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　　"Straight, straight …" In the past two days, the Yangtze River Smile Station, a new observation point for finless porpoises in Nanjing Gulou section of the Yangtze River, was very lively. Many citizens have found finless porpoises in the waters there. With the sound of exhaling and spraying water, their plump bodies jump out of the water from time to time and stir up the waves.

　　"I’m really lucky to see the finless porpoise, but I didn’t have time to shoot it!

　　"Ms. Zhang, a citizen who lives nearby, is used to bringing her children to the river for a visit.

　　At the same time of surprise, she couldn’t help wondering, "Now the weather is so hot, will they come out?"

　　"The best viewing season for finless porpoises is autumn and winter. But the hot weather in summer does not affect them to get out of the water for air. After breathing, the finless porpoise will continue to hide underwater for the summer. Even during the day, they occasionally look for a cool water to rest. " Jiang Meng, secretary general of the Nanjing finless porpoise aquatic biology protection association, explained.

　　Nanjing is the only city in China where wild finless porpoises live stably in the downtown section. Last year’s background resources survey of Nanjing Yangtze finless porpoise provincial nature reserve showed that the number of living finless porpoises in Nanjing section of the Yangtze River reached 62, a population with a total of nearly 30, living stably in the riverside waters of Gulou.

　　The "smiling elf" is playing in the hot summer, reflecting the changes in the ecological environment of the Yangtze River. Take Nanjing Gulou section of the Yangtze River as an example. In the past ten years, 22 productive wharves along the Yangtze River coastline have been demolished, more than 140 industrial enterprises have been relocated, and the coastline has been vacated by 4.5 kilometers. The "10-year fishing ban" has been solidly implemented by intelligent monitoring means such as drone cruise and camera identification.

　　"Nanjing Tidal Water Station and Power Plant Wharf are located in Jiajiang, which is an important wintering ground and feeding ground for fish in the Yangtze River. After the effective implementation of the’ 10-year fishing ban’, fish resources have increased, which is more conducive to the living and reproduction of finless porpoises, and the national second-class protected animal black dragonfly has also gathered here. " According to Jiang Meng, 11 young porpoises were also observed during the background resource investigation cycle last year, indicating that the population has good development potential.

　　The bigger change happened on the shore. Along the Yangtze River, the construction of the Yangtze River National Cultural Park has been started one after another. The 12.2-kilometer Drum Tower section has undergone a new transformation, and a number of old sites have been rejuvenated. The historical relics such as the Treasure Boat Ruins Park, the Victory Memorial Hall for Crossing the River, the Zhongshan Wharf, the former site of the Capital Power Plant of the Republic of China, and the former site of the Naval Hospital of the Republic of China are lined up in turn …

　　In the past three years, the comprehensive environmental improvement project of the park section of the Yangtze River Shoreline Bridge was implemented in Gulou District, Nanjing. Within a total coastline of 1.8 kilometers, the hydrophilic trail was connected in series with the landscape green space and the wetland along the river, and the "online celebrity" reflected the intersection of Hongqiao Feijia River. The situation that "people can’t see the river and the river can’t see people" became a thing of the past.

　　On the waterfront of the Drum Tower, the sparkling river is close at hand, the reeds and grass are swaying and the blue waves are lapping on the shore, citizens and tourists are walking on the hydrophilic trail, and the finless porpoise square, happy stage and Xiaguan train theme park are distributed in chains, which has become a good place for everyone to entertain and relax.

　　At the beginning of last month, another river-watching punch-in point was completed and put into use-the container-type "Yangtze River Smile Station" was transformed into a finless porpoise science hut. The species information wall, message collection area and lighting interactive device were welcomed by young parents and children. The preface on the wall clearly stated that with the full implementation of the Yangtze River protection, the number of finless porpoises living in Nanjing section of the Yangtze River today has increased by 24% compared with five years ago.

　　The observation platform built on the shore is streamlined and undulating, with various "small thoughts" behind it. "In order to protect the living habits of finless porpoises, the platform was designed in accordance with the original ecological landform, and concrete was partially poured on the inner foundation of the anti-slide pile to minimize contact with the embankment." Hui Hong, a four-level researcher of Nanjing Xiaguan Binjiang Business District Management Committee, introduced.

　　In addition, the platform material is light weather-resistant steel with little pollution and low noise, which is processed in advance and installed on site; When the transport vehicle stops at the riverside road, it will not go deep, and the Shi Quan with a diameter of 30-40 cm will enter the site by manual handling; Low-altitude lighting is used to avoid direct exposure to the river … People give up the most modern and labor-saving construction methods and make way for the "smiling elves".

　　Last month, Nanjing Yangtze River Proliferation and Release Station, the first professional proliferation and release station in the province, was unveiled at the riverside of Gulou, and at the same time, more than 30,000 fish fry were released, including mullet, tong yu, long-snooker and other species. In the future, activities such as popular science education of aquatic organisms in the Yangtze River and temporary care and rescue of endangered aquatic organisms will be carried out here one after another. The "smiling elf" finless porpoise is witnessing a great change in the symbiosis between people and rivers.

　　Article source: Xinhua Daily

After the adjustment of the national medical insurance catalogue in 2023, relevant supporting documents are also in full swing. In the two drafts just released, the National Medical Insurance Bureau has made new regulations on the negotiation of drug renewal rules. Under the favorable stimulus, the share prices of many innovative pharmaceutical companies in China have risen.

On July 4th, the National Health Insurance Bureau issued two documents, namely, Contract Renewal Rules for Negotiated Drugs (Draft for Comment, 2023) (hereinafter referred to as Contract Renewal Rules) and Bidding Rules for Non-exclusive Drugs (Draft for Comment), which are important supporting documents for the drug list management of national basic medical insurance, industrial injury insurance and maternity insurance in 2023.

Zhao Heng, founder of Latitude Health, a medical strategy consulting company, told CBN that from the current exposure draft, the update of the drug list negotiation rules is relatively beneficial to pharmaceutical companies, mainly because the decline in drug prices has slowed down, which will help the single product not fall too sharply after heavy volume. However, as the overall decline is still linked to the actual expenditure of the medical insurance fund, the overall benefits are limited.

Three kinds of drugs are included in the routine catalogue management.

The "Renewal Rules" proposes that drugs that meet one of the following conditions can be included in the routine catalogue management: first, they are non-exclusive drugs; Second, the drugs negotiated in the catalogue in 2019, and the exclusive drugs whose payment standards and payment scope have not been adjusted for two consecutive agreement cycles; The third is to negotiate drugs that have entered the catalogue and have been continuously included in the "drugs negotiated during the agreement period" for more than 8 years.

Compared with the relevant documents in 2022, the category of "drugs more than 8 years old" has been added. The specific rule is that the drugs negotiated in the 2017 version of the catalogue will be calculated from 2018, and the drugs negotiated in the 2018 version will be calculated from 2019, and 2019 and beyond will be calculated according to the year of implementation of the catalogue.

Zhao Heng believes that drugs that have been negotiated into the catalogue and continuously included in the "drugs negotiated during the agreement period" for more than 8 years have entered the regular catalogue, which means that drugs that have been listed for a long time may no longer need to be negotiated after more than 8 years. Of course, if there are new indications or sudden sharp growth, they will still be transferred to the negotiation part.

Hu Shanlian, a senior medical insurance policy research expert and professor at Fudan University School of Public Health, told CBN that the above-mentioned "drugs over 8 years old" category has simplified the management process as much as possible from a long-term perspective and reduced the burden on enterprises and medical insurance departments as much as possible.

The Contract Renewal Rules divides the contract renewal rules of negotiated drugs (including drugs with contract renewal) into three categories, including simple contract renewal and renegotiation, in addition to being included in the routine catalogue management.

The condition of simple renewal is that the agreement will expire on December 31, 2023, and drugs that meet the following conditions can be simply renewed, and the renewal period is 2 years, including exclusive drugs; The actual expenditure of the fund during the agreement period does not exceed 200% of the fund expenditure budget (the estimated value of the enterprise, the same below); The increase of fund expenditure budget in the next two years is reasonable. The core gradient price reduction rule of simple renewal has not changed, but the reference standard requirements for gradient price reduction starting in 2025 will change dynamically.

According to the "Renewal Rules", the expenditure budget of the medical insurance fund will no longer be calculated according to 65% of the sales amount from the renewal in 2025, but will be calculated according to the drug expenses included in the medical insurance payment scope. Considering the change of reference standard, the amount of medical insurance payment node is also increased accordingly.

Zhao Heng said that in terms of the link between the decline and the actual expenditure of the medical insurance fund, the adjustment standard for the decline exceeded 200 million yuan, 1 billion yuan, 2 billion yuan and 4 billion yuan from the original fund expenditure, and it was correspondingly increased to 300 million yuan, 1.5 billion yuan, 3 billion yuan and 6 billion yuan from 2025. This is relatively good for pharmaceutical companies. After all, the adjustment amount has increased, which is conducive to single products with a sales amount that is not particularly high.

Zhao Heng also said that the new rules of this negotiation are more friendly to products listed in the medium and long term. For varieties that have been continuously listed in the "drugs under negotiation during the agreement period" for more than 4 years, the reduction of payment standard is halved on the basis of the calculated value of products within 4 years, which is beneficial to products that have been listed for more than 4 years, which means that the price decline of products listed in the medium and long term is slowed down.

The "Renewal Rules" propose that drugs that meet the following conditions can be included in the scope of renegotiation: including exclusive drugs; Drugs that do not meet the conditions for inclusion in the routine catalogue management and simple contract renewal; Drugs that the enterprise applies for renegotiation and meet the requirements.

Zhao Heng believes that in 2022, drugs with increased indications through renegotiation or supplementary agreement will be deducted from the last decline when calculating the decline of renewal this year. This means that the decline of renegotiated products at the time of renewal will also slow down.

The final price of drugs depends on many reasons, such as cost, value, market competition, commercial agreement, government price control and so on.

Looking forward to the next step, Hu Shanlian believes that multi-indication pricing is a new problem at present, and it is also the most difficult problem how to determine the price reduction in drug price negotiations. Therefore, on the one hand, enterprises have the right to decide freely, and ask for price increase or price decrease according to the results of expanding indications in clinical trials; On the other hand, the medical insurance department can renew the contract by "selective evaluation" according to more valuable indications. In terms of methods, it can use the weighted pricing of the proportion of people with various indications to calculate a single new price.

Another document published by the National Medical Insurance Bureau, Bidding Rules for Non-exclusive Drugs (Draft for Comment), puts forward that the conditions for non-exclusive drugs to participate in the bidding are that, after expert review, it is recommended to add non-exclusive drugs to the medical insurance drug list, except for drugs selected in centralized procurement of drugs organized by the state and drugs priced by the government.

In terms of payment standard, if the drug is included in the medical insurance catalogue through bidding, the lowest price quoted by each enterprise shall be taken as the payment standard for the generic drug. If the quotation of the enterprise is lower than 70% of the willingness to pay for medical insurance, 70% of the willingness to pay for medical insurance will be used as the payment standard for the drug.

Hu Shanlian said that the document emphasized the response and feedback from the policy level on the bidding of "non-exclusive drugs". "Including the procedure, how to conduct expert review, submit information, expert calculation and enterprise bidding; Further, if enterprises encounter special circumstances such as great differences in specifications and different specifications of different enterprises, medical insurance can organize experts to study and put forward treatment opinions and fully communicate with enterprises, which is very important for promoting enterprise development. "

Hu Shanlian also mentioned that the document once again emphasized two aspects: ensuring pricing and ensuring supply. For example, "enterprises participating in the bidding must ensure the market supply, and they must not cut off the supply without reasonable reasons" and "there will be no illegal acts in the bidding process", all of which are measures to make full use of the market mechanism to put the national negotiation rules into practice.

New changes in the sixth round of medical insurance catalogue negotiations

Prior to this, on June 29th, the National Medical Insurance Bureau announced the "Work Plan for Adjusting the Drug List of National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance in 2023", which is the sixth consecutive year since the establishment of the Medical Insurance Bureau. According to the established timetable, this year’s work procedure is still divided into five stages: preparation, declaration, expert review, negotiation and announcement of results. The declaration was officially launched on July 1, and the negotiations were completed and the results were announced in November.

According to the above plan, the adjustment range of the drug list in 2023 is from January 1, 2018 to June 30, 2023, and the indications or functional indications of new generic drugs approved by the State Drug Administration have undergone major changes, and drugs that have obtained drug approval documents for this change, and drugs included in the National Essential Drugs List (2018 Edition), etc. Among them, there are no restrictions on the approval time for drugs included in the Catalogue of Drugs to Encourage Imitation, drugs included in the List of Drugs to Encourage Research and Development for Children, and drugs for the treatment of rare diseases. In addition, some detailed rules such as enterprise reporting process and content will also be adjusted.

According to the National Medical Insurance Bureau, on the basis of previous years’ experience, this year’s catalogue adjustment plan has been slightly adjusted. According to the rules, the time requirements for drug approval and modification of indications have been postponed. In terms of evaluation methods, the evaluation indicators have been further improved, and factors such as clinical needs and patients’ benefits have been comprehensively considered to evaluate the value of drugs more accurately, so as to better achieve the goal of "value purchase" and strengthen the supervision of corporate behavior.

This year’s catalog negotiations will continue to tilt towards innovative drugs. According to the data of the National Medical Insurance Bureau, the waiting time for new drugs listed in China to be included in the medical insurance catalogue has been shortened from the average of nearly five years in the past to less than two years. The expenditure of medical insurance on new drugs increased from 5.949 billion yuan in 2019 to 48.189 billion yuan in 2022, an increase of 7.1 times.

In recent years, medical insurance negotiations have promoted a large number of exclusive varieties of anticancer drugs and drugs for rare diseases to be included in medical insurance at appropriate prices, and the catalogue has been adjusted for five consecutive years, superimposed and included in the medical insurance reimbursement of drugs, which has reduced the burden on patients by more than 500 billion yuan.

The Hong Kong Maicheng mooncake promoted by Brother Yang has recently encountered a public uproar. Media reports pointed out that although the mooncake was registered in the name of a Hong Kong company, it was actually not related to Hong Kong and the product was from Foshan, Guangzhou. This makes consumers feel misled, especially considering Brother Yang’s aggressive promotion and the sales of the mooncake reaching 50 million yuan, as well as the significant benefits he personally received from it.

More details about the mooncake began to circulate on the Internet. Some netizens said that before Xiao Yang’s promotion, the price of the same mooncake on Taobao was only 59 yuan for three boxes, but after Xiao Yang’s promotion, the price soared to 169 yuan. Although this may be the price difference caused by the merchant clearing the inventory, another user who claimed to have worked at Meicheng Mooncake, "Yangjiaoxiu", revealed that the factory’s production environment had serious hygiene problems, and even described it as "stinky". He claimed that workers do not wear gloves when making mooncakes, and that individual ingredients such as eggs have quality problems, but they are still mixed with fresh eggs to reduce costs. According to his description, the black truffle mooncakes produced by the factory in Shiling, Huadu District, Guangzhou are so cheap that they cost only 50 cents that even factory insiders dare not eat them.

Although these revelations are currently not supported by direct evidence, if true, Brother Yang will face significant questions about his integrity. Potential problems with the mooncake production environment touch the food safety red line and are far more sensitive than simple price adjustments. Given that mobile phones are usually banned in production workshops, obtaining direct evidence is difficult.

The mooncake incident has undoubtedly had a negative impact on Xiao Yang’s public image and further weakened his credibility. How to deal with this PR crisis in the future is crucial for him, otherwise he may suffer from long-term negative public evaluation.