1, drugs more cost-effective:
The state through negotiations, so that the pharmaceutical companies to reduce prices, which is aimed at the high incidence of children's leukemia, such as AiYeYang, the original price of 4,958 yuan reduced to 2,980 yuan a, a reduction of 39%;
Lung cancer SaiKeRi, the original price of the previous 1,759 yuan, and is now 510 yuan, a reduction of 71%, SaiKeRi before 890 yuan, currently is 260 yuan, a reduction of this for cancer patients when the boon, but also the new version of the implementation of the medical insurance reimbursement of the benefits of the medicine, is also the new version of the medical insurance. 71%, Sai Keri before 890 yuan, is currently 260 yuan, reduced this for cancer patients when the gospel, but also the new version of the medical insurance reimbursement of drugs after the implementation of one of the benefits.
2, indirectly improve the claims ratio:
Domestic drugs have A, B, C, three categories, of which Category A drugs are medical insurance catalog drugs, reimbursement of 100%, Category B is reimbursed 30% - 70%, Category C is not reimbursed at all. This is the new version of the medical insurance reimbursement of drugs after the implementation of the most common children's fever cold tablets, double Huanglian oral liquid, strong loquat lozenges, from Category B to Category A, the reimbursement is 100%.
3, a lot of new drugs:
New 148 kinds of good drugs, eliminated 150 kinds of old drugs, these two points are compared to the old version of the health insurance of the biggest difference, and the new health insurance catalog contains a total of 2,643 kinds of drugs.
What is the impact of the inclusion of drugs in the health insurance on pharmaceutical companies
The health insurance department will adjust the payment standard of the drug according to the price level of the generic drug, but also the generic name into the scope of centralized purchasing, such as the emergence of a major national policy adjustments or the actual price of drugs in the market is significantly lower than the current payment standard, the NHIC will consult with the enterprises to reformulate the payment standard and be notified separately.
In summary, under the general trend of comprehensive centralized procurement of drugs and medical consumables, the fundamental survival and development of drug and medical consumables manufacturers is still the quality of their products, for drug manufacturers, their products should at least pass the consistency evaluation of quality and efficacy. On the other hand, due to the national organization of band purchasing bidding enterprise has a more stringent number of restrictions, in the procurement volume allocation of highly centralized situation, generic drugs and medical supplies manufacturers once the bidding loss, which means the loss of market share, the bidding cycle must be faced with a huge risk of survival and development of the crisis.
Legal basis:
The Chinese People's **** and State Social Insurance Law
Article 27
Individuals who participate in basic medical insurance for employees and whose cumulative contributions have reached the state's prescribed number of years by the time they reach the statutory retirement age shall no longer pay basic medical insurance premiums after their retirement, and they shall enjoy basic medical insurance benefits in accordance with the state's regulations; those whose contributions have not reached the prescribed number of years may contribute up to the state's prescribed number of years, and they may contribute up to the state's prescribed number of years. If they have not yet reached the state's prescribed limit, they may contribute until the state's prescribed limit.
Article 28
Medical expenses that conform to the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with the state regulations.
Article 29
The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.