At nine o'clock, medical insurance negotiations officially begin.
The scene fell into silence, and the noise of whispering disappeared instantly.
Chen Linghui coughed, looked directly at Wei Kang, and began to speak.
He also saw that Wei Kang was young. He had only taken over Sanqing Pharmaceutical for less than a year. He was not the person in charge of business and probably had little negotiation experience. Therefore, he planned to take the initiative with a thunderous attitude to see if he could win from the beginning. Intimidate the opponent and make maximum concessions.
“Our medical insurance negotiation team came this time with great determination, mainly based on the concept of people’s health first. We hope that through today’s negotiations, we can minimize the burden on patients and at the same time provide better services for more people. More patient services.”
"As we all know, the expenditure on cancer treatment in the medical insurance fund is very large, accounting for 13%, second only to cardiovascular and cerebrovascular diseases. Since the launch of the national drug negotiation mechanism, we have been working hard to make more anti-cancer patients Drugs have entered the medical insurance catalog, and in recent years, nearly a hundred new anti-tumor drugs have been added to the medical insurance catalog.”
“Of course, most of the drugs included in medical insurance are domestically produced drugs, and new foreign anti-cancer drugs are relatively expensive. For example, the current biggest competitor of Sanqing anti-cancer drugs, Merck’s Keytruda, has not been available because it is too expensive. Enter the medical insurance directory."
“If the Sanqing anti-cancer drug is much cheaper than Keytruda, then it will definitely not be a problem to enter the medical insurance catalog.”
"Sanqing Pharmaceutical previously issued a notice to the entire network, saying that it would allow patients across the country to receive medical treatment and take medicines. Everyone has seen this benevolent heart. Now that we are entering the negotiation process, I believe that the Minister of Health will not break his promise. I will definitely show the utmost sincerity.”
"The price of Sanqing anti-cancer drugs overseas is very high, and they must have made a lot of money. Therefore, the domestic price should be given to the maximum extent, so that we can shoulder the responsibility of a national enterprise. Only then can we believe in the sincerity of President Wei.”
"Of course, we also take into account that Sanqing's investment in the research and development of new drugs is very high. The state has always tried its best to support high-tech enterprises. Therefore, as long as the price of Sanqing decreases, we will try to increase the reimbursement ratio. This is also the reason why our medical insurance sincerity."
"As long as both parties are sincere, I believe this negotiation will reach a relatively satisfactory result."
"Mr. Wei, what do you think?"
With his words, he first threw out his national justice and benevolence, and then used Wei Kang's previous speech to make a big fuss, asking the other party to maximize profits. If Wei Kang's price reduction is not large, it will inevitably give people a sense of discomfort. The impression of integrity.
Of course, it’s not like he didn’t offer benefits. If Sanqing really offered a sincere price, he would adjust the reimbursement ratio for anti-cancer drugs, so that most of the costs would be borne by medical insurance, which would promote the sales of anti-cancer drugs. If sales increase significantly, income will also increase significantly. Overall, it will be beneficial to both parties.
The drugs in the medical insurance catalog are divided into three categories: Category A, Category B, Category B and Category C. The reimbursement ratio of drugs in each category is different.
Class A drugs are effective and low-cost. They are reimbursed at 100% of the reimbursement ratio and do not require out-of-pocket payment. Class A drugs are uniformly formulated by the state and cannot be adjusted by various localities.
There are many types of Class B drugs with good curative effects, but some of them must be paid out of pocket. The specific reimbursement ratio varies according to local policies and specific drugs.
Category C drugs are health products and new drugs, and are basically paid for at your own expense.
It should be noted that not all drugs in the medical insurance catalog can be reimbursed, but they also need to be looked at according to the type of disease or specific group of people.
For example, oseltamivir is a commonly used anti-influenza drug and is a Class B drug under the national medical insurance. However, there are certain restrictions. For example, the oral constant-release dosage form of oseltamivir is only available for anti-influenza drugs for people at high risk of severe influenza and for patients with severe illness. For viral treatment, granules are limited to children or patients with swallowing difficulties who are not suitable for oral sustained-release dosage forms.
If you do not meet the conditions of use, you will have to pay out of your own pocket.
The domestic drug catalog has a total of close to 200,000 drugs. Medical insurance can reimburse 95% of Class A drugs, only more than 2,000 kinds, and about 1,000 Class B drugs.
Most of the remaining drugs are Category C drugs and cannot be reimbursed. As for imported drugs for serious diseases, special effects and life-saving drugs, they are all in Category C drugs.
This drug classification is very important and authoritative, because the reimbursement of commercial medical insurance is also based on the standard medical insurance. Only Class A and B drugs that can be reimbursed by medical insurance can be reimbursed in proportion to commercial reimbursement.
Wei Kang smiled slightly and seemed unmoved. He just nodded and said: "Team Leader Chen, what I said naturally counts. You can rest assured on this."
"In addition, I am also very interested in Keytruda's market, so our Sanqing anti-cancer drug will definitely be cheaper than its price."
As soon as these words came out, everyone around them nodded secretly. Sure enough, Sanqing was indeed sincere, at least much more sincere than Merck.
Chen Linghui felt at ease, and a smile appeared on his tense face.
"Very good, then the President and we have reached a consensus on price reduction. I believe the subsequent negotiations will be much easier."
"Here, I need to emphasize that everyone knows that there has been a rumor in the medical industry that anti-cancer drugs with an annual cost of more than 300,000 yuan cannot be included in the medical insurance catalog. This is indeed true."
"But I know that Sanqing's anti-cancer drugs are very effective, and most cases are completely cured within a few months."
"So there is no such thing as an annual fee. This is good for patients and medical insurance from every angle. Haha."
He gave a rare smile, then looked at Wei Kang and asked every word.
"Mr. Wei, what is your psychological price for anti-cancer drugs?"
Wei Kang smiled lightly and said: "I very much agree with you. If the annual cost exceeds 300,000, there is really no need to enter medical insurance. Sanqing will never exceed this value."
"As for my psychological price, it depends on how high your budget is for domestic drugs."
He suddenly looked serious: "I know that many domestic PD-1 anti-cancer drugs have been reduced to cabbage prices. The competition for domestic drugs is very fierce. The annual cost they quote for medical insurance has been reduced to less than 40,000 yuan."
"This is based on the pricing standards of generic drugs. Although Sanqing is also a domestically produced anti-cancer drug, it cannot compare prices with generic drugs when it independently develops new drugs."
"If Team Leader Chen uses this price to demand Sanqing, it would be an insult to Sanqing and must not be accepted."
Chen Linghui breathed a sigh of relief. From Wei Kang's words, he had figured out the approximate price range of Sanqing.
The annual cost should be much higher than that of domestic drugs, but lower than that of imported drugs, which seems reasonable. Considering that Sanqing anti-cancer drugs have no follow-up treatment costs, the overall price can be increased a little.
Now that the highest and lowest prices have been set, the subsequent negotiations will depend on the bargaining skills of both parties.
So he smiled and nodded: "Of course, Sanqing is a self-developed new drug and has been recognized by overseas markets. It will naturally be treated according to the specifications of imported drugs."
He immediately cheered up, started talking, and started negotiating the price.
"Then let's calculate the quotation based on the annual cost. I think our goals are the same, and we don't want any tricks. We mainly consider the patient's burden level."
"Everyone knows that the annual income level of urban residents in our country is still very low. According to the National Bureau of Statistics, the average annual income of non-private employees is less than 100,000, and the average annual salary of employees in the private sector is just over 50,000."
"As for the disposable income of residents, it is even lower. The per capita disposable income of residents this year is only 32,189 yuan, which is quite low. If we set the price high and it is far beyond the affordability of the people, it will definitely be It doesn’t make any sense.”
"According to the "National Medical Security Benefits List", it stipulates that the maximum payment limit for employee medical insurance plus large medical expense subsidies for employees and resident medical insurance plus critical illness insurance should in principle reach about six times the average annual salary of local employees and the per capita disposable income of residents. .”
Chen Linghui looked embarrassed and said: "You see, when we set prices, we must consider the whole country and cannot be limited to one place. Otherwise, the prices set will be affordable for the residents of first-tier cities, and the residents of small towns may have to sell the goods."
He slowly puts out a price.
"So our first requirement is that the cap line for residents' medical insurance should not exceed 200,000 yuan, and the cap line for employee medical insurance should not exceed 250,000 yuan. As for the specific reimbursement ratios in various places, we can discuss it further."
"This is based on the fact that Sanqing anti-cancer drugs only have a one-time treatment cost."
"Mr. Wei, what do you think?"
Everyone in the audience held their breath for a moment and looked at Wei Kang, waiting for his reaction.
There was a hint of sympathy in his eyes.
Because this price is too low compared to the miraculous curative effect of Sanqing.
And this price is paid by the patient and the medical insurance fund in proportion.
If you enter Category B drugs, based on the highest out-of-pocket ratio of 80%, the patient only needs to pay a few hundred thousand.
Especially the price of Eagle Country, which is more than 800,000 US dollars, has been exposed. This price in China is really a bargain.
