Medicare “soul bargaining hand” personally: Why should we drop another 4 cents?

Text The chapter comes from the public number: xiake Island (ID: xiake_island) , author: Zhang Yan, the original title: The title picture comes from: Oriental IC.

“If the price is 4.4 yuan, there are too many 4 and the Chinese people find it unpleasant. It will cost another 4 cents, 4.36, okay?”

In the past two days, a “soul bargaining” video went viral on the Internet. The bargaining sentence in the video landed at the medical insurance price negotiation site of the National People’s Congress Conference Center. They are the medical insurance expert group formed by the National Medical Insurance Bureau and the negotiators of pharmaceutical companies.

The “countless fans” negotiation is the largest “match” in the 30 years since China established the medical insurance system:

Of the 150 negotiated drugs, a total of 97 drugs were successfully negotiated, and the average price dropped by 60.7%, including 22 anticancer drugs, 7 drugs for rare diseases, 14 diabetes, hepatitis B, hepatitis C, rheumatism Drugs for chronic diseases such as arthritis, 4 children.

Xu Wei, Director of Zhejiang Medical Service Management Office is one of the medical insurance experts involved in this negotiation. In the video of the whole network, he “cut” the last sword “soul cut” “The price hand” is him.

</ iframe> </ p></p> <p label = "Picture remarks" class = "text-img-note"> A scene of “soul bargaining” spreading across the Internet </ p></p> <p> </ p></p> <p label = "大 Title" class = "text-big-title"> One </ p></p> <p> </ p></p> <p> In order to ensure fairness and justice, the <strong> “double-blind” lottery </ strong> model was adopted in this medical insurance negotiation. Enterprises and medical insurance experts determine the allocated negotiation room on that day by drawing lots. After entering the room, the expert opens the sealed envelope to know the price to be negotiated on the spot and the medical insurance floor price. </ p></p> <p> </ p></p> <p> “There are two quotations. If the psychological price is not reached twice, you will be out of the game by yourself.” In the video, the experts participating in the negotiation were frank and clear the “rules of the game” from the beginning: </ p></p> <p> </ p></p> <p> The two sides use the method of <strong> price comparison </ strong>. <strong> The National Medical Insurance Bureau first determines the expected price of medical insurance payment, and the company quotes it twice. The two drugs that exceed the expected price by 15% will be eliminated. </ strong>. </ p></p> <p> </ p></p> <p> Nothing wrong, you are playing a <strong> psychological game </ strong>-On the one hand, companies do not know the expected price paid by the medical insurance bureau, and they must be cautious about quotations; on the other hand, medical insurance experts cannot When revealing the “card” in his hand, he should try his best to guide the company to report the price as expected. </ p></p> <p> </ p></p> <p> “Floating 15% on our expected price is a basis on which we can sit down and talk. Only when the price meets our expectations can the two parties formally sign the contract,” said Xu Wei, the “bargainer”. Before the negotiations, the National Medical Insurance Bureau has done a lot of homework, such as extracting authoritative backbones in pharmacoeconomics and medical insurance management nationwide, establishing a pharmacoeconomics group and a fund measurement group, grouping parallel calculations, and setting a base price for drugs. </ p></p> <p> </ p></p> <p> In addition, after getting a list of all the drugs to be negotiated, medical insurance experts will also make expected preparations based on the clinical use of these drugs, their demand and the selling prices in other countries. </ p></p> <p> </ p></p> <p> In short, the clinical demand for medicines, patient expectations for drug prices, medical insurance fund affordability, enterprise R & D costs, and acceptance levels, all considerations have all condensed into the soul sentence of medical insurance experts: < strong> “There is still a gap”, “There is a certain gap”, “There is a large gap”, “There is a considerable gap”, </ strong> <strong> “Do you want to go out and apply again?” </ strong> </ p></p> <p> For companies, whether they can get the right price is a matter of “stress.” According to Xu Wei, during the negotiation process, business representatives frequently asked their superiors for instructions. Although the stipulated negotiation time is half an hour, overtime is the norm at the site of the fairy bargaining. </ p></p> <p> </ p></p> <p> Of course, there are times when prices are unsettled and unsuccessful. The public information of the Medical Insurance Bureau shows that a total of 53 drugs failed to be negotiated this time, including 4 renewal drugs. </ p></p> <p> </ p></p> <p> In Xu Wei’s view, there are two main reasons for <strong> “talking collapse”: first, the estimated base price exceeds the affordability of the enterprise, and pricing in China will undoubtedly affect the global pricing of drugs; It is that the pharmaceutical companies have not done enough homework, and the prediction and estimation of the entire situation and prices are not in place. </ Strong> </ p></p> <p> </ p></p> <p> “Some companies have n’t entered the Chinese market for a long time. They have n’t realized the market potential of China. They have not prepared enough for early market research. They always compare South Korea and Taiwan with some small markets, which has resulted in negotiation failure. Xu Wei said. </ p></p> <p> </ p></p> <p label = "大 Title" class = "text-big-title"> 二 <br /> </ p></p> <p> </ p></p> <p> <strong> “How many people is there in China? Now it’s our country to negotiate with you and give you another chance” </ strong> After the video got hot, this sentence in Xu Wei’s mouth won countless netizens Like it. </ p></p> <p> </ p></p> <p> China’s huge market size is the largest bargaining chip in the hands of medical insurance experts. Xu Wei said that during the negotiation, he persuaded the other party more than once that China’s market is huge. If it enters the medical insurance market, the sales of medicines will increase tremendously, and the production costs of enterprises will fall. It is necessary to give the lowest price. </ p></p> <p> </ p></p> <p> “In the past, it was one province and one province to discuss the price separately. After all, the weight of a province is smaller, and many pharmaceutical companies are more willing to give medicines to give preferences rather than directly reduce prices. But this time the negotiations In China, we represent the entire Chinese market and have a say in negotiations. “</ P></p> <p> </ p></p> <p> Xu Wei also revealed that <strong> internationally accepted confidentiality practices </ strong> were introduced in this negotiation. If a company asks, the government will promise not to make the price public to the public, so that the company will be more comfortable giving the lowest global price. . </ p></p> <p> </ p></p> <p> Facing the Chinese market with unlimited potential, regardless of the health insurance bureauHow much the “soul bargaining” of the drug companies “meat pain”, they are still “extremely sober”, and find ways to enter the medical insurance bureau’s bargain list. </ p></p> <p> </ p></p> <p> In 2019, according to the PDB comprehensive database data provided by the China Pharmaceutical Industry Information Center, CICC calculated the sales of four star products of Metroloxacin, Herceptin, Anvitin, and Novotel. The data shows that although the price reductions of the four drugs after entering medical insurance were 29%, 65%, 62%, and 43%, due to the increase in sales, the actual sales amount of the four varieties in 2018 increased by 13%, 48%, 74% and 120%. </ p></p> <p> </ p></p> <p> “As the medical reform enters the Sham Shui Po District, both the approval cycle for innovative drugs and the access period for medical insurance have been significantly shortened. <strong> The drugs entered into the medical insurance list will be available to patients on January 1 next year. Buying also means that pharmaceutical companies can realize returns faster </ strong>. </ P></p> <p> </ p></p> <p> Xu Wei told reporters that when the country designed the entire negotiation process, many factors were taken into consideration, such as the concerns of companies on the rate of return and how people can use medicine faster and cheaper, so that companies can negotiate Gives the biggest discount. </ p></p> <p> </ p></p> <p> Describe in his words that after confirming entry into the medical insurance directory, some companies can be said to be “excitingly tearing their eyes” <span class = "text-remarks" label = "Remarks"> (Of course, it is not ruled out that they were cut (“Cry cry”) </ span>, showing the importance of the Chinese market to these pharmaceutical companies. </ p></p> <p> </ p></p> <p> <strong> “Exchange price for quantity” </ strong> is the general policy of medical insurance price negotiation, and the core purpose is to promote a substantial drop in drug prices. In recent years, around the price of drugs, various national departments have promoted a series of policies, including the implementation of consistency evaluation of generic drugs, the promotion of centralized bidding and procurement of drugs, the inclusion of large quantities of drugs into key monitoring, and the negotiation of medical insurance prices for innovative drugs. And the purpose of price negotiation is definitely not complicated-let the common people use good medicine and can afford it. </ p></p> <p> </ p></p> <p> According to preliminary estimates, the average price of new drugs this time has decreased by 60.7%. If calculated based on the actual reimbursement ratio of 50%, the <strong> patient personal out-of-pocket ratio will fall below the original 20% </ strong>, The out-of-pocket ratio of individual medicines will be reduced to 5%; the renewed 27 medicines will decrease by 26.4%, and the individual out-of-pocket ratio of patients will decrease simultaneously. </ p></p> <p> </ p></p> <p> Take melanox as an example <span class = "text-remarks" label = "Remarks"> (Indications include rheumatoid arthritis, ankylosing spondylitis, psoriasis, polyarticular juvenile characteristics Hair offThere is no cure for drugs; patients with diabetes, hepatitis B, rheumatoid arthritis, and chronic obstructive pneumonia have more high-quality new drugs to choose from. </ p></p> <p> </ p></p> <p> Xu Wei said that the medical insurance negotiation reflects the results of the deepening reform of China’s medical, medical insurance and medical linkage, especially in the negotiation of new drugs. With the speed of the review and approval of new drugs accelerated, the negotiations successfully The vast majority of drugs are new drugs marketed in recent years. </ p></p> <p> </ p></p> <p> More new drugs enter the medical insurance list through negotiations, which can better meet the needs of ordinary and affordable medicines. </ p></p> <p> </ p></p> <p> As for the drugs that failed to enter the list, the door of the National Health Insurance is still open to them: Xiong Xianjun, director of the Department of Medical Services Management of the National Medical Security Bureau, said at a press conference that <strong> The National Medical Insurance Bureau will consider Clinical needs, medical insurance affordability, and willingness of enterprises to lower prices, and renegotiating work </ strong>. </ p></p> <p> </ p></p> <p> In other words, in the future, more medicines will reach patients at lower prices and faster. </ p></p> <p> </ p></p> <p> <span class = "text-remarks" label = "Remarks"> The article is from the public number: </ span> <a href = "https://mp.weixin.qq.com/s/LTdQj9K6qFKJSfr8MWc0pg" target = "_blank" rel = "nofollow" style = "text-decoration: none;"> <span class = "text-remarks"> Xia Ke Island (ID: xiake_island) </ span> </a> <span class = "text -remarks ">, author: Zhang Yan. </ span> </ p></p> </div> <p class="post-tags"></p> </article> <script src='//unpkg.com/valine/dist/Valine.min.js'></script> <div id="vcomments"></div> <script> new Valine({ el: '#vcomments', appId: 'nFXLD31mFjDHlrEDx3OQWstS-gzGzoHsz', appKey: 'GhTuxYTHv3w2aqSJ0urXJov5', }) </script> <style> #veditor { background-image: url(https://image.bestzuo.cn/images/20200708160947.gif!getwebp); 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