[exclusive] 2017 local medical insurance supplement summary analysis: many provinces and cities have exceeded the scope of national regulations, and ethnic medicine has broad prospects!

Since the release of the 2017 national new version of the medical insurance catalogue, the local medical insurance supplement catalogue has also come out People from all walks of life in politics and business and patients have high hopes for the local supplement catalogue, hoping that it can be published as soon as possible to adapt to the medical technology level and improve the clinical drug use level, further reduce the medical cost burden of the majority of insured personnel, and at the same time let pharmaceutical enterprises obtain the corresponding new drug research and development Market return According to the current laws, regulations and documents, the national class a drugs shall not be adjusted All provinces (regions and cities) should have issued the local directory of basic medical insurance, work injury insurance and maternity insurance drugs before July 31, 2017 The adjusted quantity (including transfer in, transfer out and restricted payment scope) shall not exceed 15% of the quantity of national class B drugs (i.e 291 kinds) On the whole, there is not much room for the adjustment of provincial medical insurance catalog Each provincial medical insurance department should supplement according to its own needs on the basis of medical clinical technology level and cognition, and also take into account the economic needs of local medical innovation How to solve the contradiction between the limited space for drug adjustment and the large demand for drug adjustment is the biggest test for the relevant departments The author summarizes and analyzes the list of medical insurance supplements in Qinghai, Ningxia, Gansu and other provinces as of December 22, 2017 Before entering the analysis of local supplement catalog, we will review the adjustment of national medical insurance catalog four times over the years (as shown in the figure below) From the above data, we can see that: 1 Chinese patent medicine (including ethnic medicine) and Western medicine are showing an increasing trend, more drugs are included in the medical insurance, which meets the urgent needs of insured personnel for drug use, but also benefits pharmaceutical companies; 2 The growth rate of medical insurance of Chinese patent medicine (including ethnic medicine) is significantly larger than that of Western medicine, and the proportion of Chinese patent medicine increased from 38.6% in 2000 to 48.8% in 2017 From the perspective of the overall development trend, by the time the next new version of the catalogue is released again, the proportion of Chinese patent medicines will easily exceed half, and it is predicted that the "spring" of Chinese patent medicines has come Note: the supplementary quantity in the table is only the change before and after the quantity (compared with the corresponding category of the national version), and does not involve the transfer in and transfer out quantity of varieties As shown in the above table, statistics on the list of medical insurance supplements in 12 provinces and cities, such as Qinghai, Ningxia and Gansu, can be seen as follows: 1 Since the new version of the national medical insurance catalog was issued, many provinces and cities have not completed the formulation of the supplement catalog (maybe they are in the process of preparation); 2 The number of medical insurance supplements in some regions has exceeded the scope of the state (15%), such as Gansu (381), Tibet (379), Xinjiang (379), Jiangsu (307), Hubei (294), etc It can be seen that the growth trend of Chinese patent medicine, especially national medicine, is significantly higher than that of Western medicine For the protection of national medicine, the state has opened a wide door to its adjustment, which is not limited by the proportion, but the increased varieties are required to meet the national medicine standards officially issued by the State Food and drug administration; 3 The number of medical insurance catalogue in Shanghai 2017 is on the high side (marked in red), because it is calculated by dosage form, not calculated by active ingredients For example, in the 2017 Shanghai medical insurance catalog, there will be two different numbers for two different dosage forms of drugs, while all drugs in the other provinces and cities medical insurance catalog have only one number (counted as one) no matter what dosage form Specific example: in the Shanghai catalogue, Changchun Ruibin (injection) number is 1266, Changchun Ruibin (oral regular release dosage form) number is 1267, In Guizhou catalogue, the number of vinorelbine is 834, so the actual number of varieties is different from the number; 4 Henan Medical Insurance supplement includes 36 kinds of drugs such as the current drugs in Henan Province which are not in the 2017 version of the state and the lilalutide injection which are negotiated by the state; Beijing Medical Insurance supplement includes 477 kinds of drugs such as dorasetron injection which are newly added in the 2017 version of the national drug catalogue and 36 kinds of drugs such as lilalutide injection which are negotiated by the state; the number of national drugs in Jiangsu and Henan Medical Insurance is not It may be that the regional conditions determine the limited quantity of ethnic medicine In general, the transfer in of provincial drug catalog focuses on the existing varieties in the previous version of the provincial medical insurance catalog, and the drugs widely used by medical institutions with "reasonable price" are preferred; while the transfer out drugs mainly consider the existence of safety problems, not suitable for clinical needs, nutritious drugs, etc., as well as the drugs that have been cancelled or discontinued are generally transferred out However, when the new version of the medical insurance catalogue was released, Chen Jinfu, director of the medical insurance Department of the Ministry of human resources and social security, made a policy interpretation, saying that the adjustment of the medical insurance catalogue should establish a normal and dynamic access mechanism for medical insurance drugs, make a good organic connection between the access, payment standards, use management and other links, and gradually realize the whole process management of medical insurance drugs Looking at the supplement situation of each province, the overall principle of the adjustment plan of each province is consistent with the national catalog, and tends to transfer in the varieties that conform to the principles of pharmacoeconomics and are suitable for the local disease spectrum, as well as the clinically necessary drugs for major diseases, paediatric drugs, emergency drugs, etc in the final analysis, the high sex price ratio and the local actual drug use situation are the primary factors to be considered In ethnic areas, such as Tibet, Xinjiang, Ningxia, Qinghai and other places, ethnic medicine is specially considered, because ethnic medicine is not limited by this adjustment index Ethnic medicine is an important part of traditional Chinese medicine, with a long history, distinctive regional and national characteristics It has made indelible contributions to the protection of the health of people of all ethnic groups for thousands of years It has gradually entered the market, has a certain foothold, and is concerned by the majority of people Only by "liberalizing" the medical insurance policy, strengthening the research and development of national medicine, and training the counterpart talents of national medicine, can national medicine develop healthily and rapidly Due to the inconsistency of drug use laws and medical policies in various provinces and cities, the time for the issuance of medical insurance catalogue is uneven This summary is only based on the changes in the number of medical insurance After the introduction of the local supplementary catalogue of medical insurance, the author will analyze the transfer in and transfer out of specific drugs in different regions It is rumored on the Internet that all localities will complete this work by the end of this year, but the author finds that it is unlikely to improve the supplement by the end of this year, and hopes that relevant departments of each province can implement the supplement of the medical insurance catalogue as soon as possible, and issue the local medical insurance list The author will also pay close attention to the trends of the people's and social security departments in various places in time, and provide the latest and most comprehensive updates of local medical insurance supplement Please pay close attention to the database of medical intelligent medical insurance catalog query for the latest medical insurance supplement Because just meet you, leave footprints just beautiful!