[Turn] The payment is difficult to pull down the pharmaceutical company, and the shot

Source: Sai Bailan/Mu Zhi

01

Cancellation of hospital consumables for consumables

The hospital's payment has always been the focus of tearing and game. The contest between enterprises, hospitals, and medical insurance is full of the entire return cycle. Especially in terms of consumables, the repayment cycle can even grow for more than a year, which seriously exceeds the time stipulated in the policy.

Some insiders told Sai Bailan that the pharmaceutical companies have become a "bank" to provide "interest -free loans" to the hospital. Especially with the implementation of the collection policy, the profit of product profits has fallen sharply, and the difficulty of repayment has caused tremendous financial pressure on the drug company.

In order to solve this problem, the country has introduced a series of documents in recent years to continuously increase the supervision of the payment settlement of medical institutions. But in order to completely solve this illness, you must start with the subject of the payment.

On August 12, 2022, the Ningxia Medical Insurance Bureau publicly solicited the "Implementation Plan for Procurement Procurement Work (Trial)" of the Ningxia Hui Autonomous Region Medical Institutional Medical Consumption Alliance.

According to the implementation plan, according to the direct settlement and evaluation of the medical insurance fund and the enterprise, the medical consumables within the alliance purchase the medical insurance directory will be incorporated into the direct settlement range in a timely manner. For medical consumables outside the medical insurance catalog, medical institutions and enterprises should be cleared in a timely manner, and the settlement time must not exceed the end of the month after the delivery acceptance.

On August 10, the Xiamen Municipal Medical Insurance Bureau, Health and Health Commission, and Market Supervision and Administration Bureau jointly issued the notice of the implementation of the "Concentration Procurement Procurement Procurement Procurement Procurement Procurement Procurement Procurement Purchase of General Medical Consumption Institutions in Xiamen" (hereinafter referred to as the "Plan").

The new plan proposes that in order to ensure the timely settlement of the payment, the payment of the product payment in the general consumption collection is included in the scope of the medical insurance payment. Product payment. The product payment paid by the Medical Insurance Fund is deducted from the medical insurance settlement model of medical institutions, and the permissions of the payment of consumables for consumables for medical institutions will be completely canceled.

This means that the criticism of the criticism of "arrears" may be completely removed.

02

How difficult is the payment of pharmaceutical companies?

Prior to the introduction of the "two -vote system", the pharmaceutical company did not need to face the hospital directly, but instead sold the drug to the hospital through a series of dealers. The natural repayment problem was the issue of the dealer.

However, after the two -vote system is fully implemented, enterprises need to face the hospital directly, which is equivalent to passing the pressure of previous dealers to the pressure on the pharmaceutical companies. In the face of so many hospitals in the country, the pressure naturally doubles. For the sake of continuing cooperation in the future, few pharmaceutical companies dare to tear their face to tear their skin to the arrears hospitals.

The medical representative of a well -known pharmaceutical company told Sai Bailan: "The more hospitals with more arrears, the more difficult it is to do. In order to repay the payment as soon as possible, the company will even allocate more money for the relationship."

He said that overall, the difficulty of repayment has been resolved to a certain extent after the collection, but there are still arrears, but even more serious than before.

In September 2018, the Hubei Provincial Pharmaceutical Industry Association investigated eight representative pharmaceutical business enterprises and learned that some public medical institutions' drug repay periods were 960 days long, and it violated 32 times that of 30 days of payment in violation of the country's requirements. The amount is as high as 86 million yuan.

With the increasing situation of the ownership of pharmaceutical companies, in November 2019, the State Health and Health Commission issued a document, requiring the provinces of comprehensive medical reform pilot provinces to take the lead in promoting the direct payment of the medical insurance agency with drug production or distribution enterprises, and other provinces must actively actively actively actively explore.

In August 2021, the Shandong Provincial Medical Security Bureau, Shandong Provincial Department of Finance and other departments jointly issued the "Notice on Printing and Distributing Pharmaceuticals and Medical Insurance Fund and Medical Enterprises of Pharmaceuticals and Medical Consumption of Public Medical Institutions in medical insurance. Before the end of the month, the province will establish a unified pharmaceutical and device settlement supervision platform in the province, and complete the direct settlement of the pharmaceutical consumables medical insurance fund to purchase the drug consumables. By 2025, the direct settlement of medical insurance funds and pharmaceutical companies will be officially implemented.

In addition to Shandong, Shaanxi, Guizhou, Tianjin, Liaoning, Henan and other provinces and cities have also opened pilots to promote the direct settlement of medical insurance funds and enterprises and alleviate the pressure on enterprises.

Some experts told Sai Bailan: "After the implementation of the new policy, the impact on the repurchase of pharmaceutical companies should be immediate, but whether it can be implemented nationwide as soon as possible, it depends on the specific landing situation."

03

Multiple measures are proceeded, and medicine is separated or becoming a trend

Propagation of direct settlement of medical insurance funds can largely alleviate the difficulty of recovery in pharmaceutical companies, but the chain impact that can be generated in the future may not be limited to solving the problem of pharmaceutical companies.

A researcher in the pharmaceutical industry told Sai Bailan that when the medical insurance fund and the pharmaceutical company directly settled, the hospital became a state of "overhead" in this industrial chain, lost payment permissions, from reporting to purchasing to purchase. Autonomy will be weakened.

He believes that this may further promote the "medicine separation" to reality. In addition to helping pharmaceutical companies to solve the problem of recovery, it can also promote the development of anti -corruption work.

Driven by interests, whether it is clinical medical care, hospital procurement, or sales of pharmaceutical companies, or even officials in the vocational department, it may take risks and seek personal gain for themselves during the circulation of medicines and equipment. As the medical representative above said, pharmaceutical companies even need to prepare special funds for accounts.

The direct settlement with pharmaceutical companies means that another intermediate link is cut off. In the long run, it can be rectified in the industry's atmosphere, which is important for medical insurance and patients.Some experts told Sai Bailan that medical insurance direct settlement of pharmaceutical companies will touch the "cheese" of a large number of vested interests, and it is indispensable in the subsequent promotion process.However, as the reform enters the deep water area, only this can make some people "pain" the most valuable policy.

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