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    Home > Medical News > Latest Medical News > The adjustment process of restoring medical insurance catalogue in CCTV focus interview

    The adjustment process of restoring medical insurance catalogue in CCTV focus interview

    • Last Update: 2019-09-05
    • Source: Internet
    • Author: User
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    When you go to the hospital to see a doctor or prescribe drugs, the general doctors and patients will give priority to the drugs listed in the medical insurance catalog Because only drugs that enter the medical insurance catalog can be reimbursed by medical insurance Therefore, which drugs are in the catalogue and which are not, are of great importance to patients, hospitals and pharmaceutical enterprises Not long ago, the State Medical Security Bureau and the Ministry of human resources and social security officially released the latest version of the list of drugs for the routine access part of the national basic medical insurance, work-related injury insurance and maternity insurance Compared with the old list, some drugs were listed and some drugs were transferred out So, how is the list of drugs adjusted this time, and what changes will it bring to drug use? The adjustment of the national medical insurance drug catalog is the first comprehensive adjustment of the drug catalog since the establishment of the National Medical Insurance Bureau in 2018 After adjustment, there are 2643 drugs in the conventional access part, including 1322 western drugs and 1321 Chinese patent drugs In 1998, China established the medical security system for urban employees In 2000, the first edition of the national basic medical insurance drug catalog was published This year's adjustment is the fourth comprehensive adjustment to the catalog Different from the previous adjustment of "more in and less out", this adjustment significantly increased the intensity of transfer out, with 150 varieties transferred out What are the principles for such adjustment to transfer drugs out of the medical insurance catalog? What kind of drugs have been transferred out? It is worth noting that the drugs transferred out of the adjustment of the medical insurance catalogue include the first batch of drugs in the catalogue of drugs for rational use under the state key monitoring issued by the national health and Health Commission In the list of key monitoring drugs, most of them are drugs for auxiliary treatment These drugs are widely used in many departments due to their wide indications Although the dosage is huge, the clinical effect is not obvious Such drugs take up a lot of medical insurance funds A large number of medical insurance funds are used to pay for some drugs with low clinical treatment value, which is a hot topic of social concern and also a pain point to be solved This time, the catalog adjustment has made a good judgment on this pain point Through the transfer out and transfer in of drugs, the structure of drugs in the medical insurance catalog has changed a lot, thus adjusting the use structure of medical insurance funds In and out, optimize the structure With less money spent on unnecessary drugs, there will be more money to spend on drugs that are truly effective In this adjustment, the newly added drugs cover the priority national essential drugs, drugs for treatment of major diseases such as cancer and rare diseases, drugs for chronic diseases and drugs for children, including 5 drugs for treatment of major diseases, 36 drugs for chronic diseases such as diabetes and 38 drugs for children through routine access On the one hand, increasing dosage forms makes the treatment effect better At the same time, some innovative new drugs are included in the regular access directory of the medical insurance directory New dosage forms and new products are added into the medical insurance drug catalog to better meet the needs of clinical rational drug use A total of 148 new varieties were added to the regular access part of the drug catalog adjustment, including 47 Western medicines and 101 Chinese patent medicines No matter whether it is transfer in or transfer out, what is the principle of such adjustment? The transfer in or transfer out of a drug will not only affect the patients and the clinic, but also affect the sales of the enterprise to a large extent How to adjust the medical insurance drug catalogue? Is the procedure fair and just? This is an expert review of the adjustment of the medical insurance catalog Several experts argued fiercely And this is just one of them This is the case for transferring out a drug, and the drugs to be transferred in need to pass five passes and cut six generals This is July 5, the experts of the traditional Chinese medicine group reviewed the scene Both transfer in and transfer out have experienced four rounds of work In May 2019, 5000 medical experts with different medical professional backgrounds conducted a survey on medical insurance drugs; in June and July 2019, 400 famous experts in clinical medicine, pharmacy, pharmacoeconomics and medical insurance management conducted expert review; in July 2019, more than 3000 medical experts from 24 provinces nationwide conducted a selection vote; In August 2019, the list of drugs in the regular access catalogue and the list of drugs to be negotiated will be finalized The fierce discussions among experts did not come out of thin air These judgments were based on data and statistics Jiang Ling, who participated in the review process, felt deeply about this This is the voting site on July 14 More than 3000 clinical medicine experts from 24 provinces and cities nationwide voted on the drugs to be listed The routine access catalogue is settled, while some exclusive products with high clinical value but relatively expensive price have entered the list of drugs to be negotiated, including 128 drugs to be negotiated The treatment field mainly involves major diseases such as cancer, rare diseases, hepatitis C, hepatitis B, hypertension, diabetes and other chronic diseases Many products are new drugs approved by the State Food and Drug Administration in recent years, including major innovative drugs in China In the next step, after confirming the negotiation intention of the enterprise, the negotiation will be organized according to relevant procedures, and the successful negotiation will be included in the catalogue In this adjustment of the medical insurance catalogue, the drugs are "in and out", the structure is more optimized, and the drugs with definite curative effect and reasonable price are added; the drugs with low clinical value and better substitution are transferred out, which can not only improve the treatment effect, but also reduce the medical burden to a certain extent In the future negotiation process, more and more life-saving and emergency medicines will be included in the medical insurance This is a good thing for patients At the same time, the adjustment of the catalogue will also play a positive role in the management of medical behaviors, the continuous innovation of the pharmaceutical industry, and the promotion of the linkage of medical treatment, medical insurance and pharmaceutical reform The new catalogue will be put into effect on January 1, 2020 You can check the relevant information on the official website of the State Medical Security Bureau at http://www.nhsa.gov.cn/ Disclaimer: This article is reprinted by yaozhi.com The copyright belongs to the original author The purpose of reprinting is to transmit more information and does not represent the view of this platform If the content, copyright and other issues of the work are involved, please contact the message on this website, and we will delete the content as soon as possible
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