349 medicines will be transferred out of medical insurance

01 Multi-province drug transfer or digestion

The National Standing Committee set the tone for the "14th Five-Year Plan" for universal medical security, and it is clear that the basic medical insurance coverage of the country will be basically unified by 2022
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During the "14th Five-Year Plan" period, we must further promote the reform of the medical insurance system, do our best and do our best, and adhere to the basic concept of medical insurance throughout, gradually improve the level, and be sustainable
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Promote the coordinated reform of medical insurance and medicine - continue to implement the centralized procurement of drugs organized by the state, expand the scope of centralized procurement of high-value medical consumables, and curb inflated prices of drugs and medical consumables
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According to the regulations of the National Medical Insurance Bureau, the provincial medical insurance department should speed up the digestion of the original self-supplemented varieties to ensure that all the digestion work is completed before June 30, 2022 (in simple terms, it is to gradually transfer out the local medical insurance over a period of time)
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At present, the medical insurance catalogues of various provinces across the country are being transferred or digested gradually.
According to the incomplete sorting of Cyborg Blue, Chongqing, Qinghai, Yunnan and other provinces will be removed to supplement the medical insurance varieties
.

Chongqing

The "Announcement on Chongqing Municipality's Gradual Digestion of the List of Locally Supplemented Medical Insurance Class B Drugs" issued by the Chongqing Municipal Medical Insurance Bureau stipulates that real estate drugs with purchased data and other drugs produced and sold by local pharmaceutical companies and whose sales ratio exceeds 20% in Chongqing Non-real estate drugs are included in the final year of digestion
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The 89 medicines included in the third year of digestion will stop being reimbursed by medical insurance from July 1, 2022
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Qinghai Province

The "Notice of the Qinghai Provincial Department of Human Resources and Social Security on Printing and Distributing the Supplementary Drug Digestion Catalog in Qinghai Province" issued by the Qinghai Provincial Medical Insurance Bureau stipulates that in 2022, the remaining 98 varieties will be transferred, and medical insurance, medical insurance, and medical insurance will be suspended from January 1, 2023.
Work injury insurance payment
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Yunnan Province

The Yunnan Provincial Medical Insurance Bureau issued a notice on the "Digestion and Adjustment Plan for Drugs Beyond the Scope of the National Medical Insurance Drug Catalog in Yunnan Province", stating that in order to strictly implement the "2019 National Drug Catalog", from 24:00 on June 30, 2020, the "2019 version" will be synchronously implemented.
The medicines listed in the National Drug Catalogue, the medicines that exceed the dosage forms paid by the national medical insurance, the decoction pieces of traditional Chinese medicines that meet the state's clear non-payment, and the national key monitoring drugs will not be reimbursed by medical insurance
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According to the proportion and progress of digestive medicines in Yunnan Province, there are 162 digestive medicines in the third year, accounting for 19.
355% of the digestive medicines, and medical insurance reimbursement ends at 24:00 on June 30, 2022
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In other words, there will be at least 349 drugs that will no longer be reimbursed
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According to the progress of relevant aspects, the timetable for the transfer of medical insurance from local supplementary varieties is as follows:

1.
The drugs in the key monitoring catalogues are the first to be removed from the medical insurance catalogue;

2.
In principle, the supplementary varieties in other places should be cleaned up within three years, and the proportion of the varieties cleaned up in three years is 40%, 40%, and 20% respectively
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At present, the pace of cleaning up the last 20% of the provinces has been further advanced
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02 A batch of over 1 billion varieties was transferred out

From the perspective of specific varieties, there are many large varieties of drugs that have been transferred or digested with sales exceeding 1 billion
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For example: Cerebroside Carnosine Injection, Cefoperazone Tazobactam Injection, Oxiracetam Injection, Yanshuning Injection, Sodium Phosphate Creatine Phosphate Injection, Sodium Potassium Magnesium Calcium Glucose Injection, Cefidiazine Injection, Dazhun Rhodiola In 2020, sales of various products such as injections and cefamando injections will exceed 1 billion yuan in public medical institutions in China
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As we all know, the more medicines that are transferred or digested in more provinces, the greater the impact on the market
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In addition to local medical insurance, the national medical insurance list will also call out 11 varieties in 2021 - dehydrocholic acid, lincomycin (anti-acne preparation), amiloride, enfuvirtide, methylisoindigo, morpholino Beimide, Tianeptine, Clenbuterol, Hepatitis B Yangyin Huoxue Granules, Hepatitis B Yiqi Jieyu Granules, Ginseng Hemorrhoids Ointment
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The National Medical Insurance Administration has clarified the principles for the transfer of drugs from the medical insurance list: comprehensively considering factors such as clinical value, adverse reactions, and drug economy, the evaluation believes that the risks outweigh the benefits of drugs
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Specifically, the transferred drugs are all of low clinical value and can be replaced, or those that have been purchased in small quantities on the national procurement platform in recent years
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In the context of the dynamic adjustment of the medical insurance catalogue, in addition to the large varieties that have been transferred by local or national medical insurance, it is expected that the drugs that are included in the local key monitoring and rational drug use catalogues and drugs that meet the above conditions may also become the "focus of attention" transferred by medical insurance.

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03 Alternative varieties usher in new market opportunities

The National Medical Insurance Administration made it clear that the experts took substitutability as an important indicator in the review process, and the drugs that were called out were all available in the list with equivalent or better efficacy
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In the new version of the National Medical Insurance Catalogue, two old hepatitis B treatment products, hepatitis B Yangyin Huoxue granules and hepatitis B Yiqi Jieyu granules, were replaced by tenofovir and entecavir oral liquid respectively
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Hepatitis B is an infectious disease with the highest incidence in China.
The market size of hepatitis B drugs in China has grown from 6.
881 billion yuan in 2011 to nearly 15 billion yuan in 2016
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Amitofovir tablets is the first original new oral hepatitis B antiviral drug in China, and entecavir is one of the highly effective and low-resistant drugs recommended by the "Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2019 Edition)".
The annual sales of entecavir in public medical institutions in China were 2.
577 billion yuan
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Judging from past data, after the drug enters the medical insurance, it is expected to achieve rapid increase in volume
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For example, the Chinese market of Herceptin reached nearly 3.
4 billion yuan in 2018, and Herceptin entered the national medical insurance through negotiation in 2017.
The sales in the Chinese market in 2017 were 2.
6 billion yuan
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In 2021, the medical insurance catalog has been implemented.

Attachment: Chongqing's 3rd year digestive medicine:

Qiwei Gandanqing Capsule (Chinese patent medicine, Chongqing Huachang Pharmaceutical Co.

Qinghai Province Supplementary Drug Digestion Catalog:

The third batch of drugs withdrawn from medical insurance in Yunnan Province: