The country talks about speeding up the admission of drugs into the hospital!

Recently, the Fujian Provincial Medical Insurance Bureau and the Fujian Provincial Health and Health Commission jointly issued the "Notice on Accelerating the Implementation of National Negotiated Drugs in 2021", requiring all designated medical institutions in the province to implement the main responsibility for rational drug use, and to establish in-hospital drug allocation and medical insurance drug catalog adjustments.
Through the linkage mechanism, a special pharmacy management meeting will be held within 2 months from the implementation of the new version of the catalogue to adjust and optimize the medication catalogue of the medical institution according to its functional orientation, clinical needs and diagnosis and treatment capabilities, and to provide the country-talked drugs in a timely manner
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At the same time, Fujian also proposed that the allocation of clinically necessary drugs should not be affected by the limitation of the total amount of medical insurance, the number of drug catalogues of medical institutions, performance evaluation indicators, and the inclusion of "dual-channel" management.

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In addition to including the 67 nationally negotiated drugs newly added to the 2021 National Medical Insurance Drug List into the province's "dual-channel" management drug scope, Fujian also includes agalsidase alpha injection concentrated solution, ustekinumab injection.
15 varieties such as liquid and Nosinagen sodium injection are listed as the third batch of medical insurance drugs in the province to be paid for by outpatient services
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Timely coordinating and coordinating the pharmacy meeting to continue the local medical reform and innovation policy.
Since its establishment in 2018, the National Medical Insurance Administration has vigorously promoted the reform of drug catalog management, established and improved the dynamic adjustment mechanism of the catalog, and the adjustment period of the medical insurance drug catalog has been greatly shortened from the original maximum of 8 years to Once a year, this also gives some new drugs the opportunity to be included in the medical insurance drug list in the year they are launched
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However, although the frequency of access to the medical insurance catalogue has been greatly accelerated in recent years, the mode of drug access by medical institutions has not changed significantly, resulting in the phenomenon of "difficulty in hospital admission" for some nationally-discussed drugs, giving rise to the "last mile" problem of new drugs landing.

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In order to promote the landing of drugs under the national talks, in addition to the new "dual channel" policy last year, the National Medical Insurance Bureau will also jointly issue a document with the National Health Commission every year, requiring all localities to do a good job in the landing of drugs under the national talks
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The "Notice on Adapting to the Normalization of National Medical Insurance Negotiations and Continuing to Do a Good Job in the Negotiation of Drugs" issued last year made it clear that all designated medical institutions should establish a linkage mechanism for in-hospital drug allocation and the adjustment of the medical insurance drug catalogue.
To meet the needs of clinical drug use, we need to coordinate the holding of the Pharmaceutical Affairs Council in a timely manner, and "dispensing as much as possible"
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This time, Fujian is obviously working on the top-level design, and has given a "two-month" time limit
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This time, Fujian has also put forward a number of detailed requirements to optimize and improve policy measures.
For example, it is clear that it is necessary to further optimize and improve the evaluation mechanism for the use of drugs in medical institutions.
The special negotiated drugs that are reasonably used can be listed separately according to regulations or according to the application of medical institutions, and are not included in medical treatment.
The proportion of institutional drugs and the average cost per time affect the scope of assessment indicators for their landing
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The timely convening of pharmaceutical affairs meetings to study the situation of negotiating drug allocation and the negotiating drug allocation rate shall be incorporated into the relevant indicators of public medical institution assessment and the content of agreement management of designated medical institutions
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It is worth noting that Fujian still continues its local medical reform and innovation policy, by combining the province's actual situation and following the "suitable for outpatient use, long use cycle or high annual total cost of standardized treatment, and indications for the province's current unified release.
According to the principle of “therapeutic drugs not covered by outpatient special diseases”, the third batch of 15 medical insurance drugs for the overall payment of outpatient clinics was selected, including agalsidase α injection concentrated solution for the treatment of Fabry disease, Crohn’s disease treatment The high-value drugs that are more concerned in the industry, such as ustekinumab injection for the treatment of spinal muscular atrophy, and nosinagen sodium injection for the treatment of spinal muscular atrophy
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According to the medical insurance payment policy stipulated in the "Notice of Fujian Provincial Medical Security Bureau on Outpatient Overall Payment of Some Medical Insurance Drugs", Fujian will not set a threshold for these drugs, and the reimbursement ratio will be 80% for employees' medical insurance and 60% for urban and rural residents' medical insurance, capped at the ceiling.
The line is shared with the annual cap line of the two local systems
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Explore the innovation of payment methods in many places to promote the rational allocation of drugs in the country.
In January this year, the 2021 version of the National Medical Insurance Drug List was officially implemented.
74 kinds of newly included drugs, including the 67 kinds of exclusive drugs outside the list that were successfully negotiated, were accurately supplemented for tumors, chronic diseases, etc.
Anti-infection, rare diseases, women and children and other drug needs, patients benefit a wide range
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The industry generally believes that it is of great significance to continue to promote the implementation of national medical insurance negotiation drugs as soon as possible to improve the level of medical insurance for insured personnel and to promote the progress of clinical technology
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Fujian's innovative reform of outpatient co-ordinated payment for some countries' talk about drugs is actually implementing the relevant requirements put forward by the National Medical Insurance Bureau
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The "Notice on Doing a Good Job in the 2019 National Medical Insurance Negotiation Drug Landing" jointly issued by the National Medical Insurance Administration and the National Health and Health Commission has made it clear that local medical insurance departments should make scientific calculations and careful organization, and ensure the safety of funds and rational use of drugs.
Under the premise, actively explore payment methods that conform to local actual conditions
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For negotiated drugs that are suitable for outpatient treatment, have a long use cycle, and have a high course of treatment cost, the burden on patients can be reduced by including outpatient special disease guarantees and exploring single-disease payment according to the fund's income and expenditure
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Under the top-level deployment, in order to ensure the implementation of the drugs under the national talks, all provinces and cities across the country are speeding up the exploration of payment method reforms that conform to local actual conditions, and some provinces and cities have also proposed specific equipment requirements, such as: Notice on Strengthening the "Dual Channel" Management of National Negotiations for Drug Equipping in Designated Medical Institutions"
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In response to the 221 nationally discussed drugs at that time, Shanxi made it clear that medical institutions that have clinical needs but have not yet been equipped should hold a special pharmacy committee meeting before the end of August, and they will all be included in the drug catalog of this medical institution at one time
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When it is required to adjust the drug varieties in the future, the medical institution shall hold a meeting of the Pharmaceutical Affairs Committee within one month, and all of them shall be included in the drug catalogue of the medical institution at one time
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In November 2021, Zhejiang Province issued the "Notice on Implementing the "Dual Channel" Management Mechanism of National Medical Insurance Negotiation Drugs", proposing that in principle, according to the needs of diagnosis and treatment, the allocation rate of national drug varieties should not be lower than that of a public comprehensive medical institution.
30%, third-level and second-class public comprehensive medical institutions, third-level public traditional Chinese medicine hospitals (including integrated traditional Chinese and Western medicine hospitals) not less than 20%, and third-level public specialized medical institutions are not less than 60% of the corresponding specialized national drug varieties
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In December 2021, Liaoning Province issued the "Notice on Continuing the Implementation of National Medical Insurance Negotiated Drugs", clarifying that the negotiated drugs will continue to be managed by classification, and the negotiated drugs will be divided into high-value drugs and drugs that are managed according to conventional category
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117 drugs such as vedolizumab for injection in the new version of the National Medical Insurance Drug List have been identified as high-value management drugs and included in "dual-channel" management.
Among them, 34 drugs such as megastat capsules are limited to outpatient applications.
Actual settlement
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In December 2021, Tianjin issued the "Notice on Continuing to Do a Good Job in National Medical Insurance Negotiation Drug Supply Guarantee and Classified Management", clearly implementing classified management and dynamic adjustment of state negotiated drugs, clear indications, clear diagnosis and treatment paths, and patient costs.
The burden is relatively heavy, and there is no national consultation drug outpatient guarantee mechanism for drugs currently covered by the city’s current Mente and corresponding disease-specific guarantees, involving Maglustat Capsules, Vedelizumab for Injection, and Selepag 30 varieties such as slices
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The medical insurance fund is the largest purchaser of medical services in China, and its entry into the medical insurance catalogue will help greatly speed up the volume of drug sales
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According to data from Minet.
com, there are 8 products with over 100 million products in the 2020 edition of Guotan, whose sales increased by more than 100% in the first half of 2021
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The industry generally believes that with the implementation of the "dual-channel" new policy to open up out-of-hospital channels, and medical institutions continue to consolidate their responsibilities under the guidance of the medical insurance department to ensure reasonable allocation and use, the large-volume effect of the medical insurance catalogue on innovative drugs will be further enhanced
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Among the 47 new domestically produced drugs through negotiation this year, 26 are new domestically produced drugs
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Some people in the industry pointed out that through the normalized value purchase and strategic purchase of medical insurance funds, the pharmaceutical industry will continue to be guided on the road of innovation and development in the future
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In the first half of 2021, the new products with sales of over 100 million and the growth rate of more than 100% Source: Minet.
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