On May 8, the medical website of the pharmaceutical industry, as the review rate of the drug was accelerated, the other parts of the pharmaceutical industry should not be left behind, as did the adjustment of the health care catalogue. Recently, the ministry of human society is seeking comment on the establishment of the dynamic adjustment mechanism of the health care drug catalog. In Shanghai fudan university, professor, school of public health, health development research center director Hu Shan united point of view, the current government to health insurance directory to formulate a series of measures, including directory dynamic adjustment, embodies the "small step walk, don't stop" train of thought. 

 

Adjust once in two to three years 

 

From 2004 to 2009, the proportion of medicines covered by health care increased to 15.5 percent, compared with a 15.4 percent increase in 2009-17, with a 15 percent increase in each adjustment. For future dynamic adjustment, hu said that every two to three years, it is appropriate to increase the variety by 5%. 

 

Chen hao, a researcher at the center for drug policy and management at the university of huazhong university of science and technology, said that China's health insurance has a "positive directory" approach to medicine. The management decided the limited number of prescription drugs into the directory, is based on the medical insurance directory formation of the historical evolution, the medical insurance fund limited tolerance, guide the rational use of drugs and drug supply side management efficiency etc. The result of multi-factors comprehensive considerations. The relatively narrow scope of the catalog must not meet the diverse, multi-level, and optional requirements of clinical requirements. In the long run, China's health care drug catalog will eventually be targeted at "negative directory" management, which is in line with the objective law of medicine. 

 

In Chen hao's view, the social department's dynamic adjustment of the health care drug catalog needs to be taken into account. On the one hand, to enhance the support capability of universal health care, the ginseng protect the burden, at the same time, fully consider the requirements of medical insurance fund safety, sustainable operation, should be health care medicine directory adjustment work and medical insurance payment methods, medicine health care payment standards work together effectively, in fully protect people's rights at the same time, adopt the total pay to guide and promote rational drug use, save health care and social resources; Medical insurance directory, on the other hand, dynamic adjustment should follow the principle of decision-making should be evidence-based, into and out drugs should be fully considered clinical evidence, management factors, drug economics basis and fully coordinate the relationship between social welfare and industrial innovation efficiency. 

 

There is no room for withdrawal 

 

"Is now a small step for a walk, through to improve the health insurance coverage and improve the medical insurance fund two ways to ensure the endurance of the medical insurance fund is unlikely to bring up the mechanism is particularly important." "Said hu. 

 

The funding pool for health care is unlikely to expand indefinitely, and if there is no drug exit, the potential for new drugs will be reduced. "Some invalid or ineffective products, such as auxiliary medication and nutritional medicine, should do some measure, there is no clinical evidence should bring up; on the other hand, some curative effect is not the exact proprietary Chinese medicine should be firmly tuning out, the current medical insurance directory of proprietary Chinese medicine proportion is very high, 48.9% of the directory drugs, takes up over 30% for medicine, so to keep the good products, to eliminate the bad products." "He explained to the reporter. 

 

Chen Haoze suggested that medical insurance directory drug withdrawal mechanism should consider several aspects, such as drugs and inconsistent enterprise qualification, product prices, medicine, clinical efficacy and quality of misconduct by evidence to doubt, severe adverse drug events, poor drug economics evaluation, endanger the safe operation of the medical insurance fund, etc. The list of medicines for health care should be rechecked regularly to ensure that the health care fund is reasonably and effectively used, and is safe and sustainable for the long term. 

 

Which product opportunities are coming? 

 

In addition to confirmed in practice is not suitable for medical insurance fund support or more reported adverse events, the lack of adequate clinical curative effect and may endanger the safety of medical insurance fund operation and drug promptly removed from the directory and Tony also believes that the government can fully take care of clinical medication requirements, timely will receive sufficient evidence and clinical evidence, drug economics are beneficial to the medical insurance fund long-term sustainable operation of new drugs, new drugs into the directory, let patients to share the social benefits of scientific and technological progress in a timely manner. 

 

At present, the information, technology and management methods that are needed in the dynamic management of the catalog are available and provide realistic conditions for the realization of this idea. So, what products will get the chance? 

 

"The new medical insurance directory is not HCV drugs, in fact, in the Chinese market, HCV drugs was more important; tumor drugs, medical insurance directory can consider kidney cancer, ovarian cancer, a few cancer drugs such as bone marrow cancer; as the population ages, the alzheimer's and other mental disease treatment also has the potential to increase. In addition, multiple antibiotic resistant is the focus of future development." Hu Shan explained, to meet the demand of clinical products, first have to be sort of disease clinical needs, the need to classify the drug development as soon as possible, in view of the existing in the international market, the curative effect of products, to speed up the review. Government departments are proactive and encouraging drug companies to innovate in this direction, promoting government and corporate engagement. Hu said that companies are now focusing on new drugs, and that they should also consider the status of future changes in health care. 

 

It is reported, bristol-myers squibb, the best set of jersey (dara he wei hydrochloride) and speed (o (ShuRuiWei soft capsule) as the first fully oral direct joint treatment against hepatitis c virus in the recently approved by state food and drug supervision and management of administration. 

 

Adjustment into the national health insurance directory products, not only to locate a new drug clinical demand, you can also pay attention to the various provinces and cities major varieties of health care in the directory. 

 

On April 18, the national health and family planning commission convened the national rural poor special treatment of a serious illness work kick-off meeting, requirement by the end of 2017, on children's congenital heart, children's congenital heart ventricular septal defect, atrial septal defects (children with acute lymphoblastic leukemia, young children with acute early granulocyte leukemia, esophageal cancer, gastric cancer, colon cancer, rectal cancer, end-stage renal disease nine kinds of serious illness of intensive treatment to cover all in poor areas. 

 

Qingdao city in shandong province in 2013 began to negotiate special medicines for high value consumables, determine whether can into the government set up a special fund for protection of a serious illness, negotiations with has the qualification of pharmaceutical enterprises. In Hu Shan al view, the "high value also to focus on drugs, at least to consider in the next round of adjustment, both for medical insurance directory adjustment or medicare drug prices negotiations." 

 

In addition, the products that enter more provinces will also be the direction of dynamic adjustment of future health care. 

 

But in these areas, how do you choose the product? In the past, whether it was healthcare negotiations or a catalog adjustment, it was largely approved by experts. In fact, experts are also affected by drug companies, not necessarily objective. Hu suggested that future changes in the health care catalog should be combined with two aspects: one is to recommend the pharmaceutical industry to declare, and the other is to review the nominations, which will be more comprehensive.