Some drugs will be transferred out of the local medical insurance catalogue, and the scope of drugs used in national medical insurance will be basically unified by the end of the year
2022-07-26
Recently, some media released news such as "some drugs will be transferred out of the local medical insurance catalogue by the end of the year", which attracted some social attention. Why are these drugs listed in the medical insurance catalogue? Will it affect patients' medication? The reporter interviewed the relevant person in charge of the medical service management department of the national medical security administration on relevant issues. Realizing the basic unification of the scope of medical insurance drugs is conducive to the formation of a unified national drug purchase market. The person in charge said that at the beginning of the establishment of the basic medical insurance system, in view of the small number of varieties in the national medical insurance drug catalogue and the large differences in drug use habits between regions at that time, the state allowed provinces to supplement some drugs according to the local economic and social development level, medical needs, drug use habits and other actual conditions, However, it should not exceed 15% of the number of "class B drugs" in the national catalogue, which was an expedient policy for the medical insurance environment at that time. In recent years, China's medical security industry has developed rapidly, and the national medical insurance drug catalogue has been dynamically adjusted every year. In four years, more than 500 new and good drugs have been included in the catalogue, and the price of drugs has been significantly reduced after negotiation. The guarantee capacity and level of the national medical insurance drug catalogue are not as good as before. Local supplementary drugs can basically be better replaced by drugs in the national catalogue, and it is of little significance to continue to retain local supplementary drugs, On the contrary, it causes the fragmentation of medical insurance drug catalogue management and affects the unity, fairness and balance of the medical insurance system. Realizing the basic unification of the scope of medical insurance drugs is an important measure to solve the imbalance and insufficiency in the field of medical security in China. First, it is conducive to enhancing the fairness of China's medical security system and the balance and inclusiveness of medical security treatment. Second, it is conducive to the formation of a unified national drug purchase market and better play the role of medical insurance strategic purchase. Third, it is conducive to making room for more new and good drugs to be transferred into the medical insurance catalogue in time, and providing more high-quality medical security services for the masses. Fourth, it is conducive to improving the convenience of people seeking medical treatment in different places, improving the experience of medical insurance services, and improving the well-being of people's livelihood. Over the past three years, the "digestion" of local supplementary drugs has been stable and orderly, and the clinical and mass drug use has been basically unaffected. The "opinions of the CPC Central Committee and the State Council on deepening the reform of the medical security system" issued in February 2020 clearly proposed to gradually realize the basic unification of the scope of medical insurance drugs throughout the country. The 2022 government work report also included the task of basically unifying the scope of Medicare drugs in the country this year. According to the requirements of the Party Central Committee and the State Council, the national medical security administration actively and steadily promoted the basic unification of the scope of medical insurance drugs throughout the country, comprehensively considered various factors such as the affordability of local medical insurance funds, clinical and public drug habits, and the renewal cycle of drugs, and studied and formulated a three-year "digestion" plan for local supplementary drugs, that is, from 2020, according to 40% in the first year and 40% in the second year In the third year, the proportion of 20% will be gradually transferred out of the drugs added according to the regulations in the original provincial drug catalogue, and by the end of 2022, the scope of medical insurance drugs will be basically unified across the country. Referring to the current progress of "digestion" of medical insurance supplementary drugs in various regions, the person in charge said that as of June 30 this year, 15 provinces and Xinjiang production and Construction Corps had completed the task of "digestion" of all local supplementary drugs in advance, and the completion time of "digestion" of drugs in the remaining 16 provinces, including Beijing, was the end of this year. In other words, by the end of 2022, all provinces in the country will complete the "digestion" of local supplementary drugs to realize the basic unification of the scope of medical insurance drugs in the country. On the whole, the work was carried out smoothly and orderly, and the clinical and mass medication were basically not affected. The guarantee ability of the medical insurance fund is stable and sustainable. Drugs that are "digested" have substitutes with lower prices and better quality. Some netizens said, "is it because the medical insurance fund is not enough that local governments transfer some drugs out of the medical insurance catalogue?" In response to this problem, the person in charge said that in 2021, the income of the national basic medical insurance fund (including maternity insurance) was 2.88 trillion yuan and the expenditure was 2.4 trillion yuan. On the whole, the national medical insurance fund has a balance of revenue and expenditure, with a slight balance. The scale of revenue and expenditure is commensurate with the level of economic development, and the fund's guarantee ability is stable and sustainable. In fact, it is under the strong guarantee of the medical insurance fund that the National Medical Insurance Bureau has gradually transferred many new and good drugs into the medical insurance catalogue since its establishment, realizing the significant expansion of the scope and level of medical insurance drug protection. "Some netizens are very concerned about the third batch of 'Digest' drugs in Beijing. Some we media highlighted 'transfer out drugs containing amlodipine, ibuprofen, etc' when forwarding messages, which attracted social attention, and there are some misunderstandings." The person in charge said that the "amlodipine" transferred out of Beijing this time is actually "amlodipine dropping pills". Clinically, the mainstream dosage form of amlodipine is tablet or capsule, which is produced by dozens of enterprises and has always been a variety in the medical insurance catalogue. The transferred dropping pills are rarely used in clinic. Data show that from September last year to June this year, the Beijing medical insurance fund actually paid nearly 300million yuan for amlodipine in various dosage forms, while the dropping pill dosage form was 0. In fact, the "ibuprofen" involved is only "ibuprofen gel". The "ibuprofen" in the existing national medical insurance drug catalogue includes capsules, tablets, oral liquids, granules, ointments and other dosage forms, which can fully meet the needs of clinical medication. He said that on the whole, the local supplementary drugs "digested" by all provinces in the country have substitute drugs with lower price and better quality in the existing national medical insurance catalogue, and the transfer out has little impact. Next, the national medical insurance administration will strengthen the scheduling of "digestion" of drugs across the country, guide all regions to do a good job in the conversion and connection between local directories and national directories, and guide designated medical insurance pharmaceutical institutions to choose better alternative drugs in the national directory, so as to avoid the impact on clinical medication. (outlook new era)
Edit：sishi Responsible editor：xingyong
Source：http://paper.people.com.cn/rmrb/html/
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