National Health Insurance Administration: These three types of drugs can be added at the provincial level

Three types of drugs, provincial medical insurance can be supplemented recently, the State Health Insurance Bureau said in a reply, the provinces (autonomous regions, municipalities directly under the Central Government) based on the national "drug catalogue", in accordance with the adjustment authority and procedures prescribed by the State to meet the requirements of ethnic medicine, medical institutions preparations, Chinese medicine tablets into the scope of provincial medical insurance payments, according to the provisions of the State Council medical security administrative department after the implementation.
The Interim Measures for the Administration of Essential Medical Insurance Drug Use, published in July 2020, also make it clear that provincial health insurance departments may, on the basis of the National Drug Catalog, include qualified ethnic medicines, medical institutions and Chinese medicine tablets in the scope of provincial medical insurance payments in accordance with the adjustment authority and procedures prescribed by the State.
recent years, some provinces have begun local replenishment of these three types of medicines.
November 17, Hainan Medical Insurance Bureau issued a "notice on doing a good job in 2020 to be included in the scope of basic medical insurance in our province of Chinese medicine tablets, ethnic medicine declaration work" proposed, according to the relevant documents, decided to carry out Chinese medicine tablets, ethnic medicine into the province's basic medical insurance drug scope of the declaration work.
Chinese medicine tablets and Chinese medicine formula particles with national or local standards, in accordance with the relevant laws and regulations and policy provisions of the state and Hainan Province, as well as ethnic medicines approved for listing by the relevant state departments may be included in the scope of the declaration.
The follow-up will be in accordance with the provincial medical insurance fund affordability and local drug demand, after expert evaluation procedures will be declared Chinese medicine tablets, ethnic medicines into the province's basic medical insurance fund payment scope, and in the province's designated medical institutions issued a document to implement.
In principle, the provincial government shall not increase the list of medicines for medical insurance On August 20, 2019, the State Administration of Health Insurance issued the Notice of the Ministry of Human Resources and Social Security of the State Administration of Health Insurance on the publication of the national catalogue of drugs for basic medical insurance, work injury insurance and maternity insurance.
class B drugs added in the original provincial drug catalogue should be gradually digested within 3 years.
the digestion process, provinces should give priority to adjusting the scope of payments for medicines that are included in the scope of national key monitoring.
On June 17 this year, the three departments of the State Health Insurance Administration issued the Notice on Doing a Good Job in Basic Medical Security for Urban and Rural Residents in 2020, which once again made it clear that by the end of June 2020, the state's key monitoring varieties will be removed from the catalogue and the digestion of 40% of the provincial-level added varieties will be completed.
the previous news, the rest of the additional varieties in principle within three years to complete the clean-up, three-year clean-up of the proportion of varieties are 40%, 40%, 20%.
, at least 20 provinces have so far implemented the local update directory transfer policy, according to Saibai Blue incomplete statistics.
according to Saibai Blue's observation, the provincial and local supplements to withdraw from health insurance restrictions mainly concentrated in late June 2022.
A comprehensive look at these two provisions can be found that, at this stage, on the one hand, the provincial medical insurance for conventional drugs does not have the authority to add, and the drugs that have been added need to be gradually digested within 3 years;
is not difficult to see, compared to conventional drugs can only take the national health care adjustment route, these three types of drugs can be said to have obtained a health care supplement path that can be seen as an opportunity.
The results of the national medical insurance adjustment will be announced in accordance with the relevant arrangements for the national medical insurance adjustment work, November-December is the announcement of the results stage, this stage will be published the results of the drug catalog adjustment, the release of a new version of the drug catalog, synchronously clear management and implementation requirements.
September 18, the State Health Insurance Administration published the "2020 National Health Insurance Drug Catalog Adjustment through the form of examination of the list of declared drugs."
, 728 drugs passed the formal review, according to Seber blue combing.
addition, 23 negotiated drugs in the catalogue that require a reallocation of medicare payment standards and significant changes in adaptation can also be declared, i.e. a total of 751 varieties have passed the formal review.
November 11, the State Health Insurance Administration issued the "on the 2020 National Health Insurance Drug Catalog Adjustment Expert Review Results Inquiry Notice" shows that according to the "2020 National Health Insurance Drug Catalog Adjustment Work Programme", the State Health Insurance Administration recently organized experts on the 2020 National Health Insurance Drug Catalog adjustment through the form of examination of the declared drugs conducted a number of rounds of evaluation.
, the expert evaluation stage has been completed, the declared enterprises can log on to the "2020 National Health Insurance Drug Catalog Adjustment Declaration System" to inquire about the results of the review.
next step, the National Health Insurance Administration will organize negotiations and other related work in accordance with the working procedures.
the above information can be seen, the general health insurance catalog varieties have been selected, the relevant enterprises can enter the system to see if their varieties are in the catalog.
according to the 2020 National Health Insurance Drug Catalog Adjustment Work Programme, the 2020 catalog adjustment is divided into preparation (July-August 2020), enterprise declaration (August-September 2020), expert review Five phases (September-October 2020), negotiated access (October-November 2020) and the publication of the results (November-December 2020) are expected to be completed by the end of the year.
should now be the start-up phase of health-care negotiations, which, when completed, will enter the catalog publishing phase, which will be a wait-and-see for pharmaceutical companies.
, let's review the drug categories that may be transferred in and out of the new health care catalog.
The relevant provisions of the Interim Measures for the Administration of Essential Medical Insurance Drugs issued by the State Health Insurance Administration on 31 July are as follows: According to Article 8 of the Measures, eight categories of drugs, such as drugs and health care drugs, which are mainly tonics, are not included in the list of medical insurance: Article 9 of the Measures stipulates that medicines with the following conditions shall be transferred directly out of the list of medical insurance: Article 10 of the Measures provides that medical insurance may be transferred if they meet the following conditions. Directory: The relevant provisions of the 2020 National Health Insurance Drug Catalog Adjustment Work Programme issued by the State Health Insurance Administration on August 17 are as follows: Drugs that comply with Article 7 and Article 8 of the Interim Measures for the Administration of Essential Medical Insurance Drugs and are not included in the 2020 Drug Catalog for new drugs: The scope of the list of drugs: The scope of adjustment of the payment criteria: