The Ministry of human resources and social security issues the negotiation results on the access of medical insurance drug catalogue

Source: Ministry of human resources and social security website 2017-07-19 Department (bureau) of human resources and social security of all provinces, autonomous regions, municipalities directly under the central government and Xinjiang production and Construction Corps, Fujian Medical Insurance Office: According to the notice on printing and distributing the catalogue of drugs for national basic medical insurance, work injury insurance and maternity insurance (2017 version) (HR & s Department [2017] No 15), our department organized experts to negotiate on some drugs and determined the payment standard for medical insurance It is hereby announced and notified as follows: 1、 36 kinds of drugs (hereinafter referred to as "relevant drugs") such as lilalutide injection are included in the category B scope of the national directory of drugs for basic medical insurance, work injury insurance and maternity insurance (2017 Edition) (hereinafter referred to as the "drug directory") The competent departments of social insurance of all provinces (regions and cities) shall not transfer the relevant drugs out of the directory, nor adjust the limited payment scope 2、 The payment standard specified in the column of "medical insurance payment standard" in the attached table includes all expenses jointly paid by the basic medical insurance fund and the insured personnel The sharing proportion of the basic medical insurance fund and the insured personnel shall be determined by each overall planning area The period of validity of the prescribed payment standard is up to December 31, 2019 After the expiration of the period of validity, it shall be adjusted according to the relevant provisions of the medical insurance drug payment standard During the validity period, if a drug with the same generic name (generic) is listed, our department will adjust the medical insurance payment standard of the drug according to the generic price level and issue it separately; if the actual price of the drug market is obviously lower than the current payment standard, our department can negotiate with the enterprise to re formulate the payment standard and issue it separately 3、 All provinces (districts and cities) should actively explore various ways to strengthen drug administration and promote rational use of drugs For drugs requiring "prior review before use" or other drugs requiring strict management, unified prior review regulations shall be established; drugs with large consumption and high cost shall be included in the intelligent monitoring system of basic medical insurance medical service for key monitoring and cost analysis; effective measures shall be taken to encourage designated retail pharmacies to provide drugs for the insured, and the pharmacies shall play an important role in The positive role of medical insurance in drug supply 4、 All provinces (districts and cities) shall earnestly implement the requirements of this circular, and include the relevant drugs into the category B scope of the drug catalog, which shall be implemented together with the drug catalog At the same time, we should accelerate the adjustment of class B drugs in our province (District, city) and release them as soon as possible Appendix: list of 36 kinds of related drugs Ministry of human resources and social security July 13, 2017