Medical insurance catalog adjustment plan soliciting opinions for more rare diseases are expected to enter medical insurance

The State Medical Insurance Bureau recently issued the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalogs (Consultation Draft)" (hereinafter referred to as the "Work Plan"). According to the "Work Plan", before June 30, 2022, rare disease therapy drugs approved by the State Drug Administration Department can be included in the scope of the national medical insurance directory adjustment in 2022, which also means that more rare diseases are expected to be included in medical insurance.

The "Work Plan" clearly states that the 6 -category of drugs outside the directory can be included in the scope of the national medical insurance drug directory adjustment scope of 2022, including from January 1, 2017 to June 30, 2022, the new universal drug approved by the state drug supervision department ; From January 1, 2017 to June 30, 2022, medicines that have undergone major changes in indications or functions by the national drug regulatory department; drugs that are included in the latest version of the "New Coronatte Pneumonic Pneumonia Diagnosis Plan"; Drugs of the National Basic Pharmaceutical Catalog (2018 Edition); incorporate a list of encouraging imitation drugs or encouraging R & D and declared children's drugs, and drugs approved by the state drug supervision department before June 30, 2022.

Among them, the adjustment of catalogs involving rare disease treatment drugs has attracted much attention.

In the adjustment of the national medical insurance catalog in 2021, the "sky -high medicine" Nosna sodium injection of "sky -high medicine" Sonica sodium injection per need of 700,000 yuan per needle is used for the treatment of rare diseases. The "floor price" enters the new version of the medical insurance directory. Such a "soul bargain" not only made rare patients see hope, but also attracted more attention from this group.

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.

It is reported that since the establishment of the State Medical Insurance Bureau, it has carried out the medical insurance drug directory access negotiations for four consecutive times. A total of 250 drugs were added to the directory through medical insurance negotiations, and the average price decreased by more than 50%. By negotiating price cuts and medical insurance reimbursement, a total of 149.49 billion yuan was reduced to patients in 2021.

According to the "Work Plan", the adjustment of the national medical insurance and drug catalog in 2022 is divided into five stages of preparation, declaration, expert review, negotiation, and announced results, and will be announced in November 2022 to announce the adjustment results of the medical insurance drug directory.

Source: Workers Daily

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