What is the development trend of Chinese herbal medicine? It is clear at a glance from the implementation of the National Medical Insurance Catalogue in 2019

Chinese herbal pieces are an important carrier of Chinese medicine culture In the supporting documents of 2019 national medical insurance catalog, the supporting policies of provinces (cities) fully reflect the support of local governments to the Chinese Herbal Pieces industry Standing at the annual pass, we carefully read these supporting policies, which will help us to judge the development trend of sub industries Chinese Herbal Pieces refer to Chinese herbal medicines and processed products which can be directly used for dispensing or preparation under the guidance of the theory of Chinese medicine In a sense, compared with traditional Chinese medicine, Chinese herbal pieces can better reflect the diagnosis and treatment characteristics of "syndrome differentiation and treatment" According to the data, in 2018, the scale of Chinese Herbal Pieces industry reached 210.49 billion yuan, an increase of 14.2% year-on-year, which is an important part of the pharmaceutical industry and one of the most active sectors On August 20, 2019, the national medical insurance bureau and the Ministry of human resources and social security issued the notice on printing and distributing the catalogue of drugs for national basic medical insurance, work injury insurance and maternity insurance (medical insurance Fa [2019] No 46) The core contents of Chinese Herbal Pieces in the document are as follows: 1 Chinese herbal pieces include the scope of pieces to be paid by medical insurance fund and the scope of pieces to be paid by medical insurance fund which shall not be adjusted by local government 2 In addition to 892 varieties approved for payment by the basic medical insurance, work injury insurance and maternity insurance fund, the Chinese herbal pieces also list the pieces that cannot be included in the fund payment 3 The Chinese Herbal Pieces in the drug catalog are produced from the Chinese herbal pieces with national standards through expert review For other pieces of traditional Chinese medicine with national or local standards, the provincial medical security departments can take the lead, together with the human resources and social security departments, according to the local fund affordability and drug demand, and the corresponding expert review procedures can be included in the provincial (District, city) fund payment scope, but the non payment pieces specified in the catalog shall not be added 4 The payment management measures for Chinese Herbal Pieces in the drug catalog, national drugs, Chinese herbal pieces and hospital preparations adjusted by each province (District, city) shall be formulated by the provincial medical security department 5 The part marked with "□" in Chinese Herbal Pieces means that it will not be paid when it is used alone, and the prescription composed of all these pieces will not be paid 6 The fund can only pay for the prescription of Chinese patent medicine and the prescription of Chinese Herbal Pieces issued by doctors with corresponding qualifications Each overall planning area should establish the doctor system of medical insurance agreement and strengthen the examination and approval management of doctors' prescription qualification From the above content, we can clearly see that the access scope of "Chinese Herbal Pieces" in the national medical insurance catalog has evolved from the previous "exclusion method" (single taste or compound prescription are not paid, and single taste is not paid), to The definition method of "access (892) + exclusion (continuation of the previous single taste / compound limited method)", in a sense, further reflects the seriousness of the national catalog, and for the scope of payment restriction, also reflects the new version of the national drug catalog "emphasis on treatment, light nourishing" principle Innovation and development at the provincial level after the release of the new national medical insurance catalog, provinces and cities have successively issued local supporting documents As of December 30, 2019, about 20 provinces (cities) have officially issued supporting documents, as shown in the attached table These supporting documents can be roughly divided into the following situations: 1 Directly forward and implement the national directory and relevant regulations Such as Fujian, Shaanxi, Hainan and other provinces 2 In accordance with the national catalog and relevant regulations, appropriate transitional adjustments are made, such as: Beijing "does not pay for the local herbal pieces in accordance with the relevant contents of the national medical insurance drug catalog 2019", Hunan "continues to temporarily implement the original documents for 406 kinds of herbal ultramicro pieces produced by the provincial enterprises that have been approved to be included in the catalog of our province, with the self payment ratio of 10%, and accepts The next step is the evaluation scope of Chinese Herbal Pieces in our province 3 Waiting for further supporting documents, such as Tianjin "herbal pieces, hospital preparations of medical institutions and our city's work arrangement will be separately organized according to the requirements of national documents" 4 Make a separate list of Chinese herbal pieces, such as Heilongjiang "notice on access management of Heilongjiang basic medical insurance, industrial injury insurance and maternity insurance list of Chinese Herbal Pieces" (h.y.f (2019) NO.67), which defines the list of Chinese Herbal Pieces in the province, with 1197 pieces, 117 pieces are not paid for single taste, 59 pieces are not paid for single taste or compound prescription Several key issues worthy of attention: 1 Whether the payment of Chinese Herbal Pieces belongs to "class a" or "class B": Gansu and Heilongjiang are clearly defined as "payment of Chinese herbal pieces according to class a"; the self payment proportion in the Access Catalogue stipulated by Hunan is zero, and the self payment proportion of ultra micro pieces is 10%; other provinces have no clear categories and continue the existing policies 2 For the new varieties based on the development of traditional Chinese medicine, such as "traditional Chinese medicine formula granules" and "broken wall decoction pieces", some provinces have made it clear that "only traditional decoction pieces" and some provinces have "continued the existing system" At present, there is no unified opinion, which needs to be further clarified 3 Prescription authority of Chinese Herbal Pieces: most provinces have continued the description of the national medical insurance catalog, that is: "the fund can pay according to the regulations only for the prescription of Chinese patent medicine and Chinese Herbal Pieces issued by qualified doctors The whole province should establish the medical insurance agreement doctor system, strengthen the examination and approval management of doctors' prescription qualification If we can't apply the decoction pieces based on the principle of TCM theory, we can't reflect the treatment characteristics of TCM, which belongs to irrational drug use Therefore, how to expand the group of doctors with TCM Decoction Pieces prescription qualification in the next step is a long-term restrictive problem that all decoction pieces sales enterprises need to pay attention to 4 For 892 kinds of access pieces and pieces other than those discharged by the unit / compound, whether there is an opportunity to access the provincial medical insurance catalog? From the policy, we found that the policies of most provinces are the continuation of the national catalog "For other pieces of traditional Chinese medicine with national or local standards, it can be led by the provincial medical security departments, together with the human resources and social security departments according to the The fund affordability and drug demand of the land shall be included in the fund payment scope of the province (District, city) through the corresponding expert review procedure, but the description of "non paid pieces of Decoction" specified in the catalogue shall not be added Conclusion: the new version of the medical insurance catalogue and the supporting documents of each province reflect the overall idea of "support + specification" for the industry of "Chinese Herbal Pieces" The author believes that under the promotion of the national policy of support for Chinese medicine, Chinese herbal pieces will develop rapidly with the progress of Chinese medicine industry.