36 negotiated generic drugs are included in the reimbursement scope of Beijing Medical Insurance

Yesterday, the Beijing Municipal Bureau of human resources and social security issued a notice to include generic drugs of 36 negotiated drugs in the city's medical insurance reimbursement scope and to make clear the payment standard In July last year, the Ministry of human resources and social security issued a document to include 36 negotiated drugs into the category B scope of the national directory of drugs for basic medical insurance, work injury insurance and maternity insurance (2017 version), and simultaneously determined the medical insurance payment standards for these drugs Among the 36 drugs, 31 were western medicine and 5 were Chinese patent medicine There are 15 tumor drugs in western medicine, involving lung cancer, gastric cancer, breast cancer, colorectal cancer, lymphoma, myeloma and other common cancer types, including tumor targeting drugs such as trastuzumab, rituximab, bortezomib, lenalidomide, etc., which are of great concern to the society and are urgently needed by the insured There are also 5 cardiovascular drugs, such as tigrilol for acute coronary syndrome The other drugs are kidney disease, ophthalmology, psychosis, anti infection, diabetes and rare diseases Three of the Chinese patent medicines are tumor drugs, and the other two are cardio cerebrovascular drugs Through negotiation, compared with the average retail price in 2016, the price of the 36 drugs dropped by 44% on average, and the highest reached 70% Yesterday, the Municipal Bureau of human resources and social security issued a notice that the generic drugs of the 36 negotiated drugs will be included in the category B drug list of Beijing's basic medical insurance, work injury insurance and maternity insurance drugs For the payment standard, if the generic drug specifications are consistent with the negotiated drugs, the payment standard shall be temporarily implemented according to the actual market sales price of the generic drugs, but shall not exceed the payment standard of the corresponding negotiated drugs; if the generic drug specifications are inconsistent with the negotiated drugs, the payment standard shall be calculated by referring to the notice of the national development and Reform Commission on printing and distributing the rules for the differential price comparison of drugs (fgjg [2011] No 2452) If the calculated payment standard is higher than the actual market price of generic drugs, the actual market price of generic drugs shall be taken as the payment standard After this notice is issued, all designated medical institutions in the city can timely provide negotiated generic drugs according to the clinical treatment and drug demand, and guarantee the drug demand of insured personnel according to the principle of reasonable inspection, reasonable treatment and rational drug use.