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On October 19, the Guangdong Provincial Medical Insurance Bureau issued the "Scope of "Dual Channel" Management Drugs in Guangdong Province (2021)", which included a total of 221 drugs, which is a very large number
.
In addition to Guangdong, some regions have also released "dual-channel" drug catalogs in recent times
.
The industry predicts that as the "dual channel" policy is successively implemented in various places, the medical insurance negotiation drugs will further achieve a rapid increase in volume, and the market structure inside and outside the hospital may change
Clarify that medical institutions are the main body of "dual-channel" drug supply
Clarify that medical institutions are the main body of "dual-channel" drug supply Judging from the scope of the “dual-channel” management of drugs in Guangdong Province, most of the star drugs are listed
.
The four major domestic PD-1 Sintilizumab, Tilelizumab, Teriplizumab and Karelizumab are among them
For the treatment of rheumatoid arthritis or ankylosing spondylitis, baritinib, adalimumab, infliximab, etanercept, and skuziumab must be paid by a rheumatologist
.
Aflibercept can accumulatively pay up to 9 pieces per eye, and up to 5 pieces in the first year
For some traditional Chinese medicine injections, such as Xuebijing injection, it is limited to emergency rescue for critically ill patients in second-level and above medical institutions; ginkgolide injection is limited to patients in the recovery phase of cerebral infarction in second-level and above medical institutions, and a single hospitalization can pay up to 14 Days; Astragalus polysaccharide for injection is limited to patients with tumors in medical institutions of grade II and above, and the maximum payment for a single hospitalization is 14 days
.
The Guangdong Provincial Medical Insurance Bureau once stated that the establishment of a "dual-channel" management mechanism puts forward higher requirements on designated medical institutions, and further clarifies that medical institutions are the main body of "dual-channel" drug supply.
Medical insurance designated medical institutions should give priority to purchase and use" Dual-channel" medicines
.
"Dual-channel" pharmacies should strengthen drug quality management.
Prior to this, Guangdong also clarified the specific method for direct settlement of "dual-channel" drugs.
One is to include "dual-channel" drugs and implement unified medical insurance payment standards and price policies in designated medical institutions and "dual-channel" pharmacies
.
Second, if outpatient medical expenses and medical institutions implement per capita payment or total payment, the out-of-charge prescription drugs will be paid by the insured person, and the rest will be paid by the medical insurance agency and the "dual channel".
Out-of-hospital promotion effects of drugs may be affected by differences in local policies
Out-of-hospital promotion effects of drugs may be affected by differences in local policies It is understood that the accelerated implementation of the "dual channel" policy marks a solid step towards diversification in the supply of medical insurance drugs, and it has contributed to the promotion of the reform of the drug management system of medical institutions, the improvement of the service quality of medical insurance designated retail pharmacies, and the solution of negotiated drugs.
The problems of "difficulty in entering the hospital" and "difficulty in landing" have a positive impact on better meeting the people's drug demand and other aspects
.
A review found that, up to now, most regions have issued notices on the "dual-channel" management of drugs in national medical insurance negotiations, but not many regions directly issue lists
.
Jiangsu Province released the first annual “dual-channel” drug list in July this year, with a total of 100 types, involving 83 types of drugs and innovative drugs with major diseases, long service cycles, and high treatment costs.
The treatment field is in line with the limited payment scope of medical insurance.
Malignant tumors, rheumatoid arthritis, mandatory spondylitis, coagulopathy, sudden pulmonary fibrosis, fundus disease, AIDS, hepatitis C, pulmonary hypertension, acromegaly and some rare diseases
.
In September, the Anhui Provincial Medical Insurance Bureau announced the "Anhui Province National Negotiation Drug "Dual Channel" Management Catalog (2021 Edition)", taking into account the actual supply of drugs in all cities in the province, and incorporating 188 different specifications of national negotiation drugs
.
In early October, the Hunan Provincial Medical Insurance Bureau passed the expert selection process and solicited opinions from relevant departments to determine the first batch of "dual-channel" management drugs in Hunan Province in 2021, with a total of 49 drugs, including 40 western medicines and 9 Chinese patent medicines
.
A few days ago, the industry also circulated a "dual-channel" management drug catalog (first batch) in Henan Province, with a total of 88 varieties
.
According to the plan of the National Medical Insurance Administration, before the end of October this year, all provinces must determine the list of drugs that are included in the "dual-channel" management of the province and announce it to the public
.
According to data from Mi Nei.
com, the 2020 National Medical Insurance Catalogue was officially implemented on March 1 this year, and sales of some new varieties have skyrocketed
.
The sales of Zai Lab's niraparib tosylate capsules in China's public medical institutions in 2020 will be around 30 million yuan, and it will soar to nearly 190 million yuan in the first half of 2021
As the "dual channel" policy is successively implemented in various places, it is expected that the medical insurance negotiation drugs will further achieve a rapid increase in volume, and the market structure inside and outside the hospital may change
.
According to the data of the pilot pilot in Sichuan Province, the supply ratio of "dual-channel" drugs in hospitals and out-of-hospital pharmacies (DTP pharmacies) is about 20% and 80%, mainly outside the hospital
