and frequent diseases of county residents, the rescue of critical illnesses and the referral of difficult diseases, the training and guidance of personnel in rural primary health care institutions, as well as part of the public **** health services, natural disasters and emergency response to public **** health emergencies, etc.).
Gradually abolishing the policy of drug markups, and compensating for the resulting reduction in the reasonable income of public hospitals by taking measures such as setting up additional fees for medicinal services and adjusting some of the fees for technical services, as well as by means of payments from the medical insurance fund and increased government investment.
3. Circular of the General Office of the State Council on the Arrangement for Public Hospital Reform Pilot Work in 2011
Reform the mechanism of compensating doctors with medicines. Explore various specific ways to separate medicine, gradually abolish the policy of drug markups, and compensate public hospitals for the resulting reduction in reasonable income by taking measures such as setting up additional fees for medicinal services and adjusting some of the fees for technical services, as well as by means of payments from the medical insurance fund and increased government investment.
In accordance with the principle of total control and structural adjustment, the prices of medical services reflecting the value of medical personnel's technical labor are reasonably adjusted; large-scale equipment purchased by public hospitals with government funding is set at a price for examination based on the cost of the equipment after deduction of depreciation. Reform of medical services project-based pricing method, and actively carry out the pilot project of charging according to the type of disease, the number of types of disease is not less than 50.
4. "The State Council on the issuance of the "Twelfth Five-Year Plan" to deepen the reform of the medical and health system and the implementation of the program of notice"
Promoting the reform of the compensation mechanism. Taking the mechanism of "medicine for medicine" as the key link, promoting the separation of medicines, gradually abolishing the policy of drug markups, and changing the compensation of public hospitals from three channels of service charges, income from drug markups and financial subsidies to two channels of service charges and financial subsidies.
The reasonable income or loss reduced by the reform will be compensated by adjusting the price of medical technology services and increasing government investment. Raise the fees for diagnosis and treatment, surgery, nursing fees, reflecting the reasonable cost of medical services and the value of the technical labor of medical personnel. Medical technology service fees are included in the scope of medical insurance payments in accordance with the regulations.
5. Notice of the General Office of the State Council on the Issuance of Four Points of Opinions on the Comprehensive Reform of County-Level Public Hospitals
Reform the mechanism of "medication for medicine", and encourage the exploration of various forms of separation of medicine. The policy of drug markups will be canceled, and the compensation of pilot county-level hospitals will be changed from three channels, namely service charges, drug markup income and government subsidies, to two channels, namely service charges and government subsidies.
In accordance with the principle of total control, structural adjustment, reduce the price of drugs and high-value medical supplies, reduce the price of large medical equipment inspection, treatment, government-funded acquisition of large-scale medical equipment according to the reasonable cost of the development of inspection and treatment prices, has been loaned or pooled funds to purchase large-scale equipment in principle by the government to repurchase, repurchase the difficulties in reducing the price of a limited period of time. Reasonable increase in Chinese medicine and reflect the value of the technical labor of medical personnel, such as diagnosis and treatment, nursing, surgery and other items, so that medical institutions through the provision of quality services to obtain reasonable compensation.
6. The National Development and Reform Commission, Ministry of Health, Ministry of Human Resources and Social Affairs on the county-level public hospitals to promote the reform of pharmaceutical prices
The abolition of the drug markup policy reduces the reasonable income, through increased government investment, adjusting the price of health care services and other ways to compensate. Pilot public hospitals should strengthen internal management, improve service quality and operational efficiency, and reduce medical costs. After the abolition of the drug markup policy, to ensure that the pilot public hospitals to reduce drug prices by about 15%.
Adhering to the principle of "total control and structural adjustment", the price of medical services should be reasonably adjusted, and synchronized with the abolition of the drug markup policy and the increase of government investment.
Everywhere to take into account the level of economic development, the public's affordability and affordability of basic medical insurance and other factors, to reasonably determine the level of control of the total cost of medicine in the region, with specific reference to the actual total cost of medicine in the three years before the reform of the region, the health insurance fund and the urban and rural residents of the individual medical expenditure and other comprehensive estimates.
Adjustment of the price of medical services, combined with financial compensation and health insurance payment level of the specific situation, to compensate for the abolition of the drug markup policy reduces the reasonable income; on this basis, and gradually rationalize the relationship between the ratio of the price of medical services. To effectively improve the value of the technical labor of medical personnel to reflect the diagnosis and treatment, surgery, nursing and Chinese medicine specialty services and other medical services prices, the really low bed fee can be adjusted appropriately; at the same time, reduce the price of large-scale medical equipment inspection and treatment and testing category.
During the pilot reform period, local governments can authorize county (city and district) level governments to study the adjustment of medical service prices within the prescribed principles.
7. Circular of the National Health and Family Planning Commission, Ministry of Finance, Central Editorial Office, National Development and Reform Commission, and Ministry of Human Resources and Social Affairs on the Issuance of Opinions on Promoting Comprehensive Reform of County-level Public Hospitals
Break up the practice of compensating doctors with medicines, and improve the compensation mechanism. The compensation of county-level public hospitals has been changed from three channels of service charges, income from drug markups and government subsidies to two channels of service charges and government subsidies, and the policy of drug markups has been abolished. The reasonable income of hospitals thus reduced will be borne by many parties*** through adjusting the price of medical technology services and increasing government investment, as well as through strengthening accounting and economizing on operating costs by hospitals. Giving full play to the role of medical insurance compensation, the medical insurance fund through the purchase of services to hospitals to provide basic medical services to be timely compensation, reduce the medical insurance fund policy within the reimbursement ratio and the actual reimbursement ratio of the gap. The price adjustment policy and health insurance payment policy are interconnected.
The main measures to deepen the reform of the medical price system
1. Eliminate the mechanism of compensating doctors with medicines, improve the reform of medical prices in county-level public hospitals, and push forward the reform of urban public hospitals on a pilot basis.
2. Streamline the price-price relationship of medical services, and establish a dynamic price adjustment mechanism based on changes in cost and income structure.
3. Strengthen the price, medical insurance, medical and other related policies to ensure that the healthy operation of medical institutions, medical insurance fund can afford, the burden on the public will not increase.
4. Strengthen the drug market price research and regulatory work to ensure that the market price after the reform is basically stable.
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