More children's medicines and rare diseases are expected to be included in medical insurance

More children's medicines and rare diseases are expected to be included in medical insurance

The National Medical Insurance Bureau issued the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog Adjustment Work Plan" in 2022

Charity Charity News (reporter Chen Feng) The National Medical Insurance Bureau recently issued the "Work Plan for the Adjustment of National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog" (hereinafter referred to as the "Work Plan") and related documents, which means This year's medical insurance catalog adjustment is about to be officially launched.

The most concerned "which medicines are expected to be included in medical insurance reimbursement" and "how to renew the contract after expiration" and other questions can be found in the "Work Plan".

According to the "Work Plan", 6 categories of drugs outside the directory can be declared to participate in the adjustment of the medical insurance directory in 2022, including from January 1, 2017 to June 30, 2022 Or the drugs that have undergone major changes; new crown pneumonia -related therapeutic drugs, etc.

Compared with last year, the medical insurance catalog adjustment in 2022 added new children's medicines, generic drugs, etc. Among them, the scope of children's medicines should be issued in the three batches of encouragement of R & D and declared children's drugs issued by the State Health and Health Commission and other departments. Imitation drugs should be in two batches of encouragement of imitation drugs.

"More children's medication in medical insurance can reduce the burden on patients' medication." Zou Liping, member of the Standing Committee of the Pediatric Branch of the Chinese Medical Association, believes that this will also play a guiding role in the pharmaceutical market, encourage more enterprises to focus on the development of children's medication and bring the gospel to patients.

In the adjustment of the National Medical Insurance Catalog in 2021, after 700,000 yuan per need for the treatment of spinal muscle atrophy, Nosina Sodium injection liquid was negotiated with medical insurance for more than 30,000 yuan. Pay attention.

Up to now, more than 60 rare diseases in China have been approved for listing, of which more than 40 kinds have entered the national medical insurance catalog and involved 25 diseases.

The "Work Plan" clearly states that before June 30, 2022, rare disease treatment drugs approved by the State Drug Administration Department can apply for medical insurance negotiations this year. Includes rare diseases.

During the dynamic adjustment of the medical insurance directory, the "soul bargaining" of drug negotiations has attracted much attention. The medical insurance department and pharmaceutical companies negotiated on the pharmaceutical payment standards, and directly decided whether the drug could enter the medical insurance and what price in the medical insurance. In 2021, there were 67 exclusive medicines outside the directory of the medical insurance, with an average price reduction of 61.71%.

The "Renewal Rules for Negotiated Drugs (Draft for Soliciting Opinions)" proposes three types of negotiating drug renewal rules for conventional directory management, simple renewal and renewal of negotiations, and detailed provisions of the three renewal methods.

Since its establishment, the National Medical Insurance Bureau has carried out the medical insurance directory access negotiations for four consecutive times. A total of 250 drugs have been added to the directory through negotiations, and the average price has decreased by more than 50%. By negotiating price cuts and medical insurance reimbursement, a total of about 150 billion yuan was reduced to patients in 2021.

The "Work Plan" also proposed for the first time that non -unique medicines intended to be included in the medical insurance directory use bidding and other methods to synchronize medical insurance payment standards. Some experts said that this will give full play to the leverage of the medical insurance fund, a positive impact on the structure and market price mechanism of the drug use, further reduce the burden on the patient's medication and benefit the general public.

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