The medical problem of the common people has always been the focus of people's livelihood.
With the continuous deepening of the reform of the medical and health system, more and more drugs have been reduced in price in recent years, and the price reduction of medical equipment and consumables has also been fully implemented in the past month. This includes the heart stents that the people are very concerned about.
How about the use of coronary stents in various places after the national centralized collection of coronary stents landed for one month?
In the face of the high-value medical consumables that are still inflated, how will the centralized procurement mechanism work?
"News 1+1" today connects with Jiang Changsong, an associate researcher of the National Medical Security Research Institute of Capital Medical University, and is concerned about: Are there many people using a stent for price reduction?
"Price reduction" bracket has been fully implemented nationwide
The first batch of "price reduction" brackets will be implemented in 18 provinces, autonomous regions and municipalities on January 1, 2021, and full coverage has been achieved today.
After the price of coronary stent products dropped from 13,000 yuan to an average of 700 yuan, in some places, medical consumables such as intraocular lenses, hemodialysis and orthopedic trauma have also begun to be purchased on a trial basis.
The "price reduction" stent was implemented for one month, benefiting patients, doctors and hospitals
Jiang Changsong, Associate Researcher, National Institute of Medical Security, Capital Medical University:
①Patients: The patients who benefited the most this time.
First of all, the economic burden has been significantly reduced; at the same time, the product quality level has also been improved, that is, the product grade is often said to be improved; in addition, the accessibility has also been expanded.
In the past, some patients chose conservative treatment because of financial burden, and now they can use the selected high-quality, affordable stent.
②Doctors: It used to be a bit difficult to communicate with patients when using products due to economic reasons. Now that the price of products has dropped and the cost of communication has been greatly reduced, doctors also embrace this reform.
③Hospitals: From the hospital's point of view, they received advance payments and increased cash flow, which benefited all parties.
After the price of the heart stent was reduced, the amount used increased slightly, indicating that the clinical use is well standardized
Jiang Changsong, Associate Researcher of the National Institute of Medical Security, Capital Medical University: Judging from the year-on-year and quarter-on-quarter data, the comparison between January last year and January this year, and the comparison between December last year and January this year, are converted into the same number of working days. The selected stents, including the usage of all stents, have increased slightly without major fluctuations.
There was neither a substantial increase nor a substantial decrease, but a slight increase.
This is also in line with our previous prediction, which shows that the standardization of our clinical use of stents is relatively good.
do not worry! The price of heart stents does not decrease the quality
Jiang Changsong, Associate Researcher of the National Institute of Medical Security, Capital Medical University: The quality is not compromised at all, and the price reduction without the quality is fully reflected.
The social responsibility of the selected companies felt that the surgical techniques and curative effects of the products used by the doctors were not compromised.
① The first entity responsible for product quality is the enterprise, and the enterprise will not make fun of its reputation;
②The selected product is still the previous product, which is exactly the same as before the collection without any discount;
③The alloy brackets that can be included in the scope of this centralized procurement are themselves high-quality products;
④The drug regulatory department and medical department will work together to intensify inspections and report adverse events.
The quality of the product is quite guaranteed, and the common people don't have to worry about this problem at all.
How to protect the interests of medical institutions after the price of heart stents is reduced?
Jiang Changsong, Associate Researcher, National Institute of Medical Security, Capital Medical University:
The interests of the hospital are guaranteed: ① The advance payment of the medical insurance fund is based on the purchase scale of the annual agreed purchase amount, 30% is in place at one time, so that the hospital's cash flow is relatively good.
② The medical department that settles by project, that is, the hospital that charges fees according to the product itself, has a policy of retaining the balance when the medical insurance is settled at the end of the year, and 50% of the retained funds of the medical insurance balance will be rewarded to the hospital.
According to this data calculation, if a medical institution uses a selected product, it may be rewarded with a balance of medical insurance funds of 2,000 to 3,000 yuan.
③If the medical institution is a DRG or DIP packaged payment institution, it is also emphasized that the medical insurance payment standard will not be lowered in the first year. That is to say, the cost of using a product in the hospital before is 10,000 yuan. Now it only costs 700 yuan. The 9,300 yuan that came down was all obtained by the hospital itself, which would also ensure the interests of medical institutions.
After the price reduction of heart stents is implemented, both selected and unselected companies need to pay attention
Jiang Changsong, associate researcher of the National Institute of Medical Security, Capital Medical University: In addition to paying attention to the interests of patients, doctors and hospitals, we also pay attention to the interests of enterprises.
For example, is the quantity guaranteed for the selected products?
Is the payment back guaranteed?
Has the cost reduced after mass production?
Has the sales cost been reduced after winning?
Has the financial cost of collections been reduced?
We all need to pay attention to these aspects of the selected companies.
In addition, we are also concerned about the unselected companies. Now that absorbable stents, drug balloons, etc., will appear to replace the selected products, we are all concerned about these issues.
After the price of the heart stent is reduced, how to protect the interests of doctors?
① The balance of the medical insurance fund will be 50% or 40% rewarded to medical institutions, and the remaining liquid funds will be mainly used for the performance of doctors.
Finally, it is given to doctors through bonuses or other forms to become sunshine income and encourage them to use the selected products.
②After the price of heart stents drops, the service fees of related surgical items will be increased in due course.
For example, coronary angiography, balloon dilatation, and stent implantation, which are directly related to coronary intervention surgery, have undergone certain adjustments in Beijing, Shanghai and Jiangsu.
We have also made statistics on the price of surgery. For coronary interventional surgery, taking a tertiary hospital in the country as an example, the total of these three fees should be around 8,500 yuan on average.
However, the price in Shanghai is relatively low, only 4,000 yuan, and Beijing is only 5,000 yuan. The corresponding increase in Beijing this time is 1,000 yuan, so that the doctor's income is also guaranteed.
After the price of cardiac stents was reduced, the provinces actively took the lead in promoting the purchase of related auxiliary materials
Jiang Changsong, Associate Researcher of the National Institute of Medical Security, Capital Medical University: In addition to the purchase of cardiac stents, there will be some purchases of coronary balloon guide wires at the local, provincial and municipal levels.
Today is the Sichuan Seven Provinces Alliance, Guangdong Seven Provinces Alliance, Guizhou Three Provinces Alliance, and about 24 provinces including Hubei, Hunan, etc. have made the purchase of coronary balloons, which has dropped from 3,000 yuan to 300 yuan.
Inner Mongolia also took the lead in purchasing guide ribbons in 14 provinces.
After the price of medical consumables is reduced, what areas need to be solved?
Jiang Changsong, Associate Researcher of the National Medical Security Research Institute of Capital Medical University: The 2020 Medicare No. 51 "Notice of the Office of the National Medical Security Administration on Implementing 15 Coding Standards for Medical Security Information Services" just released mentions many supporting measures.
For example, for corporate repayment, the repayment will be in place by the end of April; 30% of the advance payment in the hospital; the price of the unselected product on the Internet; the payment standard of medical insurance; various settlement requirements; requirements for stocking... all aspects and all-round , Multi-angle guarantee the use of the selected products, so that patients can use the selected products solidly and affordably.
In addition, the selected products are now zero markup. How much money the hospital buys and sells to patients is also how much money, so that patients can enjoy tangible benefits.
The future can be expected! Medicines and medical consumables will continue to reduce prices
Jiang Changsong, an associate researcher at the National Institute of Medical Security, Capital Medical University: Generally speaking, the expectations of the people are sustainable.
As far as a certain product is concerned, such as coronary stents, after completing the centralized procurement this time, the stent may not be made next time, and other products may be made.
The corresponding financial burden of the cardiology department is decreasing, and perhaps the next one will be orthopedics, so that there is a continuous and rotating work to expand the patient population.
What are the disadvantages of "selling with gold" in the field of medical consumables? It's no different from "out of a thousand" on the mahjong table
Jiang Changsong, Associate Researcher of the National Institute of Medical Security, Capital Medical University: "Selling with gold" is just like "selling a thousand people" on a mahjong table in the words of ordinary people. Performance, sell at a suitable price.
But now the higher the product price, the greater the sales space, and the higher the sales cost that can be provided to various stakeholders, the better the sales. This is a kind of "cheating" behavior, in fact, it is "shameless" behavior. It is said that everyone is "suffering for a long time to sell gold."
In addition, the "sales with gold" model cannot produce large international companies. Compared with more than 10,000 companies in our medical device industry, there is actually a large gap in scale.