China has built a universal basic medical insurance network
The past ten years, the health cause of the greatest progress, the people's sense of health access to the ten years, to alleviate the masses of difficult to see a doctor, the problem of expensive to see a doctor has played an important role. So today I am here to organize the completion of the basic medical insurance network for all, let's take a look together!
Procurement, payment, supervision of multi-dimensional linkage of medicine, medical equipment, medical services, the whole chain of reshaping
The wave of social change, the spring breeze of reform blew across every key position of the social economy. In the field of healthcare, which concerns the lives and health of 1.4 billion people, "healthcare reform" has attracted a lot of attention.
In 2018, the national organizational reform, the National Health Insurance Bureau, the National Health Commission and a new set of leading institutions to build completed, health care reform into the accelerated stage. The three-legged support of the National Health Insurance Bureau, the National Health Commission and the State Drug Administration promotes the change and high-quality development of multiple ports of healthcare, medicine and medical devices from procurement, payment, regulation and other levels.
The MPS takes the lead in national centralized banded purchasing, national health insurance coding standards, and DRG/DIP payment reform; the NDRC takes the lead in medical device supervision and management regulations, and implementation of UDI for Class III medical devices; and the NHSC takes the lead in high-quality development of public hospitals, and costing of public hospitals. The three ports of medicine, medical devices and medical care to form a synergy.
Medical reform is a reform to find a balance in breaking and reconstructing, but also breeding a new industrial environment and medical vision. On the one hand, healthcare reform is both the axis of a series of policies and industrial changes in the healthcare industry in recent years. On the other hand, healthcare reform is also like a tidal wave, washing away some of the established models and patterns in the past. Healthcare reform is a long and determined variable that is rewriting the landscape of China's medical and pharmaceutical industries.
Since the new round of medical reform, China has built the world's largest basic medical insurance network covering the entire population, making a positive contribution to building a moderately prosperous society and realizing the first hundred-year goal.
From a set of data, in these ten years, the proportion of residents' personal health expenditure has dropped from 34.34% in 2012 to 27.7% in 2021, making it more convenient, affordable, efficient and smooth to see a doctor. Life expectancy per capita has risen from 74.4 years in 2012 to 78.2 years in 2021, and the foundation of health for the great rejuvenation of the Chinese nation is being strengthened.
As an important tool for squeezing out the "water" from drug prices, through centralized procurement of drugs and medicines, the average price of collectively procured drugs has been reduced by more than 50 percent, and the average price of collectively procured cardiac stents and artificial joints has been reduced by more than 80 percent, resulting in a cumulative savings of about 300 billion yuan. At the same time as the price reduction, the centralized procurement has fulfilled the commitment of the bandwagon, and the proportion of the public using original drugs and drugs that have passed the consistency evaluation of the quality and efficacy of generic drugs has exceeded 90%, and the accessibility of high-quality drugs has increased significantly.
In 2021, the number of inter-provincial medical consultations for specialties related to the first batch of national regional medical centers dropped by 9.3% compared with that of 2019, and the order of medical consultations became more reasonable. The construction of primary healthcare organizations and the training of general practitioners will be strengthened, family doctor contracting services will be improved, and the capacity of primary healthcare services will be continuously improved.
Drugs and medicines are returning to reasonable prices for the masses to "buy, use and reimburse"
In February 2020, the Central Government and the State Council issued an opinion on deepening the reform of the health care system, a health care reform document that makes clear that general objectives of the reform in 2025 and 2030.
From the point of view of the absolute number of people involved in medical insurance, relevant data from the National Health Insurance Bureau show that during the "13th Five-Year Plan" period, China's health insurance system reform has made new progress, with the number of basic medical insurance participants reaching 1.35 billion, and the participation rate stabilizing at more than 95%. At present, China has built the world's largest medical insurance network.
From the point of view of the payment ratio of China's medical insurance, the payment ratio of hospitalization expenses within the policy scope of employee medical insurance and residents' medical insurance will reach about 80% and 70% respectively in 2019. The proportion of the people's personal health expenditure in total health costs dropped from 35.29 percent in 2010 to 28.36 percent in 2019. The gold content of China's health insurance continues to improve, and the protection system is becoming more and more sound.
From the perspective of reimbursement scope and quality, the dynamic adjustment mechanism of China's medical insurance catalog has basically been formed, with a number of good drugs with high clinical value, excellent economic evaluation and life-saving and emergency-saving drugs included in the catalog, and some drugs with low clinical value, obvious abuse and better substitutes being moved out of the catalog. In addition, through the state-organized centralized band purchasing of medicines and the access negotiation of the national health insurance drug catalog, the prices of China's health insurance medicines have been continuously lowered, and the people's burden of medicines has gradually declined.
Li Shuchun, deputy director of the Department of Pharmaceutical Management of the National Health Insurance Bureau, said this year that since 2018, China's annual dynamic adjustment of the drug catalog for health insurance*** has been carried out four times, with a cumulative four-year total of 507 kinds of transfers into the catalog and 391 kinds of transfers out of the catalog, and the number of western and proprietary Chinese medicines in the catalog has increased to 2,860 kinds of medicines. Among them, the integration of national demand negotiation bargaining 250 new drugs into the catalog, the average price reduction of more than 50%.
In order to strengthen the landing of negotiated drugs, the National Health Insurance Bureau and the National Health Commission issued two joint documents to establish a dual-channel management mechanism, guiding localities to select eligible drugs to be included in the dual-channel management, and for the first time at the national level, the designated retail pharmacies are included in the negotiated drugs' supply guarantee system, and the designated hospitals are subject to the same payment policy, so that the hospitals are not equipped with the negotiated drugs for the time being in the advanced The drugstores are also being included in the dual-channel management system.
As of the end of June this year, 275 negotiated drugs within the agreement period have been equipped in 184,100 designated medical institutions nationwide, realizing the public's desire to "buy, use and reimbursement".
In order to further promote the return of drugs and medicines to reasonable prices, and reduce the medical burden of the people. Centralized volume purchasing came into being, December 8, 2018, the drug "4 + 7" collection of pilot bidding results, officially opened the prelude to the national volume purchasing of pharmaceutical consumables. 7 batches of national drug collection since the *** realization of the coverage of 294 drugs, most of which are common diseases, chronic diseases of the medication, involving the amount of money accounted for 35% of the annual procurement amount of chemical and biological drugs in public medical institutions.
Official statistics show that the average price reduction of state-organized drugs has been more than 50%, and that the average price reduction of cardiac stents and artificial joints has been more than 80%, with cumulative savings of around 300 billion yuan.
Along with price reductions, the collection and procurement has fulfilled the promise of volume, and the proportion of the masses using original drugs and drugs that have passed the consistency evaluation of the quality and efficacy of generic drugs has exceeded 90%, and the accessibility of high-quality drugs has increased significantly. Collective procurement through the quantity and price linkage, quantity for price, from the mechanism to solve the problem of high prices of medicine, purify the distribution channels of medicine, improve the industry ecology, for the high-quality development of the pharmaceutical industry to provide a good ecological environment.
Without the health of all people, there is no way to talk about the well-being of all people. Through the important grip of health insurance, poverty caused by illness and returning to poverty due to illness have been greatly avoided. It can be said that China's health insurance is not only the world's largest medical protection network, but also the world's largest poverty reduction program.
Biomedicine speed up "bend and run" Chinese medicine to accelerate the promotion of modernization and internationalization
"Thirteenth Five-Year Plan" period, China's innovative drug field is full of fruitful. The reform of the drug trial started to accelerate; "clinical value-oriented clinical research and development of antitumor drugs guiding principles" was introduced; the implementation of the ICH guiding principles, to promote the research and development and registration of international standards and other initiatives to promote China's new drug research and development from the R & D project, new drug review to the quantity and quality of new drugs and other comprehensive leap.
Taking the speed of new drug review as an example, compared with 2015, after nearly five years of drug review reform, the efficiency of review and approval has been significantly improved, and the time for approval of clinical trials of chemical and biological drugs has been shortened by more than 80%. the average time for review and approval in 2015 was 22-25 months, and by 2020, the average time will be only 3 months.
The number of innovative drugs on the market continues to grow. In terms of declaration and approval, in 2018-2021, the number of approved innovative drugs in China will be 9, 10, 20 and 25 respectively, realizing four consecutive years of growth.In 2021, 39 innovative drugs will be listed on the market in China***.Among the 39 innovative drugs, 36 of them are independently researched and developed products, accounting for 92.31%; 6 of them will realize the license-out, including vodafone, which is the most popular product in the market. The first innovative drug was approved for listing: the first PD-L1 monoclonal antibody, the first anti-new coronavirus drug and the first propofol precursor drug.
New drug R & D technology level, China's biopharmaceutical industry in just a few years to catch up or even bend the road and car. New technologies such as monoclonal antibody, ADC and cell therapy have rapidly filled the gaps and leveled the gap with developed countries in Europe and America. The gap is also narrowing in emerging fields such as nucleic acid technology, PROTAC, gene therapy, gene editing and artificial intelligence pharmaceuticals.
Capital market, more and more biopharmaceutical enterprises have gained admission tickets, enriched financing channels through the Science and Technology Innovation Board (STB) and other channels, gained the favor of capital, and further got a development boost. The proportion of bio-enterprises in the listed companies on the KTB has reached 1/3, and the average annual growth rate of R&D investment of pharmaceutical enterprises above designated size during the "13th Five-Year Plan" period is about 8%.
The "14th Five-Year Plan" for the development of the pharmaceutical industry, pointed out that the "14th Five-Year Plan" period of the industry's R & D investment increased by an average of more than 10% per annum; to 2025, new sales of innovative products accounted for the proportion of incremental revenue of the whole industry to further Increase. Innovative drugs are expected to further transform from "running with" to "leading".
In the pharmaceutical field, another key area of particular concern is Chinese medicine. As an important part of China's medical treatment, TCM has played a unique role in preventive health care, disease treatment and rehabilitation during the 13th Five-Year Plan period.
Data shows that during the "13th Five-Year Plan" period, the central government invested a total of more than 30 billion yuan to promote the rapid development of China's traditional Chinese medicine industry; the quality of traditional Chinese medicine continues to improve; and the scientific and technological innovation of traditional Chinese medicine continues to deepen. According to the national pharmaceutical industry statistics, the main revenue of the traditional Chinese medicine industry has grown from 515.6 billion yuan in 2012 to nearly 700 billion yuan in 2021.
In the first half of this year, 73 A-share listed Chinese medicine companies, 47 first half of the revenue growth, of which 28 revenue more than 1 billion yuan, 5 revenue more than 5 billion yuan, 2 revenue more than 10 billion yuan, respectively, Baiyunshan (600332) revenue of 37.2 billion yuan, Yunnan Baiyao (000538) revenue of 18 billion yuan.
In the "sea" level, Chinese medicine in the "13th Five-Year Plan" period has also achieved significant results. So far, China has built 31 national TCM service export bases, and the total export trade of TCM products during the "13th Five-Year Plan" period reached 28.19 billion U.S. dollars.
In March this year, the General Office of the State Council issued the "14th Five-Year Plan for the Development of Traditional Chinese Medicine", in the "13th Five-Year Plan" to accelerate the improvement of the top-level design of the development of traditional Chinese medicine, the policy environment continues to optimize, and support for the basis of increasing, on the basis of the existing still On the basis of the accelerated improvement of the top-level design of Chinese medicine development in the "13th Five-Year Plan", the policy environment continues to be optimized and the support continues to increase, and the current problems still exist in the development requirements, the development of Chinese medicine services, human resources, inheritance and innovation, high-quality development of the industry and other aspects of the development goals, to promote the high-quality development of Chinese medicine industry.