The national health insurance bureau announced that these drugs could not be included in the medical insurance

▍ sorting out: Cypress blue - Yuanwang just published a document from the National Health Insurance Bureau saying that the new version of the medical insurance catalog will not add any more over-the-counter drugs On April 17, the State Medical Insurance Bureau officially released the work plan for the adjustment of national medical insurance drug catalog in 2019 ▍ it is clear that the adjustment of drug catalog for transfer in and transfer out involves three aspects: Western medicine, Chinese patent medicine and Chinese herbal pieces, specifically including drug transfer in and drug transfer out Based on the drug information approved for listing by the State Food and drug administration, the company will not accept the application or recommendation of the enterprise, and will not charge the review fee and other various fees The transferred western medicine and Chinese patent medicine shall be the drugs registered and listed by the State Food and drug administration before December 31, 2018 (inclusive) Priority should be given to national essential drugs, drugs for treatment of major diseases such as cancer and rare diseases, drugs for chronic diseases, drugs for children, first aid drugs, etc According to the field of drug treatment, pharmacological action, functional indications and so on, organize experts to review by category According to the principles of pharmacoeconomics, the same kind of drugs should be compared, and the ones with sufficient evidence to prove that they are clinically necessary, safe, effective and reasonable in price should be preferred Transfer in can be divided into two ways: regular access and negotiation access Under the premise of meeting the effectiveness and safety, if the price (expense) is equal to or lower than the existing varieties in the drug catalog, it can be included in the catalog through regular way; the exclusive drugs with high price or great impact on the medical insurance fund should be admitted through negotiation (the determination time of exclusive drugs is based on the selection voting day The day before) The access method is adopted for the management of Chinese herbal pieces, and the objects of adjustment at the national level are only those processed according to the national drug standards The original drugs in the drug Catalog shall be transferred out according to the procedures If the production, sale and use of the drugs have been prohibited by the national drug regulatory authorities, the drugs shall be transferred out; if there are other drugs that do not meet the requirements and conditions of medical insurance drugs after the review of experts, the drugs shall be transferred out according to the procedures The transfer out of other drugs requires strict expert review procedures For example, the varieties with low clinical value and can be completely replaced may be transferred out of the catalog At the same time, in the policy interpretation of the national medical insurance drug catalog adjustment work plan in 2019, the state medical insurance bureau clearly stated that according to the functional orientation of the medical insurance system and the basic principles of medical insurance drugs, some drugs cannot be included in the catalog: For example, the main tonic drugs, including national endangered wild animals and plants, preventive vaccines, contraceptives and other public health drugs, used for weight loss, beauty, smoking cessation and other drugs Some of them improve the quality of life, some play a preventive role, some belong to the scope of public health security, and are not included in the scope of catalog adjustment For over-the-counter drugs (OTC), it is generally not reimbursed internationally In principle, this adjustment will not be added Meanwhile, we will adjust and improve the management methods for the use of the drug catalogue, standardize the name and dosage form of the drug, and appropriately adjust the category A and B of the drug, the classification structure of the catalogue, and the remarks, etc In the process of class A and B adjustment, priority should be given to basic drugs In general, the new version of the medical insurance catalog gives priority to the basic drugs no matter whether they are transferred in and out or the adjustment of category A and B, while the drugs that are clinically necessary, safe and effective, and reasonably priced are most likely to be transferred in As for the huge drug category of over-the-counter drugs, there is no chance for the new version of the medical insurance catalog ▍ great conjecture on transfer in and transfer out of drugs the pharmaceutical economic news once sent a forecast on the situation of drugs that may be transferred in and out of the new medical insurance catalogue Possible transferred drugs: products newly introduced into the basic drug catalogue but not listed in the medical insurance catalogue in 2018; products listed before December 31, 2018; products listed in the medical insurance negotiation catalogue, which are expected to be mainly high priced products for tumors and rare diseases; products approved in 2018 for consistency evaluation Or the situation of being transferred out: the oral medicine that is transferred out of the base medicine catalog That is to say, methyltestosterone tablets, dirithromycin enteric coated tablets, mycomycin tablets, tegafur tablets, ergotamine caffeine tablets, phenolphthalein tablets, compound diphenoxylate tablets, compound reserpine tablets, compound reserpine aminophenetidine tablets, dipyridamole tablets and buguizine hydrochloride tablets, which originally belong to 289 catalogue but have not been started by the factory for consistency evaluation, may be transferred out of the medical insurance catalogue The 2018 version of the list of basic drugs was transferred out of the traditional Chinese medicine products It includes two products: Xiaoer Huadu powder (capsule) for internal medicine and Mingmu tribulus pill for ophthalmology Products that have not been listed by manufacturers but are still listed in the medical insurance catalog For example, minoxidil oral regular release dosage form and xaquinavir oral regular release dosage form, which have been listed in China but have no valid approval, are expected to be removed from the medical insurance catalog Products that have not entered the provincial bidding catalogue for three consecutive years are also expected to be transferred out of the medical insurance catalogue Whether the products that enter the national auxiliary drug catalog will be removed from the medical insurance catalog also deserves attention The list of medical insurance published in 2017 has restricted the use of traditional Chinese medicine injections to hospitals above grade II or to the indications, and the auxiliary use of chemical drugs has also limited the indications After the publication of the national auxiliary drug catalogue in 2019, whether to further limit the indications or to be directly removed from the medical insurance catalogue is worthy of attention ▍ the new version of medical insurance catalog was published in July According to the previous draft for comments, the adjustment of drug catalog is divided into five stages: preparation, review, release of regular access catalog, negotiation and release of negotiation access catalog The regular catalog will be released in June 2019, and the negotiation access catalog will be released in August 2019 The adjustment of drug catalogue can be divided into five stages: preparation, review, release of regular access catalogue, negotiation and release of negotiation Access Catalogue According to the official 2019 adjustment plan of medical insurance catalog, in July, the regular catalog was released （1） Preparation stage (January March 2019) 1 Work out the work plan and solicit the opinions of the Ministry of industry and information technology, the Ministry of finance, the Ministry of human resources and social security, the national health and Health Commission, the State Food and drug administration, the State Administration of traditional Chinese medicine and other relevant departments and the society 2 Establish a working organization, a database of review experts, a basic database of review, and regulations on integrity and confidentiality （2） Review stage (April July 2019) 1 Medical insurance medication consultation survey A certain number of experts were randomly selected from the selection database to vote on all varieties (dosage forms) to understand the medical insurance drug demand nationwide The voting area shall be no less than 2 / 3 of the provinces in the country; the number of voting experts shall be no less than 30% from secondary and below medical institutions; in principle, the number of experts in each drug group shall be no less than 50 2 Determine the alternative list Consulting experts demonstrate and determine the technical key points of drug review, and according to the key points and the results of medical insurance drug consultation and investigation, review by professional groups to determine the list of alternative drugs transferred in (including negotiation) and transferred out For the drugs out of the medical insurance catalog in the national essential drug catalog in 2018, it is proposed to consult experts for key consideration 3 Select experts to vote From the selection expert database, according to the difference between the expert's region, the medical institution's category and level, the professional department and the reported drug evaluation classification group, the experts participating in the selection are randomly selected by level and level No less than 2 / 3 of the provinces in China participate in the selection; no less than 30% of the experts from secondary and below medical institutions participate in the selection; in principle, no less than 50 experts from each drug group participate in the selection 4 Confirm the list of transferred drugs According to the voting results of the selection experts and the number of varieties to be included, the consulting experts determine the list of transferred (including negotiated) drugs, discuss some drugs that need to be strengthened management, and study and propose corresponding management measures 5 Solicit the opinions of relevant enterprises on the list of negotiated drugs and confirm the intention of negotiation （3） Regular catalog release stage (July 2019) 1 Prepare the notice on printing and distributing the drug catalog and publishing the list of negotiated drugs 2 Solicit opinions from relevant departments on the draft notice and report the catalog adjustment 3 Printing and distributing the new version of the drug catalogue and publishing the list of drugs to be negotiated （4） Negotiation stage (August September 2019) 1 Organize enterprises to provide negotiation materials according to the specified format and time limit 2 Organize measurement experts to carry out assessment through big data analysis of medical insurance and pharmacoeconomics, and put forward assessment opinions 3 The negotiation experts shall negotiate with the enterprise according to the evaluation opinions to determine the unified national medical insurance payment standard and management policy （5） Release the negotiation Access Catalogue (September October 2019) The state health insurance bureau issued a document to include the negotiated drugs in the drug catalogue, and simultaneously clarify the management and implementation requirements Appendix: work plan for the adjustment of national medical insurance drug catalogue in 2019 In order to implement the decision-making and deployment of the Party Central Committee and the State Council, further improve the drug use guarantee level of the insured personnel, and standardize the management of medical insurance drugs, according to the social insurance law of the people's Republic of China and relevant documents, we hereby formulate the adjustment work plan of the national basic medical insurance (including work injury insurance and maternity insurance) drug catalog (hereinafter referred to as the drug catalog) in 2019 1、 Target task Guided by Xi Jinping's socialist ideology with Chinese characteristics in the new era, we carried out the spirit of the nineteen and nineteen second plenary session of the Third Plenary Session of China's Central Committee and the central economic work conference, and adhered to the development thought of people's health as the center, focusing on establishing and improving a more equitable and sustainable medical insurance system, adjusting the catalogue scope appropriately according to the fund's ability to pay, and working hard to achieve drug knot We will further optimize the structure and standardize the management, further improve the use efficiency of medical insurance funds, improve the level of medical insurance drug security, and effectively alleviate the difficulty and cost of drug use 2、 Basic principle (1) adhere to the basic starting point of maintaining the health of the insured On the basis of fund affordability, we should highlight the clinical value, make up the short board of guarantee, improve the effect of guarantee, adjust the scope of catalogue appropriately, better meet the basic clinical drug demand of the insured, and effectively safeguard the health rights and interests of the majority of the insured （2） Adhere to the basic positioning Based on the level of China's economic and social development, taking into account the bearing capacity of medical insurance fund, the burden level of the insured and the clinical drug demand, we should adhere to the basic medical insurance positioning, not only do our best, but also do what we can, reasonably determine the scope and level of drug use, and achieve the matching between the scope and the guarantee capacity （3） Adhere to the open, fair and just expert evaluation system The drug catalogue shall be reviewed and determined by experts in accordance with the scientific and standard procedures, and the administrative department shall not interfere with the results of expert review We will listen to opinions and suggestions from all sides on the adjustment plan Standardize and publicize the review procedures, strictly discipline, take the initiative to accept discipline inspection and supervision, social and other supervision, and ensure openness, fairness and justice （4） Adhere to overall planning Give full play to the advantages of Western medicine and traditional Chinese medicine, establish and improve targeted evaluation methods according to their respective basic theories, and take into account the structure, quantity and growth of Western medicine and traditional Chinese medicine as a whole Comprehensive consideration should be given to the basic theories and norms of clinical drug use, the basic laws and management requirements of medical insurance, and the policies and regulations of drug supervision, health care, traditional Chinese medicine and other departments 3、 The content of the adjustment involves three aspects: Western medicine, Chinese patent medicine and Chinese herbal pieces, specifically including drug transfer in and drug transfer out Based on the drug information approved for listing by the State Food and drug administration, the company will not accept the application or recommendation of the enterprise, and will not charge the review fee and other various fees The imported western medicine and Chinese patent medicine should