It is recommended that supplementary drug use be removed from the health insurance catalogue and essential medicines catalogue.

The National Health and Infrastructure Commission responded to a proposal by the representative to remove complementary drugs from the health insurance and essential medicines catalogues.
recently, the National Health and Health Commission of the 13th National People's Congress, the second session of the recommendation No. 5021 "on strict control of auxiliary drug use, promote scientific employment recommendations" related to the reply that the Commission will work with the relevant departments to remove supplementary drugs from the medical insurance catalogue and basic drug catalog recommendations, and as appropriate, formulate relevant policies.
the National Health and Care Commission, since 2015, the General Office of the State Council issued "guidance on improving the centralized procurement of drugs in public hospitals" (State Office issued (2015) No. 7), "on further reform and improvement of drug production and circulation policy" (State Office issued (2017) No. 13) and other documents, repeatedly proposed to strengthen the supervision and management of auxiliary drug use.
the "Several Opinions on Controlling unreasonable Growth in Medical Expenses in Public Hospitals" issued by the
Commission and the National Development and Reform Commission (No. 89 of 2015) also explicitly requires public hospitals to implement clinical path management, adopt negative prescription list management, and implement the system of prescription review, antibiotic use, auxiliary drug use, and use management of consumables.
establish a tracking and monitoring system for complementary drugs, drugs used in hospitals and high-value medical supplies, and so on, to clarify the number of drug regulations that need to be monitored, and to establish and improve a comprehensive evaluation system for clinical drug use with a focus on essential drugs.
December 2018, the State Health and Care Commission issued a "notice on doing a good job in the clinical rational application management of complementary drugs" (State Health Administration Medical Letter (2018) No. 1112), and made clear the corresponding requirements for the development of a catalogue of complementary drugs.
July 1, 2019, the first batch of national key state key monitoring of rational drug use drug catalog was officially released, including neurokines, brain sidegine peptides, olasitan, sodium phosphate creatine, calf serum deprotein, prostheritus, qukerin-reedin brain protein hydrolysis 20 drugs, such as compound coenzymes, were included, which also means that the high price, sales, small role of auxiliary "golden oil drugs" in the hospital clinically strictly restricted use, in the followed release of the 2019 version of the health insurance catalog, these 20 drugs were directly transferred out of the payment range.
statistics show that the 20 monitored varieties in the domestic sample hospital sales has reached 14.6 billion yuan, by the key monitoring varieties, the growth of related products has been greatly affected, according to The Inner Net statistics, in 2019 China's public medical institutions terminal, 20 key monitoring varieties of 14 products sales growth rate are negative.
in fact, in addition to the national version of the key monitoring directory, Zhejiang Province, Hainan Province, Jiangxi Province, Hubei Province, Guangxi, Shanxi Province, Anhui Province, Ningxia, etc. have published the provincial key monitoring of rational drug catalog, a total of 58 varieties of provincial key monitoring varieties.
the National Health and Care Commission finally stressed that the fundamental purpose of formulating a catalogue of state-focused monitoring of rational drug use is to standardize medical behavior and improve the level of rational drug use in clinical practice.
for the catalog of drugs, requires strict grasp of drug use in the case of the prescribed course of treatment, dose of reasonable use, and said that the next step, the National Health and Care Commission will actively work with the relevant departments, further standardize the focus on monitoring the use of reasonable drugs.
one is to strengthen drug management in the catalog and regulate physician prescription behavior through the development of clinical pathways, drug guidelines or technical specifications, increased prescription review and prescription review. the second
is to strengthen the monitoring of clinical use, through the establishment of a perfect monitoring and abnormal early warning system for the clinical use of drugs, timely detection of abnormal growth, non-signment, overdosion and other issues. The third
is to strengthen the key monitoring and rational drug use assessment, the clinical use of drugs included in the catalogue as an important part of the performance appraisal work of medical institutions.
attached to the 13th National People's Congress Of the second session of the second session of the recommendation No. 5021 full text representative: Your "on strict control of auxiliary drug use, promote scientific drug use" received, in business with the State Medical Insurance Administration, the answer is as follows: First, the current status of work and progress since 2015, the General Office of the State Council issued the "General Office of the State Council" Guidance on improving the centralized procurement of medicines in public hospitals (No. 7 of the State Administration (2015), "Several opinions on further reform and improvement of the policy on the circulation and use of pharmaceutical products" (State Office issued No. 13 of 2017) and other documents, has repeatedly proposed to strengthen the supervision and management of auxiliary drug use.
the "Several Opinions on Controlling unreasonable Growth in Medical Expenses in Public Hospitals" issued by the
Commission and the National Development and Reform Commission (No. 89 of 2015) also explicitly requires public hospitals to implement clinical path management, adopt negative prescription list management, and implement the system of prescription review, antibiotic use, auxiliary drug use, and use management of consumables.
establish a tracking and monitoring system for complementary drugs, drugs used in hospitals and high-value medical supplies, and so on, to clarify the number of drug regulations that need to be monitored, and to establish and improve a comprehensive evaluation system for clinical drug use with a focus on essential drugs.
December 2018, the Commission issued the Notice on doing a good job in the clinical rational application management of complementary drugs (State Health Office Medical Letter (2018) No. 1112), and made clear the corresponding requirements for the development of a catalogue of complementary drugs.
in accordance with the established procedures, the provincial health and health administrative departments to submit to me the recommended directory, by the relevant experts to organize and analyze, choose the use of the largest amount, the most concentrated 20 kinds of drugs to form the final catalog.
July 2019, the United Nations Domestic Medicine Bureau issued the "First Batch of State Key Monitoring of Rational Drug Use Drug Catalog (Chemical Drugs and Biological Products)", further putting forward work requirements for clinical lysusing.
. Response to the recommendations (i) on strengthening clinical pathway management.
committee vigorously promote the development of clinical norms and clinical path management.
is to carry out the revision of clinical path system.
the cumulative number of clinical paths issued to reach 1212, covering more than 30 clinical professional, basically achieve clinical common, multiple diseases full coverage, basically meet the needs of clinical diagnosis and treatment. The second
is to promote the application of clinical pathways.
to raise awareness of clinical path management by medical institutions and medical personnel through "further improvement of medical service action plan", clinical path training courses, exchange stakes, supervision and research, etc. The third
is to improve the clinical path management system.
issued the Guidelines for Clinical Pathway Management in Medical Institutions in 2017, revised the Guidelines for Clinical Pathway Management (Trial) issued in 2009, and refined the requirements in the light of progress.
clinical path management coverage is expanding.
at present, nearly 7,000 public hospitals in China carry out clinical path management, accounting for 88.5% of the country's public hospitals.
clinical path management effect was significantly improved, the medical expenses of inpatients in medical institutions that implemented clinical path showed a downward trend, the cost structure tended to be reasonable, and the increase of the average hospitalization cost of clinical path group was basically lower than that of the non-clinical path group.
(ii) on continuing to promote pay-per-disease and expand the scope of pay-per-disease.
since its establishment, the State Health Insurance Administration has attached great importance to the reform of the payment method of medical insurance, and guided local governments to actively promote the reform of the payment method of medical insurance by disease, the relevant grouping of disease diagnosis (DRG) and so on, through local research, special seminars and special investigations.
simultaneously strengthen the total budget management of the medical insurance fund, appropriately increase the proportion of the total budget to the primary health care institutions, and gradually establish a multi-payment method such as pay-per-disease, pay-per-head, pay-per-service unit and so on.
at present, the reform policy of medical insurance payment methods, which is suitable for different forms of medical service, and the management measures that are compatible with the reform of public hospitals, the multi-complex payment framework under the total budget management has been basically formed, and the reform results have gradually emerged.
by 2018, more than 95% of the co-ordination areas will be controlled by the total amount of medical insurance payments, establish a reasonable control index system, a sound assessment and evaluation system and dynamic adjustment mechanism;
65% of the co-ordination areas to carry out pay-per-head, 69% of the co-ordination area for mental illness, tranquillity, medical rehabilitation and other diseases requiring long-term hospitalization and the average daily cost of more stable per bed.
2019, the Health Care Administration will carry out the DRG paid national pilot, in accordance with the "top-level design, simulation operation, actual payment" thinking in three years orderly progress, through the pilot to achieve the "five one" goal, that is, to develop a set of standards, improve a series of policies, establish a set of procedures, train a team, build a number of models.
(iii) establishing a database on rational drug use.
We attach great importance to the monitoring of rational drug use data.
established the "National Antibacterial Drug Clinical Application Monitoring Network" and "National Bacterial Resistance Monitoring Network" in 2005, the National Rational Drug Use Monitoring Network in 2009 and the National Monitoring Network for Clinical Application of Anti-Tumor Drugs in 2018.
at present, the monitoring network basically covers more than two levels of hospitals throughout the country.
monitoring, analyzing and evaluating the safety, effectiveness and economy of clinical use of drugs by strengthening clinical drug monitoring, evaluation and extraordinary early warning provides a favorable basis for adjusting and perfecting management policies.
the Notice on the Issuance of the First Batch of State Key State Key Monitoring of The Catalog of Essential Drugs (Chemical Drugs and Biological Products), it is clearly stated that health and health administrative departments at all levels, the competent departments of Chinese medicine and medical institutions should establish and improve the monitoring and unusual early warning system for the clinical use of drugs.
focus on the clinical use of drugs included in the catalogue as the medical institutions and their principals of the assessment content, with medical institutions verification, evaluation, performance evaluation combined, the results of the assessment timely publicity.
(iv) with regard to the role of medical insurance, strict restrictions on the use of complementary drugs.
in order to ensure medical safety and safeguard the rights and interests of patients, the State Administration of Health Insurance attaches great importance to the rational use of complementary drugs.
in view of the lack of a standardized and uniform definition of complementary drugs, there is no explicit provision for complementary drug use in the current medical insurance policy.
But in the process of reviewing the medical insurance drug catalogue, only if it meets the conditions of clinical necessity, safety and effectiveness, reasonable price, and through strict expert evaluation procedures can be included in the scope of payment of basic medical insurance.
on the other hand, when the experts review the national medical insurance drug catalogue, on the basis of reference to the experience of medical insurance drug management and clinical diagnosis and treatment guidelines, guidelines for the clinical application of drugs, drug specifications and other technical standards, some expensive, easy to abuse or the existence of safety risks of drugs put forward a limited payment range.
in the procurement, the centralized procurement of medicines in public hospitals, according to clinical needs and drug characteristics, the implementation of drug classification procurement, classification model does not distinguish between auxiliary drugs.
to carry out tender procurement of essential and non-patented drugs produced by clinical drugs, high purchase amount and enterprise production; to conduct negotiation and procurement of some patented drugs and exclusive production drugs; to directly purchase drugs for women and children's specialized generic drugs, emergency (snatching) drugs, basic infusions, commonly used low-cost drugs and drugs not included in the tender procurement;
? (v) The fundamental purpose of formulating a national key to monitor and regulate the list of reasonably used drugs from the medical insurance catalogue and the basic drug catalogue is to standardize medical behavior and improve the level of rational use of these drugs in clinical practice.
for the catalog of drugs, requiring strict grasp of the drug instructions under the case of the prescribed course of treatment, dose reasonable use.
regards your proposal to remove complementary drugs from the medical insurance catalogue and the basic drug catalogue, I will conduct a serious study with the relevant departments to formulate relevant policies as appropriate.
the third, the next step of the goal and planning the next step, I will actively work with the relevant departments to further standardize the focus on monitoring the use of reasonable drugs.
one is to strengthen drug management in the catalog and regulate physician prescription behavior through the development of clinical pathways, drug guidelines or technical specifications, increased prescription review and prescription review. the second
is to strengthen the monitoring of clinical use, through the establishment of a perfect monitoring and abnormal early warning system for the clinical use of drugs, timely detection of abnormal growth, non-signment, overdosion and other issues. The third
is to strengthen the key monitoring and rational drug use assessment, the clinical use of drugs included in the catalogue as an important part of the performance appraisal work of medical institutions.
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