On the evening of June 9th, the National Medical Insurance Administration released a message on its official website to solicit public opinions on the "Work Plan for the 2021 National Medical Insurance Drug List Adjustment" (hereinafter referred to as the "Plan") and the "2021 National Medical Insurance Drug List Adjustment Application Guidelines"
This move means that this year's national medical insurance catalog adjustment work has officially kicked off
Reading through the two major documents, some of the new practices proposed by the National Medical Insurance Bureau deserve the attention of the industry
In delineating the scope of drugs to be transferred from the catalog, the "Plan" emphasizes that it will focus on the access to the catalog before January 1, 2016, and there will be no purchases on the national drug procurement platform from January 1, 2016 to June 30, 2021.
In the expert review stage, the National Medical Insurance Bureau will demonstrate the expert opinions of the professional group, and finally determine the list of drugs in five aspects: direct transfer, negotiation transfer, direct transfer, can transfer, and adjust the limited payment scope
And the "plan" also pointed out that, considering the functional positioning of basic medical insurance, the clinical needs of drugs, and the affordability of funds, four types of drugs will be included in the drug catalog in 2021:
From January 1, 2016 to June 30, 2021, new generic drugs approved for marketing by the State Drug Administration;
During the period from January 1, 2016 to June 30, 2021, drugs with major changes in indications or functions and indications approved by the State Drug Administration;
Drugs for the treatment of respiratory diseases related to new coronary pneumonia;
Drugs included in the "National Essential Drug List (2018 Edition)"
According to requirements, the public can make comments and suggestions before 17:00 on June 16, 2021 (Wednesday)
It is worth noting that in the scope of the drugs that are delineated from the catalog, except for the drugs that have been revoked, revoked or cancelled by the national drug regulatory authority, the National Medical Insurance Bureau has clearly considered the clinical value, adverse reactions, and Drugs whose economics and other factors are assessed to be more risky than benefits
For the first time, it is proposed to focus on drugs that have been in the catalog before January 1, 2016, and that there is no purchase record on the national drug procurement platform from January 1, 2016 to June 30, 2021
The scope of drugs for adjusting payment standards is basically the same as in previous years