[in the event of corruption in the field of medicine, the issue covered by the price division may be related to access to health insurance lists, individual pricing of medicines and irregularities in the price approval process]
In the anti-corruption storm, the ndc prices division almost “people go empty”. Almost all of the five individuals who were taken away were in charge of medical approval, and whether they were involved in the vortex of drug corruption has been the focus of recent speculation。
Close to official sources yesterday told the 1st financial journal that price reform had been identified early this year as an important element of the commission’s annual work, while drug price reform was another important direction. “the related work is continuing without significant changes in individual personnel changes.” at the same time, he indicated that, according to the deployment arrangements, the change in the price of medicines during the year (based on the government's working year) was bound to move, but that the specific programme and roll-out date had not yet been finalized。
There are dozens of times the difference between a person's access to health care
Since late august, the number of officials of the prices division who were taken away from the investigation has increased to five, including former director-general cao changqing, deputy inspector guo ken ying, liu zhenqiu, who has just taken over as director-general of cao changqing, and two deputy directors-general zhou zhou and li qianhua. Most of the people involved were in charge of medicine。
The staff of a pharmaceutical company in charge of government affairs gave a presentation to the journalist of the 1st financial journal that, if corruption in the field of medicine really occurred, the issues dealt with by the price division could be related to access to medical insurance lists, individual pricing of medicines and irregularities in the price approval process。
“drugs that are under health insurance and can be priced separately will be dozens or even hundreds of times more sold than other similar medicines.” according to the above-mentioned staff, access to the health insurance list following the listing of new medicines is crucial to the competition between medicines, and these procedures are related to the price division。
The staff member cited, for example, the fact that if they were insured, both of the same drugs would be sold for $80, and the patient would certainly buy the medicines on the health insurance list because they could be reimbursed. Soon, the sales of the two drugs will open a wide gap. As a result, a number of issues may be involved in drawing up a list of drugs that can be accessed。
Previously, the fact that “pharmaceuticals before and after access to health insurance are subject to sudden price increases” was brought to the attention of the media, and there were speculations that it might be relevant if the prices division were involved in medical-related corruption. These staff members, however, took a negative view。
“drugs are self-pricing before they are officially insured.” the staff member stated that information such as pricing after the production of new medicines would be filed in the relevant departments of the country, and that since uninsured medicines were not easily selected by patients, businesses would press prices lower than they would have been at the time of filing when they were sold, for example, through pharmacies. When they enter health insurance, they predict that they will no longer be at an advocacy disadvantage and that enterprises will raise their prices。
“this is a reasonable price increase, a market rule.” according to the staff member, the price was also publicized by the government at the time the drug was insured. If it is felt that the price of the drug is too different from that previously, it can be reprioritized after reporting. It is unlikely that many officials were taken away at this time because of the sudden increase in the price of drugs at the time of admission。
Drug-absorption pricing and approval chain
Previously, official members of the commission had indicated to the newspaper that the most frequent cases of price violations were reported throughout the country in previous years, as well as higher price increases, new name charges, monopolies, etc。
“drugs are passive consumer goods of a special nature and cannot rely solely on market regulation.” according to the aforementioned sources, both government regulation and the market itself are currently flawed, and under both, the links are distorted, and the lack of a normal market competitive mechanism for medicines results in prices that do not reflect distortions such as the cost and efficacy of medicines themselves。
Journalists looked at the information and found that the prices of medicines in china were partly regulated by the government and partly regulated by the market. The prices act and the medicines regulation act provide for a combination of government regulation and market regulation of medicines. Currently, 3,000 drugs are included in government price management, accounting for about 25 per cent of the total number of drugs in circulation in the market, 70 per cent of the market share, and another reference is made to 2,000 drugs (central 1500, local 500)。
On the other hand, there are several different ways in which our medicines are priced uniformly and separately. Individual pricing is designed to encourage enterprises to develop high-quality medicines, such as those that are significantly safer and more effective than those of other enterprises. “this stand-alone pricing may sometimes be compromised.” according to the above-mentioned staff, the separate pricing of foreign companies' “original drugs” (import drugs that have passed the patent protected period) has been regarded by industry as supranational treatment。
Previously, the bribery of a foreign pharmaceutical company, glaxo shke, had attracted global attention. Xinhua reported that, for example, with glaxoschuck's well-known drug, hepting was worth $142 in china, compared to $18 in korea, less than $26 in canada and less than $30 in the united kingdom. On the basis of statements by several former executives, it has been found that the high cost of bribery is partly due to its high pricing。
“this pricing is simply unfair.” the president of the chinese medical enterprise management association, myung-de, said to the journalist of the first financial journal。
In addition to the fact that foreign “original drugs” can be priced separately, former pharmaceutical workers have revealed to the newspaper first financial journal that many chinese pharmacies are working hard to secure a separate pricing policy. This area is still relevant to the work of the commission's prices division. In addition, the above-mentioned staff indicated that an additional risk of irregularities could be the price approval process。
Where will the price go
“in essence, a healthy market mechanism must be built.” the former director of the prices monitoring division of the national commission for development and development (conader), li ryo, has recently made it public that the role of market-based mechanisms will be enhanced through the piloting of drug benchmark price management reforms; this is both a useful attempt to address the relationship between government and the market and a useful exploration to preserve the necessary government regulation while fully playing the role of the market。
Various sectors, including pharmacists, have stressed to the paper that government regulation coexists with market regulation and cannot simply emphasize “letting”. However, government controls will be gradually reduced and weakened, and market forces will continue to grow. The government maintains the smooth functioning of the market mainly through regulation。
According to official signals, the commission has been liberalizing the price of low-priced medicines this year in order to reform the price of water-testing drugs, liberalize the price of medical services and liberalize the price of the otc in internal discussions. According to the foregoing sources, the price of medicines may seem to be the first area to achieve a breakthrough. Unlike in the past, the commission will change management thinking in this round of reform。
Among them, the “base price model” is the direction most interpreted officially. The so-called benchmark price model, i. E., the application of a flat health insurance for medicines, the choice of medicines at different prices by the patient, the overpayment by the patient, and the initiative of the pharmaceutical company to compete for prices to make them more reasonable. Deputy inspector guo kenying of the price division, who has just fallen, has repeatedly advocated this model as an effective means of indirectly guiding market prices。
According to close to official sources, the formation of drug pricing mechanisms is currently the main consensus, including market-based pricing, indirect government direction and payment of binding costs. In this process, it has been suggested that a breakthrough be achieved through the mobilization of market agents, involving reforms in pricing, tendering, reimbursement, etc。
It is worth noting that there are also many administrative institutional obstacles to changing the price of medicines and that the focus is on achieving a multisectoral “package” of reforms as soon as possible. A policy researcher from a think tank also revealed to the paper yesterday that there are also many disputes within ministries about the price adjustment of medicines, which is very difficult to advance. “a new round of price reform was initiated last quarter, but progress has been slow.”
Responsible editor: zhang dei
