In 2021, the balance of medical insurance funds will reach a new high, and there will be no worries in the short term

On March 4, the data of the "2021 Statistical Express on the Development of Medical Insurance Business" released by the National Medical Insurance Administration showed that under the impact of the new crown epidemic, the cumulative balance of medical insurance funds in 2021 will still maintain a rapid growth, an increase of 14.
67% year-on-year, and the balance exceeds 30,000.
billion
.
With such a huge balance of medical insurance funds, why the Medical Insurance Bureau has introduced such strict cost control measures in recent years is mainly to consider China's upcoming aging population
.
Overall, the number of people participating in insurance has shown a slow increase in the past five years
.
The income of medical insurance funds has grown steadily, with a compound growth rate of 10% in the past 4 years; the control of medical insurance expenses has achieved good results in the same period, especially starting from 2020, the growth rate of medical insurance expenditures has begun to be lower than that of medical insurance income; the cumulative balance of medical insurance funds in 2021 Innovation is as high as 3.
6 trillion yuan, with a compound growth rate of 15% in the past four years
.
The national medical insurance negotiation has become normalized: Since the establishment of the National Medical Insurance Bureau in 2018, the National Medical Insurance Administration has carried out the access negotiation of the medical insurance drug catalog for four consecutive times, and a total of 250 drugs have been added to the catalog through negotiation, and the average price has dropped by more than 50%
.
1.
Summary of insured persons from 2017 to 2021 By the end of 2021, the number of insured persons in basic medical insurance reached 1,364.
24 million, and the coverage of insured persons was stable at over 95%
.
Among them, 354.
22 million people participated in the basic medical insurance for employees, an increase of 9.
67 million people or 2.
8% over the end of 2020
.
The number of people participating in basic medical insurance for urban and rural residents was 1,010.
02 million, a decrease of 6.
74 million or 0.
7% from the end of 2020
.
Chart 1: National Basic Medical Insurance Participation in 2021 Units (10,000 people) Source: National Medical Security Administration, Zhongkang Industrial Capital Research Center The trend is slowing down, with the growth rate dropping from 4.
58% in 2018 to 2.
63% in 2021
.
Figure 2: Statistical unit of the number of insured employees from 2017 to 2021 (10,000 people) Source: National Medical Security Administration, Zhongkang Industrial Capital Research Center The number of retired employees has grown relatively steadily, and the compound annual growth rate from 2017 to 2021 is 3.
79%
.
Combining the growth rate of the number of on-the-job insured and the number of retired employees, it can be seen that the future on-the-job retirement ratio will soon fall below 2.
8 in 2021
.
Figure 3: Statistical unit of the number of retired employees participating in insurance in 2017-2021 (10,000 people) Source: National Medical Security Administration, organized by Zhongkang Industrial Capital Research Center The total income and total expenditure including maternity insurance were 2,871.
028 billion yuan and 2,401.
109 billion yuan respectively, and the accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3,612.
154 billion yuan
.
The total income of medical insurance has maintained rapid growth, with a compound annual growth rate of 10.
32% in the past four years
.
The significant decrease in the growth rate of medical insurance income in 2020 is mainly due to the impact of the epidemic.
From January to July 2020, many places across the country will implement a phased halving of medical insurance unit contributions.
If the impact of the reduction factor is excluded, the total employee medical insurance income (including maternity insurance) It increased by 9.
6% in the previous year
.
Figure 4: 2018-2021 China's basic medical insurance fund (including maternity insurance) total income unit (100 million yuan) Source: National Medical Security Administration, Zhongkang Industrial Capital Research Center organized medical insurance fund expenditure in the past 4 years with a compound annual growth rate of 10.
45 %, the growth rate of medical insurance expenditure is slightly higher than that of medical insurance income
.
However, it is worth noting that starting from 2020, the growth rate of medical insurance expenditure has begun to be smaller than the growth rate of medical insurance income, indicating that the national medical insurance cost control has achieved good results
.
Chart 5: 2018-2021 China Basic Medical Insurance Fund (Including Maternity Insurance) Total Expenditure Unit: (100 million yuan) Source: National Medical Security Administration, Zhongkang Industrial Capital Research Center The compound annual growth rate is 15.
51%
.
As of the end of 2021, the cumulative balance of medical insurance was 3,612.
154 billion yuan
.
Figure 6: 2018-2021 China's basic medical insurance fund (including maternity insurance) cumulative balance unit: (100 million yuan) Source: National Medical Security Administration, Zhongkang Industrial Capital Research Center Since the establishment of the National Medical Insurance Bureau in 2018, it has conducted 4 consecutive access negotiations on the medical insurance drug catalog, and a total of 250 drugs have been added to the catalog through negotiation, with an average price drop of more than 50%
.
In 2021, 140 million people will be reimbursed for 221 negotiated drugs during the agreement period, with an average actual reimbursement ratio of 68.
7%
.
Through negotiated price reduction and medical insurance reimbursement, the cumulative burden on patients was reduced by 149.
49 billion yuan during the year
.
In the 2021 catalog adjustment, 74 new drugs will be added to the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2021)" (referred to as the "2021 Catalog")
.
The "2021 Catalogue" contains a total of 2,860 kinds of Western medicines and Chinese patent medicines
.
Among them, there are 1486 kinds of Western medicines and 1374 kinds of Chinese patent medicines
.
It also contains 892 kinds of Chinese herbal medicines
.
After the adjustment of the National Medical Insurance Drug List in 2020, a total of 119 new drugs were added to the list, and another 29 drugs in the original list were transferred out of the list
.
A total of 119 drugs were successfully negotiated in this adjustment, with an average price reduction of 50.
6%
.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalogue (2020)" has a total of 2,800 types of western medicines and Chinese patent medicines, including 1,426 types of western medicines and 1,374 types of Chinese patent medicines
.
There are 892 kinds of Chinese herbal medicines in the catalog
.
In the medical insurance access negotiation in 2019, 70 new drugs were included in the medical insurance category B, with an average decrease of 60.
7%, and 27 original negotiated drugs were successfully renewed, with an average decrease of 26.
4%.

.
In the 2019 edition of the National Medical Insurance Drug List, there are a total of 2,709 Western medicines and proprietary Chinese medicines, including 1,370 Western medicines and 1,339 proprietary Chinese medicines
.
In addition, 892 pieces of traditional Chinese medicine with national standards were also included
.
In 2018, special negotiations on medical insurance access for anticancer drugs were carried out, and 17 drugs were included in the medical insurance catalog, with an average drop of 56.
7%, which was significantly lower than the prices in neighboring countries and regions, with an average drop of 36%
.
Adjusted the medical insurance payment standards for 14 kinds of anticancer drugs negotiated by the state in the early stage, with an average decrease of 4.
9%
.
4.
Conclusion In the past two years, due to the continuous epidemic of the new crown, the costs of vaccination of the new crown vaccine and nucleic acid testing have accounted for a considerable proportion of the expenditure of the medical insurance fund
.
However, the cost control policies issued by the Medical Insurance Bureau, such as centralized procurement and national medical insurance negotiation, just made up for the above-mentioned gap in capital expenditure, so that the overall operation of medical insurance funds remained healthy
.
Although the medical insurance fund currently seems to have a relatively high balance, considering that China's aging population is also facing enormous pressure and challenges, the medical insurance cost control policy issued by medical insurance is also based on the above considerations
.
For this reason, pharmaceutical companies need to constantly adjust their strategies and directions in the face of the largest buyer, from the original generic drugs, me too, to more innovative fields such as FIC and me better, in order to cope with the risks of centralized procurement
.