"Zhangzhou mode" upgrade, prescription sharing pharmacy chronic illness medical insurance direct settlement official trial

Arterial Network was informed that on July 5, Cangzhou City officially launched the chronic disease medical insurance co-ordination account to settle directly in the prescription sharing pharmacy, relying on the easy-to-review third-party prescription sharing platform, Dashen Linda Pharmacy, Zhangzhou People's Pharmacy as the first batch of out-of-town pharmacies Signed with the Social Security Bureau of Cangzhou City and officially connected to the medical insurance co-ordination account. The chronically ill patients can be settled directly after the renewal and purchase of the drug at the relevant pharmacy.

Cangzhou City chronic disease medical insurance co-ordination account in the prescription sharing platform pharmacy direct settlement initiation ceremony (business map)

Third-party prescription sharing platform helps prescription outflows across “three big mountains”

The primary goal of the "new medical reform" is to achieve "three medical linkages", and the prescription outflow is an important path to achieve "three medical linkages." The mode of prescription outflow is actually very well understood, that is, the prescription dispensing that was originally in the hospital is transferred to the outside of the hospital, and the circulation dispensing enterprise or social pharmacy is responsible for the prescription dispensing work.

From the perspective of national policies, the outflow of prescriptions is the general trend. Since 2013, the key tasks of deepening the reform of the medical and health system every year have described the description of “no restrictions on patients purchasing medicines by prescription.” In addition, Xi'an, Chengdu, Chongqing and other places have successively issued the "e-prescription" pilot program, and retail pharmacies adopt the method of docking with medical institutions to obtain electronic prescriptions and complete prescription dispensing.

However, in practice, there are still many difficulties in the prescription outflow. For example, the source of prescriptions, how to ensure the true source of prescriptions, the authenticity of prescription information, the purchase of drugs without re-use, the rational use of drugs and the traceability of the whole process; the second is the issue of medical insurance co-ordination, the medical insurance co-ordination test the rational use of medical insurance funds, to avoid large prescriptions, fraudulent insurance, etc. Finally, it is the pharmacy service capacity problem of pharmacies. Whether pharmacies can guarantee the supply of medicines and professional services, and the extension of prescriptions for which pharmacies are open requires a reasonable review.

The third-party prescription sharing platform is the best practice of prescription outflow. Through the third-party prescription sharing platform, it can connect with the hospital, obtain prescriptions, ensure the patient's truth, the prescription information is true, the medication is safe and controllable, and the retail pharmacies can be screened to let those A pharmacy that can truly satisfy the patient's demand for medicine and provide professional pharmacy services to perform prescription work outside the hospital.

Baiyang Pharmaceutical Group's easy-to-review company launched the nation's first third-party prescription sharing platform in May 2017 in Guangxi, becoming the first pilot-based sharing information sharing program in the country, and gradually explored the mature model of prescription outflow. The "Cangzhou Mode" of the prescription outflow.

The “Cangzhou Model” is characterized by the establishment of a system of efficient connection between hospitals, medical insurance, pharmacies and patients based on the easy-to-review third-party prescription sharing platform, helping the hospital to relieve the pressure of pharmacy operation and bringing patients, especially chronic patients. Convenience. For this reason, the “Zhangzhou Model” has also been unanimously recognized by the management department and patients.

"Zhangzhou mode" is upgraded again, and pharmacies use chronic drugs to get through medical insurance

After more than a year of operation, the easy-to-review third-party prescription sharing platform has explored the “gold standard” for prescription outflows.

Ma Guanglei, deputy secretary-general of China Pharmaceutical Business Association and general manager of Yiyi clinic, told the arterial network reporter that the Zhangzhou model has strong reproducibility. The strong replication is mainly reflected in the three characteristics of the third-party prescription sharing platform: First, the whole model has The complete policy basis is to achieve “legal”; secondly, both information capabilities, service capabilities and regulatory systems are relatively complete and highly professional; thirdly, the hospital and the government bring drug rationality monitoring to patients. It will bring convenient and accessible drug purchase channels, and bring pharmacies a way to legally accept out-of-hospital prescriptions, improve the marketing efficiency of prescription drugs, reduce transaction costs, and win-win results.

Recently, the Human Resources and Social Security Bureau of Ganzhou City of Guangxi issued a "Notice on the Issues Concerning the Direct Settlement of Special Chronic Diseases in the Prescription Drugstores for the Examination of Pharmacies (Consultation Draft)" (hereinafter referred to as the "Opinion Draft").

The "Opinion Draft" pointed out that the special chronic diseases of medical insurance clinics will be settled directly at the prescription sharing pharmacy, and will be trialed from July 1, 2018. A prescription-sharing pharmacy for a medical insurance designated medical institution that has signed a medical insurance service agreement with Chenzhou City, and a special chronic disease for medical insurance clinics can be directly settled. Among them, the part that is paid by the insured person is directly settled by the insured person with the pharmacy; the part that is paid by the unified fund is settled by the medical insurance agency and the pharmacy.

The re-upgrading of the "Chuzhou Mode" is mainly reflected in two aspects. First, establish a reasonable and controllable online review and opening process. Based on the easy-to-review third-party prescription sharing platform, patients can choose to upload the prescription code within two months. The hospital can use the relevant information to call the patient's medical information and records as the basis for review, so as to realize real and safe online chronic disease. Continued. Second, the pooled account is officially open to retail pharmacies. Most chronically ill patients are involved in medical insurance co-ordination account reimbursement. The first batch of prescription sharing pharmacies and medical insurance system docking, so that patients can more easily enjoy hospital extension services and out-of-hospital drug purchase services.

The 100 billion prescription outflow market is more standardized

Huachuang Securities Research Report pointed out that under the general trend of prescription outflow, such as prescription drug sales outside the hospital can reach the US level, that is, the sales outside the prescription hospital accounted for 45% of the total prescription sales, and the prescription outside the hospital will add 300 billion yuan, this increase It will be mainly undertaken by retail pharmacies, third terminals and so on. The general trend of prescription outflow will increase the overall growth rate of the pharmaceutical retail industry.

In the face of a huge prescription market, pharmaceutical companies, distribution companies, retail companies, etc. have made many attempts, including DTP pharmacy, Internet + new retail mode of medicine, third-party prescription information platform.

The industry believes that the best way to accept prescription outflows is the third-party prescription sharing platform + retail pharmacy model. First of all, the number of retail pharmacies is large, which can best cover patients. Secondly, the concentration of retail pharmacies continues to increase, and the chain rate is higher than 50%, which helps the industry to fine-tune management and improve service capabilities. Finally, innovative technology Tools and platforms “energy” for retail pharmacies, and retail pharmacy drug supply and pharmacy services can meet the needs of prescription extension.

Among them, after three years of exploration and practice, the third-party prescription sharing platform of the easy-to-review clinic has already shown the effect of the three-medicine linkage. Taking the Hongzhou Red Cross Hospital as an example, the outflow prescription of the hospital accounts for about 11% of the prescriptions prescribed by the hospital. After the “Zhangzhou Model” is upgraded, the prescription sharing platform pharmacy can apply for trial direct settlement of special chronic diseases in medical insurance clinics, and the proportion of outflow prescriptions will further increase.

In the regulation of prescription sharing pharmacies, the easy-to-review third-party prescription sharing platform has done a lot of work. Pharmacies have strict access standards in terms of system and brand, hardware, inventory and service requirements. Pharmacies and individuals operating under the regulations shall establish preventive measures and deal with them in a timely manner. The hospital and the easy-to-review clinic jointly set the access standard, and the pharmacy applies for admission when it is voluntarily, and the hospital and the easy-to-review clinic jointly check. If the audit is not completed, the pharmacy cannot enter the prescription sharing platform.

Yu Huaijun, vice president of Dashenlin Pharmaceutical Group Co., Ltd., said that the liberalization of the unified account puts forward higher requirements for pharmacies entering the prescription sharing platform. Such pharmacies need to have strong economic strength (with medical insurance funds for medical insurance patients). And the price advantage brought by cash purchase), in strict accordance with the GSP requirements and standardized management, can cooperate with the medical insurance department and the hospital to carry out the whole process supervision of medical insurance card, in order to meet the process of prescription sharing controllable, the results can be controlled.

Ma Guanglei finally said that the prescription outflow for pharmacies and platforms, the test of technical capabilities, service capabilities, industrial capabilities, easy to return to the clinic, hospitals, pharmaceutical companies, pharmacies and many other partners, continue to explore and improve the "Zhangzhou model", In combination with the actual situation in each place, we will help all provinces and municipalities complete medical reforms, realize the "three medical linkages", and ultimately realize the convenience and convenience of the people.

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