Hunan: 148 drugs including aluminum phosphate will stop reimbursement

A large number of medicines are transferred out of medical insurance

1.

According to combing, there are 20 proprietary Chinese medicines in the 82 reserved medicines, of which three Chinese medicine health products are Fufang Nanjia Oral Liquid, Xueluotong Capsule, and Fufang Yinxingtongmai Oral Liquid

The state attaches great importance to the adjustment of the local medical insurance catalogue.

According to the previous document, the timetable for the transfer of medical insurance for local supplements is to complete the clean-up within three years, with 40%, 40%, and 20% completed every year.

Recently, many regions have issued public announcements on the adjustment of the provincial medical insurance catalog for the digestion period, and the time is concentrated on June 30

Although it is said that most of the time when the reimbursement is stopped is the same as the time when the medical insurance is transferred out, the situation in Hunan Province is not exceptional

Regarding this phenomenon, Ma Wanqi, a special author of Cyberlan, once told Cyberlan that such a requirement may be to minimize the impact on clinical medication, and it is also allowed according to the relevant notice of the National Medical Insurance Bureau

2.

If the product is included in medical insurance, if it goes smoothly, because the clinical cost is lower for patients, and the hospital also has related regulations to encourage the use of medical insurance drugs, it can often achieve rapid increase in volume and bring rapid revenue growth to enterprises

For example, Shutaishen's pillar product Sutosan (mouse nerve growth factor for injection) has rapidly increased its sales revenue since its launch, and reached a peak of 1.

In 2019, Suteton achieved sales revenue of 343 million yuan, a year-on-year decrease of 37.

However, China's medical insurance currently implements a dynamic adjustment mechanism, with both outs and ins

According to the above-mentioned plan, for drugs outside the catalogue that meet one of the following conditions, they will be declared by the enterprise in accordance with the procedures, and will be included in the scope of review after passing the review

As for the drugs in the catalog, those that meet the following conditions are included in the scope of review
.
That is, drugs that have been revoked, revoked, or cancelled by the national drug regulatory authority; drugs that have been assessed to be more risky than benefits after comprehensive consideration of factors such as clinical value, adverse reactions, and drug economics; entered the catalog before January 1, 2016 , And between January 1, 2016 and June 30, 2021, drugs with relatively small sales volume on the national drug procurement platform
.

Generally speaking, according to the clinical safety, effectiveness, economy, frequency of use and other factors of the drugs, try to meet the guidelines of Article 4 of the General Provisions of the Interim Measures for the Administration of Basic Medical Insurance: "According to our ability", "scientific, standardized, meticulous, dynamic management", etc.
, strive to use every penny of medical insurance funds on the blade
.

The dynamic adjustment of the medical insurance catalogue excludes some low-quality drugs from medical insurance and frees up funds to meet the basic medical insurance needs of most people.
At the same time, there is room to accelerate the process of introducing innovative drugs into medical insurance, which will help China’s innovative drug business.
Development
.

For example, BeiGene's PD-1 and many other products included in the new medical insurance catalogue have achieved rapid volume after the implementation of the new medical insurance catalogue
.
According to its report for the first quarter of this year, during the reporting period, it achieved a net profit of US$66 million, achieving its first turnaround since its listing in 2018
.

In recent years, the adjustment trend of China's medical insurance catalogue is that on the one hand, the total amount of medicines has increased, from 1,535 varieties in 2000 to 2,800 varieties in 2020, an increase of 82.
4%, and on the other hand, the speed of adjustment has accelerated
.

With the acceleration of medical insurance adjustments, drugs that are necessary for clinical treatment and have better pharmacoeconomic evaluations are expected to enter medical insurance, while drugs that are not clinically necessary and have poor pharmacoeconomic evaluations will also not be eligible for medical insurance
.
In addition, some industry experts mentioned that the removal of the supplementary catalogue of local medical insurance will actually help China's medical insurance avoid local protection and become more fair
.

It is believed that under the continuous adjustment in the future, the quality of medicines in the medical insurance catalog will become higher
.

Attachment: "Hunan Basic Medical Insurance, Work Injury Insurance and Maternity Insurance "Drugs During Digestion Period" (2021 Edition)"