第一财经·2026-03-05 08:57Core Viewpoint - The article discusses the ongoing reforms in China's medical procurement and price governance, emphasizing the need for optimization to balance cost control and innovation in the healthcare sector [3]. Group 1: Medical Procurement and Price Governance - The government work report highlights the optimization of centralized medical procurement and price governance, aiming to deepen the reform of medical insurance payment methods and improve the use of surplus funds [3]. - The "volume-based procurement" mechanism has significantly reduced price margins in the medical supply chain, prompting discussions on further optimization among representatives at the National People's Congress [3]. - The implementation of volume-based procurement has accelerated the process of domestic substitution, effectively lowering patient burdens and regulating market competition [3]. Group 2: Challenges and Recommendations - Challenges such as protecting historical volumes and malicious low-price competition remain in the execution of procurement policies, necessitating adjustments to reporting rules and price constraints [4]. - Suggestions include optimizing procurement reporting rules to balance efficiency and market innovation, and establishing a mechanism to curb malicious low-price competition [4]. - A recommendation was made to create a balance between cost control and innovation, proposing differentiated medical insurance payment policies and an "innovation technology exemption channel" for high-value diagnostic projects [4]. Group 3: Payment Mechanism and Innovation - Concerns were raised about the disconnect between procurement and payment, where high-priced generic and original drugs still enjoy high medical insurance payment standards despite not being selected in procurement [5]. - A proposal was made to establish a direct linkage mechanism between procurement prices and medical insurance payment standards, ensuring that selected drugs have their prices reflected in payment standards [5]. - The National Medical Insurance Administration has redirected savings from procurement to pay for clinically valuable innovative drugs, encouraging pharmaceutical companies to invest in research and development [5]. Group 4: Strategic Purchasing and Negotiation Mechanism - Suggestions were made to enhance the strategic purchasing of innovative products by the medical insurance fund, expanding the coverage of innovative drugs while maintaining basic insurance [6]. - The negotiation mechanism for including drugs in the medical insurance directory needs optimization to better reflect the value of innovative drugs and align domestic and international pricing [7]. - It was recommended to consider multiple factors in negotiations to ensure reasonable pricing and innovation returns, potentially allowing for a window of autonomous pricing to stabilize market expectations [8].