Author: thumb medicine, drawing from the title: Vision China.
“I have been wearing my bracelet every day. On November 11th, the monitoring data showed that the pressure was red throughout the day. It remained under high pressure for 11 hours throughout the day.” said Liu Hongliang, deputy director of the Jilin Province Social Medical Insurance Administration. It’s not the double 11 grabbing a red envelope, but the feeling of participating in the medical insurance price negotiation on the first day.
Liu Hongliang made these memories at a press conference held by the National Medical Security Administration in Beijing on November 28. The conference also officially announced the national medical insurance list for 2019, with a total of 2,709 drugs included in the list, the biggest highlight of which is the new 70 price negotiation varieties. These successfully negotiated drugs are mostly new drugs that have been marketed in recent years and have high clinical value, including 22 anticancer drugs, 7 drugs for rare diseases, 14 drugs for chronic diseases such as diabetes, hepatitis B, hepatitis C, rheumatoid arthritis, and 4 medications for children.
In a media briefing on August 20 this year, Xiong Xianjun, the director of the Department of Medical Services Management of the National Medical Insurance Bureau, introduced that there were 128 varieties included in the scope of medical insurance price negotiations. The results showed that 70 were finally negotiated, with a success rate of 54.7%, which intuitively proved that price negotiation was difficult.
A video of the negotiating scene was circulating on the Internet, describing how AstraZeneca’s Daglie nets were cut to 4.36 yuan step by step. Dagle’s net (10mg) The market price is 15.96 yuan per piece. The negotiators of the company reported a low price of 5.62 yuan from the beginning. But this is obviously not enough. Under the persuasion of experts from the negotiation team, after two consultations with the company, the latter finally reported at 4.40 yuan, which was already lower than the global lowest price in the Korean market. In the end, because it said “4 is too bad,” Lennon was again Experts from the negotiating team cut 4 cents and were selected with 4.36 yuan.
It is precisely such a one-for-one bargain that led to an average drop of 60.7% in the prices of the 70 varieties negotiated. After being included in the category B of medical insurance, the actual reimbursement of these drugs in all places is basically more than 60%. In other words, patients pay only a maximum of about 15% of the original drug price, and even individual drugs as low as 5%.
According to CCTV’s exclusive disclosure, the National Medical Insurance Bureau has initially calculated that according to the 2018 bidding prices of these 70 drugs, the total sales of these drugs in 2020 will reach 28.5 billion yuan, and after negotiations, the total actual payment The cost was reduced to 9.9 billion yuan.
It looks like the waves are not frightening. After several rounds of negotiations, it has made tens of billions of dollars in sales. In fact, the undercurrent is surging-the game between the parties has reached the level of short soldiers. This is the difficulty of the medical insurance price negotiation.
“4 too much” is a negotiation skill
On November 13th, the last day of the price negotiation, the front of the National Medical Insurance Bureau was still waiting to prevent any possible news leakage, and the security was even more stringent than some major incidents.
The day before that, an internal letter from Eisai Pharmaceutical Co., Ltd. was circulating on the Internet. The team participating in the price negotiation of Eisai unfortunately notified the company colleagues that Eisai’s liver cancer specific drug “Leweima” failed to pass the negotiation. According to Eisai, the company made careful preparations for the negotiation and negotiated with “the largest discount, the most honest, and the most sincere price”, but it still failed.
Then Eisai confirmed the interface news. The company ’s product Leweima (Lenvatinib) Can enter the national health insurance directory through negotiation.
Liver cancer is the second most common tumor in China after lung cancer. “Leweima” is currently the only first-line drug for liver cancer in China, but because the price is not lower than the bottom line set by the Medical Insurance Bureau, it can only be regretted to be out.
Lin Song, an expert in the medical insurance negotiation team and the head of the Fujian Provincial Medicines and Machinery Joint Procurement Center, detailed the way of negotiation at the press conference of the National Medical Insurance Bureau on November 28: “The National Medical Insurance Bureau first determines the expected price paid by the medical insurance, If the company quotes twice, both quotes that exceed the expected price by 15% will be out. “
In the two attempts, the negotiating group experts will “strive to guide the company to report a sincere price”. If the final quotation of the company is within the line of “over 15% of the reserve price” of the medical insurance bureau, the negotiating expert will launch another negotiation , “Ensure that the business bid is not higher than the previously determined expected price.”
It is not difficult to see from this plan that Dagle’s net film can be cut from the price of 4.40 to 4.36 yuan, “soul sword”, provided that 4.40 yuan is already within the range of “over 15% of the reserve price” of the medical insurance bureau, and 4.36 Yuanji is likely to be the real reserve price of the Dalgali net by the Medical Insurance Bureau. The so-called “4 too much is not good” may be just negotiation skills.
Even 1% of the profit is “the baht must be compared.” This is where the price negotiation is the hardest. According to the pharmaceutical companies involved in the negotiations, the entire scene of the negotiations was recorded and recorded, and the entire process was closed.