74 new drugs were added, an average drop of over 60%.
On December 3, the results of the adjustment of the 2021 National Medical Insurance Drug List were announced: a total of 74 drugs were added to the list and 11 drugs were removed from the list.
The total number of drugs in the National Medical Insurance Drug List in 2021 will be 2,860, which will be implemented on January 1, 2022.
In the negotiation of drugs for the treatment of rare disease spinal muscular atrophy, the negotiation of medical insurance drugs reappeared "soul bargaining".
In this negotiation, the two sides spent an hour and a half, and the corporate negotiators conducted 8 discussions.
"News 1+1" invited Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration, to pay attention to: the national medical insurance drug catalog is difficult to "new"!
This year's medical insurance drug catalog negotiation success rate and price cuts both reached new highs. What are the reasons?
Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration: The success rate of this negotiation and the (price) drop (both to record highs) are both unexpected and reasonable.
There are four reasons:
① The goals of the medical insurance party and the enterprise side are the same, and everyone wants to talk about drugs.
Talking in is a win-win situation, even three wins and four wins, and it is no good for everyone not to talk about it.
② Chinese medical insurance has many advantages.
The first is the market advantage. China has a large population and a large market, which is also very attractive to enterprises. Medical insurance is negotiated with the amount of the whole country.
The second is the advantage of the system. The national medical insurance drug catalogue is under the unified responsibility of the national level, so that there is a greater volume and ability to negotiate.
The third is the policy advantage. There are many preferential policies for medicines after entering the medical insurance.
③The improvement of the medical insurance negotiation itself is more scientific, standardized, transparent and interactive.
④ Years of negotiating experience, avoiding some technical errors leading to negotiating failure.
The medicines listed in the medical insurance list can be talked about the world’s lowest price
Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration: During our negotiations, companies have repeatedly said (negotiation quotations) are already lower than the world's lowest price.
We also have a reference in this regard when we calculate, which is (reference) the world's lowest price.
In the negotiation of medical insurance drugs, the most difficult thing is not only the price, but also the evaluation of the drugs
Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration: A five-dimensional evaluation of the drugs that enter the national medical insurance catalog, including the innovation, effectiveness, economy, safety and fairness of the drugs, and finally the five dimensions Perform a comprehensive balance.
For example, this year we adopted the method of scoring, how much weight each dimension has, and there are several small dimensions behind each dimension. This is (formed) a comprehensive result.
Why is it difficult to evaluate drugs?
It is this set of evaluation methods, evaluation indicators and evaluation people that need to be continuously improved.
Why do rare disease drugs that are successfully included in the medical insurance list need to be covered by medical insurance because the number of users is small?
Huang Huabo, Director of the Medical Service Management Department of the National Medical Insurance Administration: There are two principles in the negotiations this year. One is the basic principle, which is the bottom line. In addition, the basic idea of the negotiation has been established, which is to ensure the key points, highlight the key points, make up for the shortcomings, and optimize the structure. ,Encourage innovation.
These rare disease medications are actually (a kind of) clinical shortcomings. Although sometimes there are fewer patients (some rare diseases), it is 100% for the patient's family and the patient itself.
It is a great achievement to be able to talk about the use of drugs for several rare diseases this year.
Although the price is a little higher than that of some medicines, after pharmacoeconomics calculations, the overall price is still acceptable, and they are all within our red line.