Guangdong first landing: a large number of drugs are no longer reimbursed.

On September 25, the Guangdong Medical Insurance Bureau issued the Interim Measures for the Administration of Basic Medical Insurance In Guangdong Province (Draft for Comments) (the "Draft for Comments"), which is open to the public for comments, and the deadline for public consultation is October 14.
These drugs are included in the Medical Insurance Draft, which is divided into six chapters, namely, the general rules, the formulation and adjustment of the Drug Catalog, the use of the Drug Catalog, the payment of medical insurance medication, the management and supervision of medical insurance medication, and the by-laws, with a total of 31 articles.
as a whole, Guangdong's Draft for Comments, in addition to complying with the provisions of the Interim Measures for the Administration of Basic Medical Insurance Drug Use, the biggest point of view lies in the local landing rules.
it is worth noting that compared with the national version of the health insurance catalog, Guangdong's local health insurance directory has more "hospital preparations" part, and there is a part of the single list of places to supplement drugs.
The Draft for Comments proposes that the administrative department of medical security in Guangdong Province, on the basis of the National List of Essential Medical Insurance Drugs, shall, in accordance with the adjustment authority and procedures prescribed by the State, include qualified ethnic medicines, hospital preparations and Chinese medicine tablets in the scope of payment for medical insurance in Guangdong Province, and shall implement them after filing with the administrative department of medical security in accordance with the provisions.
departments at all levels shall not make their own catalogues or adjust the scope of payment for medical insurance drugs.
These drugs are not included in the Draft for Comments on Medical Insurance, and the following drugs are not included in medical insurance: (i) drugs that primarily play a tonic role; (ii) medicines containing national precious and endangered wildlife herbs; (3) health-care drugs; (4) preventive vaccines and contraceptives; and (v) mainly enhance sexual function, treat hair loss, lose weight, beauty, quit smoking, Drugs that abstive from alcohol and other effects; (6) drugs that cannot be charged separately for reasons such as being included in medical treatment programs; (7) alcohol preparations, tea preparations, all kinds of fruity preparations (except for children's medications in special cases), oral dosages and oral bubbly agents (except in special cases), etc.; and (viii) other drugs that do not meet the requirements of basic medical insurance.
In addition, medicines in the medical insurance catalogue shall be transferred out of medical insurance after expert evaluation and approval by the provincial medical security administrative department: (1) drugs that have been revoked, revoked or cancelled by the drug regulatory authorities; (2) drugs included in the negative list by the relevant departments; (3) consider clinical value, Adverse reactions, drug economy and other factors, drugs assessed as risks greater than benefits; (4) drugs entering the Drug Catalog by means of fraud and other illegal means; (5) drugs that have been transferred out of the National Basic Medical Insurance Drug Catalog by the State Administration of Medical Security; and (6) Other circumstances prescribed by the State that should be transferred directly.
to clarify the standard of payment of medical insurance in the payment of medical insurance drugs, the Draft for Comments clearly states that a bridge mechanism between access to the Drug Catalog and the standard payment standards for medical insurance drugs will be established in accordance with the relevant provisions of the State.
addition to Chinese medicine tablets and hospital preparations, in principle, the new drugs included in the "Drug Catalog" to determine the payment standards simultaneously.
the payment criteria based on the outcome of national access negotiations.
non-exclusive drugs, the State organizes the centralized procurement of drugs (hereinafter referred to as centralized procurement) of the selected drugs, in accordance with the relevant provisions of centralized procurement to determine the payment standards;
for the implementation of government-priced narcotic drugs and psycho-drugs in category I, the payment criteria are determined in accordance with government pricing.
Article 21 of the Draft for Comments stipulates that the insured shall pay in accordance with the payment standards and sharing methods stipulated in the basic medical insurance, and that the insured shall not pay in advance, and that the use of "Class B drugs" shall be paid in accordance with the payment standards stipulated in the basic medical insurance, first by a certain proportion of the insured persons themselves, and then in accordance with the sharing method stipulated in the basic medical insurance.
proportion of "Class B drugs" individual out-of-the-money shall be determined by the administrative departments of medical security in the overall areas and reported to the provincial medical security administrative departments for the record.
In the area of the management and supervision of medical insurance drug use, Article 24 of the Draft for Comments stipulates that "targeted pharmaceutical institutions shall improve the organization, improve internal system norms, establish and improve the whole process record and management system for the "in, sale and storage" of medicines, improve the management capacity of medical insurance drugs, and ensure the safety and rationality of medical insurance drug use."
draft for comments, these Measures are intended to come into effect on January 1, 2021.
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