Do a good job in the "three balances" of the "dual-channel" management of national talks drugs

Wen | Caozhuang, Associate Researcher, National Medical Security Research Institute, Capital Medical University

Recently, the National Medical Insurance Administration and the National Health Commission issued the "Guiding Opinions on Establishing and Improving the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations" (hereinafter referred to as the "Guiding Opinions") to promote the "dual-channel" management of Chinese medicines at the national level.

This reform is an innovation in the management mechanism.

1.

The prerequisite for implementing "dual channels" is to implement classified management of negotiated drugs.

To achieve a good balance between the drugs in the catalog, the provincial medical insurance department needs to determine uniform standards, make procedures open, play the role of experts, and conduct scientific selection.

2.

This separate payment model is similar to the one-line drug payment policy in Sichuan Province.

When exploring the establishment of such a separate drug security mechanism, provinces should pay attention to the balance of treatment policies: that is, the proportion of drug reimbursements for the implementation of the separate payment policy and other drugs; the treatment policy enjoyed by the insured persons using such drugs is different from the original treatment policy.

3.

The first is to guide and give full play to the role of market players.

The above "three balances" test the wisdom and ability of medical insurance administrators, and also reflect the difficulty of mechanism innovation.