118 medicines are transferred out of medical insurance

1.
118 medicines, transferred out of medical insurance

1.
118 medicines, transferred out of medical insurance

Yesterday (June 8), the Zhejiang Provincial Medical Insurance Bureau issued a notice on public solicitation of opinions and suggestions on the "Notice on Transferring Some Medicines from Zhejiang Province's Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug List (Draft for Solicitation of Comments)" (below Referred to as "Notice")
.

According to the notice, starting from January 1, 2022, 118 drugs such as amoxicillin and dicloxacillin (see the attachment for details) will be transferred out of the Zhejiang Medical Insurance List
.

Medical insurance departments at all levels are required to update the medical insurance information system and drug database in a timely manner, strengthen policy interpretation and explanation, and guide designated medical institutions to do a good job in the substitution of digestive drugs and patient interpretation

Previously, Zhejiang Province issued a notice on the implementation of the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)".
It mentioned that starting from March 1, 2021, the province will uniformly implement the "2020 Drug Catalog" "
.

The drugs transferred out during the adjustment of the "2020 Drug Catalog" are simultaneously transferred out of the fund payment range.

The issuance of this "Notice" is in accordance with the "Notice of the Ministry of Human Resources and Social Security of the National Medical Insurance Administration on Printing and Distributing the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" (Medical Insurance Fa [2020] No.
53 ) Document requirements, refer to the "2020 Drug Catalog" containing a total of 2,800 types of Western medicines and proprietary Chinese medicines, 221 types of drugs negotiated during the agreement period, and 892 types of TCM decoction pieces that the fund can pay for.
Based on the actual situation in Zhejiang Province, some drugs will be transferred out of Zhejiang Provincial basic medical insurance, work injury insurance and maternity insurance drug catalog
.

2.
Many provinces have released the provincial supplementary medical insurance digestion list

2.
Many provinces have released the provincial supplementary medical insurance digestion list

On August 20, 2019, the National Medical Insurance Administration officially issued the 2019 version of the National Medical Insurance Catalogue and stated: "For Class B drugs that were added in the original provincial drug catalogue as required, they should be gradually digested within 3 years
.

" And at the next Wuhan meeting, it is required to call out at the rhythm of 40%, 40%, and 20% of the additional quantity of each province within three years

In June 2020, the National Medical Insurance Bureau proposed in the "Notice on Doing a Good Job in Basic Medical Security for Urban and Rural Residents in 2020" that by the end of June this year, the national key monitored varieties will be removed from the catalog and 40% of the provincial supplementary varieties will be digested
.

In recent times, many provinces have issued the provincial supplementary medical insurance digestion list:

Qinghai: 98 drugs will be released on January 1, 2022

According to the Qinghai Provincial Medical Insurance Bureau, in 2020, a total of 129 types of nationally monitored drugs and drugs that were not recruited and used by the Qinghai Provincial Drug Procurement Platform in the previous year will be transferred.
Medical insurance and work-related injury insurance will be suspended from January 1, 2021.
Pay
.

In 2022, the remaining 98 varieties will be transferred, and medical insurance and work-related injury insurance claims will be suspended from January 1, 2023

Yunnan: 340 drugs withdrew from the medical insurance list on June 30

On July 1, 2020, the Yunnan Medical Insurance Bureau issued a notice on the "Drug Digestion Adjustment Plan for Drugs Exceeding the Scope of the National Medical Insurance List in Yunnan Province".
The notice is called the strict implementation of the "2019 National Drug List" from 24:00 on June 30, 2020.
Since the beginning of this year, medical insurance reimbursements will be stopped for medicines transferred from the "2019 National Drug Catalog", medicines that exceed the payment form of the national medical insurance, compound medicines, traditional Chinese medicine decoctions that the state clearly does not pay, and key nationally monitored drugs
.

It has been determined that Yunnan Province has 837 drugs beyond the scope of the national medical insurance catalogue, including 416 Western medicines and 421 Chinese patent medicines
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According to the proportion and progress of digestive drugs in Yunnan Province, in the first year, there were 335 digestive drugs, accounting for 40.

According to the incomplete statistics of Cyber ​​Blue, many provinces have issued supplementary medical insurance digestion lists and their numbers-Beijing (224 medicines), Hebei (171 medicines), Tibet (76 medicines), Anhui (358 medicines), Tianjin (drug 79), Jilin (192 drug), Hunan (169 drug) and Jiangsu (111 drugs) and the like
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According to Cyber ​​Blue, July 1, 2020, September 1, 2020, October 1, 2020, and January 1, 2021 are the main time limits for the suspension of reimbursement for some local medical insurance products
.

In general, the end of the medical insurance for local supplementary products will be mainly concentrated at the end of June 2022

3.
Opportunities and challenges coexist for pharmaceutical representatives and pharmaceutical companies

3.
Opportunities and challenges coexist for pharmaceutical representatives and pharmaceutical companies

As we all know, the drugs included in the medical insurance catalog can be rapidly increased in volume, and the sales volume may increase substantially in the short term, and the sales volume may also increase exponentially
.

The financial report for the first half of 2020 shows that Cinda Bio's Daboshu was the first PD-1 to enter medical insurance last year.

At the same time, the sales of drugs that are removed from the catalog may face a substantial decline, which is undoubtedly a challenge for some pharmaceutical companies
.

Previously, there was a view that the smooth entry of drugs into medical insurance does not mean that they can directly enter the hospital.
Because of the restrictions on the proportion of drugs and the different hospitals’ new drug admission systems, medical representatives still need to carry out the process of entering the hospital.
Corresponding a lot of work
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In addition, after entering the medical insurance catalog, there is a high probability that the indicators of related products will also face adjustments.
If the indicators do not increase after entering the medical insurance, then the relevant medical representative responsible for the product will achieve a certain performance within a period of next year.
The pressure may be relatively small, and it is even expected to get a good bonus
.

However, if the indicators follow the trend and more subdivision work is added to the medical insurance, the situation faced by medical representatives may not be so optimistic

It is worth noting that the medical insurance bureau's adjustments to the medical insurance catalog are based on market demand, cost and other reasons for reasonable deployment
.
It can be seen from the current adjustment list issued by various provinces that, in addition to the products under the national key monitoring, some drugs whose clinical value is not accurate and can be better replaced; drugs that do not meet the conditions of safety, effectiveness, and economy will be taken the lead.
Being included in the cleanup list also reflects the country's support for innovative drugs
.

With the continuous update of the national medical insurance catalogue and the implementation of the drug digestion adjustment plan for the scope of the provincial medical insurance catalogue, in the future, pharmaceutical representatives and pharmaceutical companies will usher in huge opportunities and challenges
.
For pharmaceutical representatives, they should learn to actively adapt, and pharmaceutical companies should increase their investment in research and development of innovative drugs to continuously enhance their competitiveness
.

Attachment: List of related drugs