Policies related to pharmaceutical price reform
1. "Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical and Health System"
Promote the separation of medicines and actively explore A variety of effective methods have been used to gradually reform the mechanism of supplementing medical treatment with drugs. Gradually reform or cancel the drug markup policy through various methods such as differential price increases for drug purchases and sales, and the establishment of pharmaceutical service fees. At the same time, measures such as appropriately adjusting medical service prices, increasing government investment, and reforming payment methods will be adopted to improve the public hospital compensation mechanism.
2. The former Ministry of Health, Central Staff Office, National Development and Reform Commission, Ministry of Finance, and Ministry of Human Resources and Social Security's "Notice on Issuing Guiding Opinions on the Pilot Reform of Public Hospitals"
Promote the separation of medicine and reform The mechanism of supplementing medical care with drugs will gradually change public hospital compensation from three channels: service charges, drug markup income and government subsidies to two channels: service charges and government subsidies. Service charges and government subsidies are reasonably determined by local governments in accordance with relevant national regulations, taking into account factors such as hospital functional positioning, medical security fund affordability, local financial capabilities, urban and rural residents' income levels, and affordability of price adjustments. (Guo Wei Ti Gai Fa [2014] No. 12 Regulation: County-level public hospitals are responsible for the diagnosis and treatment of common and frequently-occurring diseases for county residents, critical and severe rescue and referral of difficult diseases, training and guidance for personnel of rural primary medical and health institutions, and some public hospitals* **Health services, emergency response to natural disasters and public health emergencies, etc.).
Gradually cancel the drug markup policy, take measures such as increasing pharmaceutical service fees, adjusting some technical service charging standards, and increase government investment through medical security funds to reduce the reasonable income of public hospitals. be compensated through other means.
3. "Notice of the General Office of the State Council on Issuing the Work Arrangements for the Pilot Reform of Public Hospitals in 2011"
Reform the mechanism of supplementing medical treatment with drugs. Explore a variety of specific ways to separate medicine, gradually cancel the drug markup policy, and adopt measures such as increasing pharmaceutical service fees and adjusting some technical service charging standards to reduce the reasonable income of public hospitals through medical security funds and increase government Compensation will be provided through investment and other means.
In accordance with the principles of total volume control and structural adjustment, the price of medical services that reflects the value of the technical labor of medical personnel shall be reasonably adjusted; the inspection price of large-scale public hospital equipment purchased with government funding shall be based on the cost after deducting depreciation. Reform the project-based pricing method of medical services, and actively carry out trials of charging by disease type, with the number of disease types being no less than 50.
4. "Notice of the State Council on Issuing the Plan and Implementation Plan for Deepening the Reform of the Medical and Health System During the Twelfth Five-Year Plan Period"
Promote the reform of the compensation mechanism. The key link is to break the "drugs to supplement medical care" mechanism, promote the separation of medicines, gradually cancel the drug markup policy, and change public hospital compensation from service charges, drug markup income and financial subsidies to two channels: service charges and financial subsidies. channel.
The reasonable income reduced or the loss caused by the reform will be compensated by adjusting the price of medical technical services and increasing government investment. Increase the charging standards for diagnosis and treatment fees, surgery fees, and nursing fees to reflect the reasonable cost of medical services and the value of the technical labor of medical personnel. Medical technical service charges are included in the scope of medical insurance payment according to regulations.
5. "Notice of the General Office of the State Council on Issuing Four Points of Opinions on the Comprehensive Reform of County-Level Public Hospitals"
Reform the "drugs to supplement medical care" mechanism and encourage the exploration of various ways to separate medicines form. The drug markup policy will be cancelled, and compensation for pilot county-level hospitals will be changed from three channels: service charges, drug markup income and government subsidies to two channels: service charges and government subsidies.
In accordance with the principles of total volume control and structural adjustment, reduce the prices of drugs and high-value medical consumables, reduce the inspection and treatment prices of large medical equipment, and purchase large medical equipment funded by the government at a reasonable cost excluding equipment depreciation. The price of inspection and treatment is set. In principle, large equipment that has been purchased with loans or raised funds will be repurchased by the government. If it is difficult to repurchase, the price will be reduced within a time limit. Reasonably increase the prices of traditional Chinese medicine and diagnosis, treatment, nursing, surgery and other items that reflect the value of medical personnel’s technical services, so that medical institutions can obtain reasonable compensation for providing high-quality services.
6. Notice of the National Development and Reform Commission, the Ministry of Health and the Ministry of Human Resources and Social Security on promoting the reform of drug prices in county-level public hospitals
The reasonable income reduced after the cancellation of the drug markup policy will be reduced by increasing government investment Compensation will be provided by adjusting medical service prices and other means.
Pilot public hospitals should strengthen internal management, improve service quality and operational efficiency, and reduce medical costs. After canceling the drug markup policy, it is necessary to ensure that drug prices in pilot public hospitals are reduced by about 15%.
Adhere to the principle of "total volume control and structural adjustment", rationally adjust the price of medical services, and proceed in parallel with the elimination of drug markup policies and increased government investment.
All localities should comprehensively consider factors such as the level of economic development, the affordability of the people, and the affordability of basic medical security to reasonably determine the total medical expense control level in the region. For details, refer to the actual total medical expenses in the region in the three years before the reform. Comprehensive calculation of expenses, medical insurance funds and personal medical expenses of urban and rural residents.
When adjusting the price of medical services, it is necessary to combine the specific conditions of financial compensation and medical insurance payment levels to compensate for the reasonable income reduction after the cancellation of the drug markup policy; on this basis, gradually rationalize the price comparison relationship of medical service items. It is necessary to effectively increase the prices of medical services such as diagnosis and treatment, surgery, nursing and traditional Chinese medicine services that reflect the value of medical personnel's technical services. Appropriate adjustments can be made to bed fees that are indeed low; at the same time, the prices of inspection, treatment and inspection of large medical equipment should be reduced.
During the reform pilot period, local governments can authorize county (city, district)-level governments to study and adjust medical service prices within the prescribed principles.
7. Notice of the National Health and Family Planning Commission, the Ministry of Finance, the Central Committee of the Communist Party of China, the National Development and Reform Commission, and the Ministry of Human Resources and Social Security on the issuance of opinions on promoting the comprehensive reform of county-level public hospitals
Abolition of drug supplements Medical and improve the compensation mechanism. Compensation for county-level public hospitals has been changed from three channels: service charges, drug markup income and government subsidies to two channels: service charges and government subsidies, and the drug markup policy has been cancelled. The reasonable income of the hospital thus reduced will be solved by adjusting the price of medical technical services and increasing government investment, as well as the hospital strengthening accounting and saving operating costs. Give full play to the compensation role of medical insurance, and the medical insurance fund will promptly compensate the basic medical services provided by the hospital through purchasing services, narrowing the gap between the reimbursement ratio within the medical insurance fund policy and the actual reimbursement ratio. Price adjustment policies and medical insurance payment policies are interconnected.
Main measures to deepen the reform of the pharmaceutical price system
1. Abolish the mechanism of supplementing medical services with drugs, improve the pharmaceutical price reform of county-level public hospitals, and promote the pilot reform of urban public hospitals.
2. Straighten out the price comparison relationship of medical services and establish a dynamic price adjustment mechanism based on changes in cost and income structures.
3. Strengthen the connection between price, medical insurance, medical care and other related policies to ensure the healthy operation of medical institutions, affordable medical insurance funds, and no increase in the burden on the people.
4. Strengthen drug market price research and supervision to ensure that market prices are basically stable after the reform.