A new version of the National Health Insurance Drug Catalog has been released

August 20, the State Administration of Health Insurance and the Ministry of Human Resources and Social Affairs issued a circular publishing the list of medicines for the regular access sections of the Country's basic medical insurance, work injury insurance and maternity insurance. The new edition of the Drug Catalog will be implemented from 1 January 2020.According to the introduction, the "Drug Catalog" is the basic medical insurance, work injury insurance and maternity insurance fund to pay for the cost of drugs standards. The new edition of the "Drug Catalog" is divided into examples, Western medicine, Chinese medicine, negotiated medicine, Chinese medicine tablets 5 parts. All cases are the explanation and explanation of the arrangement of the Drug Catalog, the specification of the dosage form of the name, the limitation of the scope of payment and so on. Western medicine includes chemicals and biological products, and Traditional Chinese medicine includes traditional Chinese medicine and ethnic medicine. The pharmaceutical component of the negotiations includes medicines that are still in the period of the negotiated agreement. The Chinese medicine drink tablets section includes the range of drink tablets paid by the fund and the scope of drink tablets paid by the fund shall not be adjusted by the local government.This release of the regular access section of a total of 2,643 drugs, including 1322 Western medicine, 1321 traditional Chinese medicine (including ethnic medicine 93); From the transfer of varieties, a total of 150 varieties, of which about half are the State Drug Administration revoked the number of drugs, the rest are mainly low clinical value, abuse obvious, there are better alternative drugs. In addition, after expert review, 128 drugs to be negotiated were identified, all of which are of high clinical value but relatively expensive exclusive products. The National Health Insurance Administration said that the next step will be to confirm the intention of enterprises to negotiate, in accordance with the relevant procedures to organize negotiations, the successful inclusion of negotiations in the catalogue, the specific list and related requirements issued separately.The State Administration of Health Insurance and the Ministry of Human Resources and Social Security require that the medical security departments of the co-ordination areas, under the guidance of the provincial medical security departments, formulate corresponding payment methods for Class A and B drugs in the Drug Catalog in accordance with the affordability and management requirements of the medical insurance fund. For medicines with limited payment scope, the rules for auditing and payment shall be formulated and the verification of clinical basis shall be strengthened. All localities shall strictly implement the Drug Catalog, and shall not make their own catalogues or use adaptable methods to increase the number of drugs in the catalogue, nor shall they adjust the scope of payment of drugs in the catalogue. Class B drugs added in the original provincial drug catalogue shall be gradually digested within 3 years. In the process of digestion, the provinces should give priority to adjusting the scope of payments for drugs that are included in the scope of national key monitoring.Extended readingSpend limited funds on the cutting edge On August 20th, the National Health Insurance Administration held a media briefing to introduce the new edition of the Drug Catalog. According to reports, this "drug catalog" adjustment is the first comprehensive adjustment since the establishment of the National Health Insurance Administration, but also since the first edition of the "Drug Catalog" in 2000 on the original catalog of varieties of a comprehensive combing. Through adjustment, the overall level of medical insurance drug catalog has been raised, and the use of limited medical insurance funds has been improved.In additions -better meet clinical needs The current Medicines Directory was issued by the Ministry of Human and Social Affairs in February 2017 and contains 2,535 Western and Chinese medicines, after which the health care sector negotiated the inclusion of 36 and 17 medicines in the list of medical insurance drugs, respectively."In order to better meet the needs of clinical rational drug use, this catalog adjustment of the regular access section added a total of 148 varieties, of which 47 western medicine, 101 Chinese medicine." Xiong Xianjun, director of the Medical Services Administration Department of the State Health Insurance Administration, said that the new drugs cover the priority of the country's basic drugs, cancer and rare diseases and other major diseases treatment drugs, chronic diseases drugs, children's medication, among which through regular access to the new major diseases treatment drugs 5, diabetes and other chronic diseases medication 36, children medication 38.Xiong Xianjun said that the vast majority of the country's essential drugs through regular access or included in the list of drugs to be negotiated, and 74 essential drugs from Class B to Class A. For patented exclusive drugs of high clinical value but expensive or have a great impact on the Fund, 128 drugs were initially identified for inclusion in the scope of the proposed negotiations, including 109 Western medicines and 19 Chinese medicines, through expert review and voting., these follow-up will also negotiate drugs, treatment areas mainly related to cancer, rare diseases and other major diseases, hepatitis C, hepatitis B and hypertension, diabetes and other chronic diseases. Many products are new drugs approved by the State Drug Administration in recent years, including major innovative drugs in China."Due to the large variety, the general impact on the fund, in order to clinical drug use and better meet the needs of the vast number of insured people, the success rate of this negotiation does not require." Mr Xiong said renewal talks for 31 drugs negotiated in 2017, which expire at the end of 2019 and are not currently available as generics, would go in sync with access negotiations for 128 drugs to be negotiated.Consuling drugs -to improve the efficiency of the use of funds compared with the current and new version of the Drug Catalog, experts said that from the conventional access to the varieties, before and after the adjustment of the number of drugs did not change much, but the number of transferred out and transferred varieties, the drug structure has undergone great changes.information provided by the National Health Insurance Administration shows that in the transfer of drugs, mainly by the State Drug Administration revoked the number of drugs and clinical value is not high, the abuse of obvious, there is a better alternative to drugs, a total of 150 varieties. Of these, a total of 79 varieties were transferred, in addition to the drugs that were revoked by the State Drug Administration.according to the introduction, in the catalog adjustment process, experts focused on the first batch of national key monitoring and rational drug use drug catalog issued by the National Health and Health Commission in June this year, after special demonstration, unanimously decided to the national health insurance drug catalog of the key monitoring drugs all transferred out."From the transfer of varieties, there are some of the larger annual sales of varieties, this time out may have an impact on the production and operation of individual enterprises. However, the evaluation opinion is that the transfer of such drugs out of the catalog, is conducive to the transfer of more life-saving drugs to make room for emergency medicine, but also conducive to promoting the industry to accelerate the transformation and upgrading. Xiong Xianjun said. this adjustment work on Chinese medicine drink tablets using access law management. In this regard, Xiong Xianjun said, Chinese medicine drink tablets by the exclusion law to change the access law, one is to make the scope of the protection of drink tablets more clear and accurate, so that the drink tablets included in the scope of payment are in line with the basic medical insurance "guarantee basic" functional positioning. Second, to a certain extent, the scope of protection in different regions is relatively unified, and enhance the fairness of the protection policy. Third, from the point of view of strengthening the management of medical insurance payment, the exclusion law to the access law can enhance the scientific, rational and accurate management of medical insurance payment. Ten cage for birds - improve the level of drug protection according to the introduction, in order to minimize unreasonable expenses of patients, to ensure that limited medical insurance funds spent on the cutting edge, in the catalog adjustment process, experts in accordance with reasonable drug use, scientific management, risk prevention, operability and other principles, repeatedly demonstrated, strict and standardized to some drugs limited the scope of payment. The focus includes antibiotics, nutritional preparations, Chinese medicine injections and other categories of drugs, and some of the drugs mainly used for outpatient treatment limited outpatient and personal account payments.   "Overall consideration: First, all payments are limited to the scope of the instructions approved by the drug regulatory department, second, to ensure that the needs of clinical rational drug use can be met, should be guaranteed in place, third, the easy to overuse of drugs, taking into account its clinical value, clinical status, alternative degree, cost level and other factors to determine the payment limit, and fourth, to strengthen the implementation of limited payment scope." Xiong Xianjun said that compared with the original, the scope of the payment is more precise and more stringent. Xiong Xianjun stressed that the payment limit is not a modification of the legal instructions for drugs, but only specifies the circumstances under which the cost of medical insurance for the use of drugs can be paid, clinicians should be based on the patient's condition reasonable medication. , in the process of catalog adjustment, the State Health Insurance Administration and the Ministry of Human Resources and Social Security adhere to the fundamental principle of "doing everything possible to ensure the basic and always adhere to sustainability". Experts agreed that through adjustment, the national health insurance drug catalog to achieve the drug "in and out", fund expenditure "cage for birds." The drug structure in the catalogue is further optimized, the management is more strict, and the quality and level of drug protection are further improved. (Health Report)