In recent years, traditional Chinese medicine has received different degrees of policy support
in terms of strategic position, standardized development mode, price, payment end, medical insurance immunization, sales end and innovation rhythm.
Among them, with the continuous updating of the national medical insurance drug catalog, in addition to the national standard Chinese medicine pieces, many places across the country have successively issued documents to explicitly include local standard Chinese medicine pieces in the scope of
medical insurance payment.
Recently, the Anhui Provincial Medical Insurance Bureau issued an important notice
.
The notice proposes to include 81 newly added Chinese medicine pieces prepared by 133 medical institutions into the scope of payment by the provincial basic medical insurance, work-related injury insurance and maternity insurance funds, and is now open to the public for comments
.
According to the notice, 81 newly added Chinese medicine pieces are, in principle, governed by the administration of Class A drugs, and there is no individual pre-payment ratio
.
For some Chinese medicine pieces with higher prices, each locality can determine the proportion of individual out-of-pocket payment in advance according to the
fund's affordability.
In addition to Anhui Province, Hunan Province recently issued the Notice on the Implementation of Traditional Chinese Medicine Pieces Newly Included in the "Basic Medical Insurance, Work-Related Injury Insurance and Maternity Insurance Drug Catalogue" in Hunan Province in 2022 (hereinafter referred to as the "Notice"
).
The "Notice" pointed out that 551 eligible Chinese medicine pieces were officially newly included in the scope of medical insurance payment, which will be officially implemented in the province from October 1, with a validity period of 3 years
.
A total of 551 new Chinese medicine pieces were added this time, which are divided into two parts
: "traditional Chinese medicine pieces" and "non-traditional Chinese medicine pieces".
Among them, there are 114 kinds of traditional Chinese medicine pieces and 437 kinds of non-traditional Chinese medicine pieces (including 299 kinds of Chinese medicine formula granules and 138 kinds of Chinese medicine ultra-micro pieces).
The Notice clarifies that the newly added Chinese medicine pieces shall be subject to Category B catalogue management, which shall be paid according to the name of the catalogue, without distinguishing between manufacturers
.
The individual out-of-pocket ratio of "traditional Chinese medicine pieces" varieties is set to 0, and the "non-traditional Chinese medicine pieces" varieties are implemented
according to the published individual out-of-pocket ratio.
In August, Jiangxi Province issued the "Implementation Opinions on Medical Insurance to Support the Innovation and Development of Traditional Chinese Medicine", which clearly supports the use of traditional Chinese medicine pieces, and gives priority to the clinically necessary, safe and effective, reasonable price, and guaranteed supply of traditional Chinese medicine pieces into the scope of payment by
the provincial medical insurance fund according to procedures.
It is reported that as of mid-September, according to the affordability of the medical insurance fund and the drug needs of the insured people, the provincial medical insurance bureau has included 891 varieties of traditional Chinese medicine pieces in the national medical insurance drug catalogue and 191 varieties of traditional Chinese medicine pieces with wide clinical application and more medical insurance reimbursement for patients into the scope of provincial medical insurance payment, including many Chinese medicine pieces commonly used in clinical practice
such as white-flowered snake tongue, piercing stone, and kiwi root.
In fact, in the "Guiding Opinions on Medical Insurance to Support the Innovation and Development of Traditional Chinese Medicine" issued by the National Medical Security Administration and the State Administration of Traditional Chinese Medicine, it is clearly emphasized that eligible Chinese medicine pieces, proprietary Chinese medicines, and Chinese medicine preparations in medical institutions will be included in the medical insurance drug catalogue in accordance with regulations; As well as all localities shall, according to the affordability of funds and clinical needs, include eligible ethnic medicines, Chinese medicine preparations and Chinese medicine pieces in medical institutions into the scope of local medical insurance payment according to procedures, and establish dynamic
adjustment mechanisms.
In this regard, industry insiders believe that this is the state's policy to encourage and support the development of the traditional Chinese medicine industry, in the future by the national and local joint promotion role, related patients are expected to usher in more high-quality and low-cost products, related enterprises are expected to get volume, and the market scale of traditional Chinese medicine pieces will continue to expand
.
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