As the most effective "baton" of the market, "price" is the core force that allows the market to play a decisive role. Reforms surrounding prices have also become a hard bone that must be gnawed under market-oriented reforms.
Li Keqiang’s deployment shows that after the pricing power in multiple areas is “returned” to the market, Chinese officials will also introduce more price reform measures to accelerate the process of market-oriented reforms.
A series of signs show that the medical and pharmaceutical sector is expected to become a breakthrough point in the current round of price reform.
The Chinese government website recently issued an article describing the details of the executive meeting in detail. The article used a special paragraph to mention Li Keqiang’s concern and statement in the medical field: "The current public hospital medical service fee is indeed too low, but the phenomenon of inflated drug prices is still Existence, therefore, through reforms, this unreasonable price mechanism must be gradually straightened out."
This statement released two important reform signals: one is medical services: in the case of the official difficulty in uniformly measuring costs, medical services may be set by the market in the future, so that the labor value of medical providers can be reflected; the second is For medicines, the current official pricing model for setting the "ceiling" of drug prices will also be adjusted.
The current administrative intervention in the price of medicines in the Mainland is determined by setting a price ceiling. According to industry insiders, this kind of drug price "ceiling" seems to control the price of drugs, but in actual operation it has caused an obvious problem: high-cost, effective drugs are closer to the "ceiling" because of their price. The space for providing hospitals with rebates in drug prices is relatively small; relatively, low-cost, poor-quality drugs are far away from the "ceiling", but they have more room for operation, making the drug market "bad money drives out good money". The phenomenon.
Liu Enguo, a professor at the National Development Research Institute of Peking University, told the China News Agency that in the past, without universal insurance, the demand side of drugs lacked a collective bargaining platform to compete with drug manufacturers. A single patient has no resistance to the price hikes of the drug manufacturers. In this case, it is necessary for the government to set the highest price. In Liu Enguo's view, the government currently has two favorable conditions to not only release drug pricing power to stimulate market vitality, but also not cause major fluctuations.
One is that with the government-led medical insurance covering the whole people becoming more and more perfect, medical insurance can already form a force on the drug demand side through collective bargaining, instead of administrative control and drug manufacturers on the supply side.
In addition, the improvement of medical insurance payment methods will also help to change the chaos in the drug market. Liu Enguo analyzed that in the past, medical insurance paid for drugs based on the price of a single drug, but at present, medical insurance payments are no longer based on the price of the drug, but on the basis of "disease" or even "number of people".
"The change brought about by the payment method is that the medication for patients is no longer the income of the hospital but the cost." Liu Enguo said, for example, if the medical insurance determines that the treatment of appendicitis is X yuan, then the medical insurance will pay the hospital for every case of appendicitis treated by the hospital. Fixed X yuan. In this case, the hospital's income level depends on whether doctors can use their professional level to choose more cost-effective drugs. If a pharmaceutical factory raises its price arbitrarily, it will naturally not be chosen by the hospital.
Prior to this, CCTV also quoted the opinion of Peng Sen, a member of the Standing Committee of the National People’s Congress and vice chairman of the Finance and Economics Committee, saying that it is now fully qualified to fully release the prices in the catalogues of more than 1,000 medical insurance covered by the main government. To the market.
However, as Li Keqiang requested, the government must not only form an open and transparent market-based pricing mechanism as soon as possible, but also promote it steadily so that the people can "tolerate" the price fluctuations that may arise from certain reforms. Therefore, the official decentralization of drug pricing power still requires a number of measures to cooperate.
Liu Enguo said that if drug prices are to be determined by the market, it is necessary to continue to improve the collective bargaining capabilities of medical insurance and continue to improve the payment methods of medical insurance. In addition, the government should also increase anti-monopoly law enforcement against pharmaceutical companies to avoid bid-rigging, price hikes, and abuse of market dominance for profiteering and other behaviors that harm consumers' interests.