Yesterday, the State Medical Insurance Bureau issued the "2019 National Health Insurance Drug Catalogue Adjustment Work Plan (Draft for Comment)" and publicly solicited opinions from the public. The work programme shows that a new version of the drug list will be issued in June 2019, and the list of drugs to be negotiated will be announced. The transfer of drugs will give priority to the treatment of major diseases such as national essential drugs, cancer and rare diseases, chronic disease drugs, children's drugs, and emergency rescue drugs.
The Beijing Youth Daily reporter saw in the work plan that the basic principle of adjusting the national medical insurance drug list is to highlight the clinical value on the basis of the fund's affordability, fill in the short-term guarantees, improve the safeguard effect, and appropriately expand the scope of the catalogue. Goodly meet the basic clinical medication needs of the insured. At the same time, we must adhere to overall planning. Give full play to the respective advantages of Western medicine and traditional Chinese medicine, and establish and improve targeted evaluation methods based on their respective basic theories, and make overall consideration of the quantitative structure and growth of Western medicines and proprietary Chinese medicines.
The National Medical Insurance Bureau pointed out that the adjustment of the drug list will involve three aspects of Western medicine, Chinese patent medicine and Chinese medicine decoction, including two items: drug transfer and drug transfer. Based on the drug information approved by the State Food and Drug Administration for listing, enterprises are not accepted for reporting or recommendation, and no evaluation fees and other various fees are charged.
Western medicines and proprietary Chinese medicines to be transferred shall be medicines registered and listed by the State Drug Administration before December 31, 2018 (inclusive). Priority is given to the treatment of major diseases such as national essential drugs, cancer and rare diseases, chronic diseases, children's drugs, and emergency rescue drugs. According to the field of drug treatment, pharmacological effects, functional indications, etc., organize experts to review by category. Comparing drugs of the same type according to the principles of pharmacoeconomics, it is preferred to select varieties that are sufficiently clinically proven, safe, effective, and reasonably priced. The transfer is divided into two types: regular access and negotiation access. Under the premise of satisfying the validity and safety, the price (expense) is equivalent to or lower than the existing varieties in the drug list, and can be included in the catalogue by routine means. Patent exclusive drugs that have a higher price or have a greater impact on the health care fund should be negotiated.
Synchronously adjust and improve the drug catalogue, use management methods, standardize the drug name dosage form, and appropriately adjust the category of the drug A and B, the catalogue classification structure and so on. In the process of adjusting the category A and B, priority is given to essential drugs.
The work programme emphasizes adherence to an open, fair and impartial expert review system. The drug catalogue is reviewed and determined by experts according to the scientific norms of procedures, and the administrative department does not interfere with the results of expert review. The reporter of Beiqing Daily learned that experts are divided into consulting experts, selection experts, measurement experts, and negotiation experts. They are mainly composed of clinical medicine and pharmacy experts, including a certain number of medical insurance experts and pharmacoeconomic experts, who are responsible for drug consultation. Specific review work such as selection and negotiation of drug calculations. Consulting experts and selection experts do not cross each other. Among them, there are about 300 consultants and about 2,000 experts.
According to the work plan, the drug list adjustment is divided into five stages: preparation, review, release of the regular access list, negotiation, and release of the negotiation access list. In June 2019, a new version of the drug list will be issued and the list of drugs to be negotiated will be announced. At the same time, from June to July 2019, the negotiation stage was carried out. In August, the negotiation access list was published, and the successfully negotiated drugs were included in the drug list, and the management and implementation requirements were simultaneously clarified.