ABSTRACT
The accessibility of drugs is the fundamental condition for achieving the universal health care, and price is the important factor of accessibility.It is essential to have a national price negotiations mechanism for the patented drugs and for exclusive production of drugs.As for the regular works, the national price negotiations mechanism should be ruled by law, while rules and regulations should be formulated accordingly.This paper discusses the specific content and the clarification of the legislative principle of legal framework for the negotiations, main roles, and selection of objects, procedure, results and application of the negotiations.It also analyses the existing problems are analyzed, and put forward the future legislation and corresponding rules.
ABSTRACT
With this retrospective study, we analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation in typical regions at home and abroad.In foreign countries, drug negotiation mechanism has been implemented for many years, and many countries have established a relatively perfect negotiation system.We selected 8 typical countries and regions for which we statistically analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation and these include the United States, Australia, Canada, France, Germany, Italy, South Korea and Taiwan.However, in recent years some Chinese medical insurance department carried out pilot works on drug negotiations, and they got some successful results of the implementation of practical experience.Eight typical Chinese regions were also selected for statistical analysis, and these include Zhejiang, Hunan, Jiangsu, Jiangxi, Chengdu and Qingdao.From the analysis of the comparison of drug negotiation mechanism in domestic and foreign typical regional, we found that foreign regional drug negotiation mechanism is more mature and perfect, while in the domestic areas the mechanism is still poor at a certain extent as compared to foreign countries.We should learn from the successful experience of foreign countries and also establish and improve the negotiation mechanism that is suitable for China''s national conditions.
ABSTRACT
Objective:The aim of the present study was to conduct an international comparison of the high-val-ue drugs payment systems of some selected countries, and introduce them to the Chinese context. Australia, America and Germany's high-value drugs payment systems were selected to serve as references for China. Methods: The main content and characteristics of three countries' payment systems were analyzed in four aspects:expenditure copayment mode, paid-scope selection, drug price negotiation, and drug rational use management which were then compared with the Chinese status. Results:Through the difference in healthcare system tradition, the above countries have vari-ous copayment mode, but they all select paid-drug by cost-effectiveness analysis with corresponding control measures. Conclusions:China should: establish a co-payment mode for the high-value drugs on the basis of a critical illness medical insurance found;build a national pharmaco-economic evaluation index system and improve the national nego-tiation superiority, while emphasizing on risk-sharing mechanism; and make series specifications to guarantee the drug to be rationally used.
ABSTRACT
The Risk-sharing agreements have achieved remarkable success in improving patients'access to drugs, lowering the uncertainty of the drugs cost-effectiveness, financial risk control and other aspects of medical in-surance fund , so they have attracted widespread attention by the concerned governments and insurers .This paper sys-tematically reviewed the patient access schemes in UK from several aspects , including the origin of the program , clas-sification , application processes and the implementation effects as well .The results of the research indicated that Chi-na has basically met the conditions for implementation of the risk-sharing agreements .In order to gradually promote the risk-sharing agreements implementation , this paper suggests that China should clarify the main root of risk-sharing agreements implementation , establish risk-sharing agreements standardization process and strengthen the application of health technology assessment in health resources allocation to improve the Chinese medicines bargaining system more scientifically and efficiently .
ABSTRACT
Many stakeholders are involved in the implementation of centralized drug procurement , namely government agencies ,drug bidding or procurement agencies ,pharmaceutical companies ,medical institutions ,doctors ,patients and health care institutions among others.The game falls into three stages.The first is that between government agencies or drug procurement agencies and medical institutions or doctors ;the second is that of price negotiations between the hospital and the winner pharmaceutical enterprise ; the third is that between doctors , patients and medical insurance agencies.Major setbacks found in the implementation of such a policy are as follows :disappearance of classic inexpensive drugs from the market ;rebates and commissions in the second bargainingphenomenon ;slow progress in the implementation of the purchase with quantity indication policy ;rapid rise of medical costs for national health insurance.Recommendations by the authors include optimization of the centralized drug procurement ;improvement of the public hospital performance appraisal system and talent evaluation system ;promotion of the purchase with quantity indication policy ;building of the game pattern of equal‐footing negotiation between hospitals and pharmaceutical companies ; and introduction of the payment management of medical insurance .
ABSTRACT
Objective: To provide policy recommendations for improving price negotiation system of patented drugs in China. Methods: This paper comparatively analyzes the commonalities and characteristics between Korea’ and Germany’s price negotiation models for patented drugs from three aspects of their goals, procedures and effects. Results:The key objective of both Korea’ and Germany’s price negotiation systems for patented drugs is to efficiently improve the utilization of national health insurance services, and responsibilities are properly assigned among differ-ent institutions to ensure the equity and efficiency of negotiations. However, due to the differences in national cir-cumstances, there is a big difference in the selection of technical assessment criteria. Conclusion: This paper sug-gests China to strengthen the convergence between price negotiations for patented drugs and medical insurance reim-bursement policy, to establish a technical assessment system with the innovation extent for patented drugs as its core, and to develop scientific and rational negotiation procedures and division of responsibilities as well.
ABSTRACT
Despite large revenues in terms of reimbursement from health insurance, many cardiovascular centers in Japan are losing money. On the other hand, manufacturers of cardiac interventional devices are making money in Japan. A big price disparity exists in the field of cardiac interventions between Japan and the West according to many surveys, the first among them being published by JETRO (Japan External Trade Commission) in 1996. Since then, the Central Social Insurance Medical Council has been discussing this issue, but the gap has not been dissolved. The IHEP (Institute for Health Economics and Policy) report on the actual condition of distribution channels for medical devices in 1997, describes several reasons for the high prices of medical equipment and devices in Japan. Among them, the high prices are best explained for by well-acknowledged fact that the sole importing distributors, which are often subsidiaries of the US manufacturers, set high prices (70% of the purchase price of hospitals) when the devices reach Japan. While we proposed several practical approaches to address this problem, we consider the high government-set prices of the devices must be dealt with first. Why is it bad to leave the government-set reimbursement price of medical devices so high, given the fact that hospitals are able to earn the margin profit because the actual price that they pay to distributors is significantly lower than the reimbursement price ? Because, if the total health expenditure of Japan can not be increased in amount due to the government budgetary problems, then the remaining budget left over to cover physician fees will likely be decreased and will eventually hurt the hospitals financial state. The government should take quick action to eliminate the existing price disparity.