No more local supplements

From January 1, 2019 version of the national medical insurance catalogue will be implemented soon, and a large number of varieties will face challenges Compared with the 2017 version, the biggest change of the 2019 version of the national medical insurance catalogue is the recovery of the authority of the supplementary varieties, which clarifies the local authority, which is negotiated by the state in a unified way and is convenient for unified management The 2019 edition of the national medical insurance catalogue clearly states: "except for the special provisions, the local government will not adjust the class B drugs In principle, the original supplemented varieties should be gradually digested within three years, and the varieties included in the national key monitoring scope should be digested preferentially." Instead of adjusting class B drugs, local governments should set unified standards and strict management Local governments should not make their own catalogues or supplement the drugs in the catalogues with flexible methods, or adjust the limited payment scope of the drugs in the catalogues, which equals to the cancellation of the original local supplement power after 2000 Within three years, the deadline for the complete digestion of the original supplementary varieties has been gradually determined How much will this affect the local varieties catalogue after the local governments have formulated their own catalogue or supplemented the drugs in the catalogue with alternative methods? According to the provisions of the 2017 edition of the national medical insurance Catalogue: "the adjusted quantity (including transfer in, transfer out and the restricted payment scope) shall not exceed 15% of the quantity of class B drugs in the country." The adjustment of class B drugs in each province (District, city) shall be reported to our department for filing in accordance with the regulations " The proportion shall not exceed 15% of the quantity of class B drugs in the country, which comes from the notice on printing and distributing the catalogue of drugs for national basic medical insurance issued by the original Ministry of labor and social security in 2000 For example, it is stipulated in the notice that "the administrative departments of labor and social security of all provinces, autonomous regions and municipalities directly under the central government can take part in the current implementation of public expenses, the scope of medical drugs for labor insurance, and the local disease spectrum and drug habits, and《 Class B drugs in the national drug Catalog shall be adjusted The sum of the increased and decreased varieties of class B drugs shall be controlled within 15% of the total number of class B drugs " Since then, the category a directory can not be adjusted, and each province in category B can supplement 15% as much as possible, which has become a fixed policy document Although 15% of the drugs are online, all regions fail to comply with the agreement According to statistics, 426 drugs were added to Guangdong's medical insurance in 2010, and 476 new drugs were added to Beijing's medical insurance in 2018, which are far greater than the required 15% online All over the country are using flexible methods to supplement the catalogue, which is why the recent transfer of 404 medical insurance varieties from Hunan Medical Insurance Bureau 1 There are 2535 drugs listed in western medicine and Chinese patent medicine in the drug catalog, including 1297 western medicine and 1238 Chinese patent medicine (including 88 national medicine), which are approved to pay by basic medical insurance, work injury insurance and maternity insurance fund Among them, there are only 5 varieties of work injury insurance fund that are allowed to pay fees, and 4 varieties of maternity insurance fund that are allowed to pay fees 2 There are 402 class a drugs of Western medicine, 192 class a drugs of Chinese patent medicine, and the rest are class B drugs The time zone for basic medical insurance fund to pay for drugs is divided into class A and class B, while the time zone for industrial injury insurance and maternity insurance to pay for drugs is not divided into class A and class B The 2017 edition of the drug catalog collected a total of 2535, including 1297 Western medicines, 1238 Chinese patent medicines (including 88 national medicines), including 402 western medicine class a drugs and 192 Chinese patent medicine class a drugs Then we can calculate 1297-402 = 895 kinds of Western medicine and 1238-192 = 1046 kinds of Chinese patent medicine in the 2017 version of drug catalogue According to the 2017 version of the drug catalogue, it should not exceed 15% of the quantity of class B drugs in the country If we calculate according to the upper limit of 15%, we can add 895 * 0.15 = 134 kinds of Western medicine class B, 1046 * 0.15 = 156 kinds of Chinese patent medicine class B, totaling 290 kinds However, the actual number of varieties is far greater than the number of theoretical values because the local governments are using flexible methods to supplement the catalogue It is clear that it will not be supplemented any more, and the original supplementary catalogue will be cancelled (16 provinces and cities): Chongqing, Guizhou, Jilin, Shandong, Beijing, Henan, Hubei, Jiangsu, Zhejiang, Fujian, Sichuan, Shandong, Guangxi, Yunnan, Qinghai, Hunan It is clear that there is no need to add any more, and it is not clear how to deal with the original supplement catalogue (5 provinces and cities): Ningxia, Liaoning, Tianjin, Guangdong and Heilongjiang Supplement ethnic medicine (4): Gansu (using ethnic medicine in the original supplement catalogue), Qinghai (clearly adding 100 kinds of Tibetan medicine), Yunnan (adding a small amount of ethnic medicine), Guangxi (excluding ethnic medicine) Undeclared (7): Hainan, Hebei, Shaanxi, Jiangxi, Shaanxi, Anhui, Xinjiang Construction Corps The implementation time of 2019 version of drug catalogue is January 1, 2020 It can be clear that Ningxia, Liaoning, Tianjin, Guangdong, Heilongjiang and other provinces and cities will have clear landing policies before this node Will the elimination of local supplements have some impact on industry, medical treatment and patient treatment? The author thinks that the cancellation of local supplement has limited influence on medical treatment and patient treatment With the increase of varieties in the national medical insurance catalog, the commodity richness tends to meet In 2000, there were 1488 varieties in the medical insurance catalog, but in 2019, there were 2643 varieties, with a net increase of 1155 varieties in 20 years (attached figure) The great richness of varieties laid a base condition for the cancellation of local supplement varieties Data source: Interpretation of national basic medical insurance, industrial injury insurance and maternity insurance drug catalogue (2019 version) However, it can be sure that the impact on pharmaceutical enterprises after the cancellation of local supplement varieties is very obvious Before this, only relying on entering the local supplement catalog to support sales varieties will have a great impact, which is basically equal to excluding medical insurance payment The 2019 version of the national medical insurance catalog clearly stipulates that "for class B drugs added according to the regulations in the original provincial drug catalog, they should be gradually digested within 3 years." The original supplementary varieties should be gradually digested within three years, and the buffer of three years will not be affected from the perspective of patients' treatment, because most of the local supplementary varieties do not conform to the class A and class B principles of the national medical insurance catalog.