1. What does the medical insurance bureau do?

The unit nature of the medical insurance bureau is the state administrative organ, which is subordinate to the local human resources and social security bureau. Medical insurance bureau's main responsibilities:

1. Responsible for accepting the daily affairs such as approval, payment and management of basic medical insurance, industrial injury insurance, maternity insurance and medical expenses pooling fund for retired cadres;

2 to provide corresponding management services for employers, employees and retired cadres who participate in basic medical insurance, industrial injury insurance and maternity insurance.

Second, after the establishment of the Medical Security Bureau, it will become the most concerned government department for pharmaceutical companies and medical device enterprises. There are three reasons:

1, market access

What is market access for domestic pharmaceutical industry? In a narrow sense, it can be understood as: bidding, entering medical insurance.

If the drug fails to pass the tender, it means losing the whole hospital market. Furthermore, if the drug fails to enter the medical insurance catalogue, even if it passes the bidding, it will have a very huge impact on its market.

Bidding and medical insurance catalogue are both market access, but now these two rights are in the hands of medical insurance bureau, and their importance is self-evident.

2. Strictly control medication.

Medical insurance control fee is obviously the key word of 20 18. Under the big action of medical insurance fee control, for pharmaceutical companies, entering the catalogue is only a threshold, and hospital access and medical insurance payment standards are the most important.

The medical insurance bureau has the right to control the cost from the source, and will have direct control over the drugs and auxiliary drugs that were used in large quantities before. In addition, under the medical insurance payment standard, hospitals will be prompted to use the lowest-cost drugs to treat patients on the basis of rational drug use. In the future, under the medical insurance environment, the game of interests of all parties will be more obvious.

3, directly determine the drug price.

Previously, the National Development and Reform Commission was responsible for drug pricing, Ministry of Human Resources and Social Security was responsible for the medical insurance catalogue, and the Health Planning Commission was responsible for bidding and purchasing, and finally it was paid by medical insurance. Therefore, the pressure of medical insurance is increasing.

Nowadays, the Medical Insurance Bureau has taken over the bidding and purchasing of drugs, which embodies the principle of "whoever pays, who trades". On the other hand, under the realistic medical insurance funds, the winning bid price of drugs will be closely tied with the medical insurance payment standard to maximize the interests of all parties.

In this case, the hospital or medical association can negotiate the drug price according to the medical insurance payment standard. They can even entrust a third-party platform to negotiate drugs with the local medical insurance bureau. The ultimate goal is only one, on the basis of medical insurance payment standards, to reduce drug prices and maximize benefits.

It can be said that medical insurance will directly affect the fate of pharmaceutical companies and even enterprises from many angles. Among them, the helm is the Health Insurance Bureau.

Over the years, there have been many chaos in centralized bidding and purchasing of drugs. Therefore, during many years of NPC and Chinese People's Political Consultative Conference meetings, many NPC deputies and CPPCC members called for the reform and improvement of the current drug centralized bidding and purchasing policy.

In view of the centralized procurement of drugs in public hospitals, at the two sessions this year, there was a proposal that the drug bidding policy arranged by local governments was seriously biased and alienated into disguised administrative examination and approval, which led to a series of problems such as local protection, regional blockade, administrative monopoly, designated distribution after winning the bid and even commercial bribery.

The emergence of medical insurance bureau has realized the integration of "three guarantees" and "four rights" The new authorities have both power and money. It is conceivable that it will play an important and decisive role in the development of medical service system and the allocation of health resources, especially in drug bidding and medical equipment procurement.