The new version of the catalog expands the scope of basic medical insurance drug coverage. Western medicine and Chinese patent medicines are included in 2,535 drugs, 339 new drugs compared with the 2009 version of the catalog, an increase of about 15.4%; attention is paid to children's drugs and As for medications for major diseases, special medications for occupational diseases have been added, such as tetrandrine and other drugs for the treatment of pneumoconiosis.
Western medicines and Chinese patent medicines increased by approximately 15.4%
Chen Jinfu, director of the Department of Medical Insurance of the Ministry of Human Resources and Social Security, introduced that the 2017 version of the drug catalog consists of four parts: common prescriptions, Western medicines, Chinese patent medicines and Chinese medicine pieces. . The rules are explanations and descriptions of the format of the drug catalog, specification of names and dosage forms, limited payment scope, etc. The Western medicine part includes chemical drugs and biological products, the Chinese patent medicine part includes Chinese patent medicines and ethnic medicines, and the exclusion method is adopted for the Chinese medicine preparation part. It is stipulated that the fund will not pay for the pieces of drinks.
The Western medicine and Chinese patent medicine section *** contains 2,535 medicines, an increase of 339 items compared with the 2009 version of the catalog, an increase of approximately 15.4%. Among them, there are 1,297 Western medicines and 1,238 Chinese patent medicines (including 88 ethnic medicines). No adjustments have been made to the traditional Chinese medicine preparations, and the provisions of the 2009 version of the Drug Catalog are still followed.
Chen Jinfu said that each province (autonomous region, city) can make appropriate adjustments to the Class B drugs in the national medical insurance drug catalog according to regulations, and publish the medical insurance drug catalog of the province (autonomous region, city). "We require that this work should be completed before July 31, 2017. After the drug catalogs of each province (autonomous region, city) are released, each coordinating region should start implementing the new version of the drug catalog within one month."
New changes
When transferring drugs, focus on new drugs, etc.
Chen Jinfu said that the drug catalog work plan proposed that “the transfer of drugs should focus on new drugs with high clinical value, and local Class B adjustments have increased more. "A large number of drugs, as well as drugs for the treatment of major diseases, drugs for children, emergency drugs, special drugs for occupational diseases, etc." The expert group strictly followed the work plan during the review, gave priority to the above-mentioned drugs, and focused on doing a good job in coordinating with other related policies in the pharmaceutical field. connection.
New pneumoconiosis treatment drugs
Chen Jinfu said that the 2017 version of the drug catalog is not only applicable to those insured by basic medical insurance, but also applicable to those insured by work-related injury insurance and maternity insurance. Special consideration was given to the use of drugs for work-related injury insurance in the formulation of the catalog. On the one hand, the medication needs of special diseases such as occupational diseases have been fully considered, and drugs such as tetrandrine for the treatment of pneumoconiosis have been added; on the other hand, the "Remarks" column of five drugs including botulinum toxin type A injection in the drug catalog has been marked It is "limited work-related injury insurance". These drugs are only paid by the work-related injury insurance fund and do not fall within the payment scope of the basic medical insurance fund. This means that the scope of medicines covered by work-related injury insurance exceeds that of basic medical insurance. The next step will also be to guide local governments to include work-related injury insurance treatment drugs with reliable efficacy in the catalog of local adjustments in a timely manner and in accordance with regulations.
Features of the catalog
91 new children's drug varieties
91 new children's drug varieties have been added. There are 540 drugs or dosage forms clearly suitable for children in the drug catalog, which has increased the protection of children's medication.
Intensified support for innovative drugs. Innovative development in the pharmaceutical industry means the development and production of drugs with better quality, better efficacy and lower cost. To this end, the catalog adjustment will focus on new drugs launched after 2009, and further favor the innovative drugs among them. Most of the innovative chemical drugs and biological products approved in my country from 2008 to the first half of 2016 were included in the 2017 version of the drug catalog or negotiated drug scope. Only a few varieties were not included in the scope of medical insurance payment (vaccines) or It was not included due to low clinical recognition and other reasons.
Focus on drugs for treating major diseases. Commonly used drugs for the treatment of cancer, severe mental illness, hemophilia, diabetes, cardiovascular and cerebrovascular diseases and other major diseases have basically been included in the drug catalog or the scope of negotiated drugs.
Strongly support traditional Chinese medicine and ethnic medicine. On the basis of adhering to "equal emphasis on Chinese and Western medicines", we have increased support for traditional Chinese medicines and ethnic medicines. The proportions of Western medicines and Chinese patent medicines in the 2017 version of the drug catalog reached 51% and 49% respectively, which is basically the same. Ethnic minority medicine experts were specially organized to review the traditional medicines of Mongolian, Tibetan and other ethnic groups, and 41 new ethnic medicines were added, an increase of 90%, which is significantly higher than other medicines.
Cohere with the 2015 national drug negotiations. Three drugs, including tenofovir, icotinib, and gefitinib, have been included in the drug catalog after expert review. In addition, the essential medicine system is strongly supported.
Drugs to be negotiated
Cancer drugs are included in the catalog to be negotiated
Chen Jinfu said that some patented and exclusive drugs are clinically necessary and have definite efficacy, but they are relatively expensive. , inclusion in the catalog based on current market prices may bring certain risks to the fund. It is necessary to explore and establish a negotiation access mechanism for these drugs. After negotiation and appropriate price reduction, qualified drugs will be officially included in the drug catalog.
In this catalog review, 45 drugs to be negotiated were identified through consultation expert review, selection expert voting and other procedures. Nearly half of these drugs are tumor-targeted drugs, covering common tumors such as leukemia, lung cancer, gastric cancer, and colorectal cancer. The rest are drugs for major diseases such as cardiovascular and cerebrovascular diseases, rare diseases, and diabetes.
“In the next step, after confirming whether the relevant companies have the intention to negotiate, we will announce to the public the list of drugs to be negotiated and organize negotiations according to relevant procedures, and include the agreed varieties into the payment scope of the medical insurance fund, and in a better way It protects the clinical medication needs of insured persons while ensuring the smooth operation of the fund.”
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