The National Basic Medical Insurance Drug Catalog contains a number of common medicines that are applicable to basic medical needs and are in sufficient supply. The medicines in the catalog*** are divided into three categories: proprietary Chinese medicines, western medicines and Chinese herbal medicines, and by category, they can be divided into Class A and Class B.
1, there are 1,133 kinds of western medicines that can be reimbursed by the medical insurance, including 315 kinds of Class A medicines and 818 kinds of Class B medicines among western medicines;
2, there are 927 kinds of pCms that can be reimbursed by the medical insurance, with 135 kinds of Class A medicines and 792 kinds of Class B medicines among the pCms;
3, and also includes 127 kinds and one class of Chinese herbal medicines and drinking tablets.
Latest National Basic Medical Insurance Drug Catalog
Notice on the issuance of the National Basic Drug Catalog (2018 Edition)
National Health Drug Administration [2018] No. 31
Provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps of the Health Planning Commission (Health and Health Commission), the Administration of Traditional Chinese Medicine:
For the implementation of the the deployment of the CPC Central Committee and the State Council and the requirements of the key tasks of deepening the reform of the medical and health system, according to the Measures for the Administration of the National Essential Drugs Catalog (State Health Pharmaceutical and Political Development [2015] No. 52) and other relevant provisions, the relevant departments have adjusted and improved the National Essential Drugs Catalog (2012 Edition) and formed the National Essential Drugs Catalog (2018 Edition). Reviewed by the State Council Leading Group of Medical Reform and submitted to the State Council Executive Meeting for consideration and adoption, it is now officially issued and shall come into force on November 1, 2018.
Please local health administrative departments at all levels (including the competent departments of traditional Chinese medicine), in strict accordance with the relevant requirements of the Opinions of the General Office of the State Council on Improving the National System of Essential Medicines (State Council [2018] No. 88), take the lead in the implementation of the National Essential Drugs Catalogue (2018 Edition), and promptly summarize and report any problems encountered in the process of implementation to the Office of the National Essential Drugs Working Committee (National Health Council Pharmaceutical Committee Office). Committee Office (Department of Pharmaceutical Affairs of the National Health Commission).
National Health Commission
State Administration of Traditional Chinese Medicine
20180930
Interpretation of the National Essential Medicines Catalog
(a) What are the features of the 2019 version of the National Essential Medicines Catalog?
The latest version of the catalog is mainly adjusted and improved on the basis of the 2012 version of the catalog. Overall, the 2019 version of the catalog has the following features: first, the number of varieties has been increased from 520 to 685, including 417 Western medicines and 268 Chinese patent medicines (including ethnic medicines), which can better serve all levels and types of medical and healthcare institutions, and promote the comprehensive provision and priority use of essential medicines. Secondly, the structure has been optimized, highlighting the basic medication needs of common and chronic diseases, as well as high-burden and hazardous diseases and public **** health, focusing on the use of medication for children and other special populations, and the new varieties include 12 types of oncology medications, 22 types of clinically needed children's medications, and so on. Third, further standardize the dosage form and specifications, 685 kinds of drugs involving more than 1110 dosage forms and 1810 specifications, which will be of great significance in guiding the production and circulation of basic drugs, bidding and procurement, rational use of drugs, payment and reimbursement, and overall supervision. Fourthly, it continues to insist on the equal importance of Chinese and Western medicines, and has increased the scope of function and treatment, covering more clinical symptoms in Chinese medicine. Fifth, the strengthening of the clinical necessity, the catalog adjustment of the new drug varieties, there are 11 drugs for non-medicare drugs, mainly clinically necessary, efficacy of the drugs, such as direct antiviral drugs sofosbuvir vipatasvir, experts agree that it can cure Hepatitis C, the efficacy of the exact.
After the release and implementation of the new version of the catalog, it will be able to cover the main clinical diseases, better adapt to the basic medical and health needs, to further improve the basic drug system to provide basic support, high quality to meet the people's disease prevention and treatment of the basic needs of medication.
(2) How does this catalog adjustment reflect the equal importance of Chinese and Western medicines?
The CPC Central Committee and the State Council attach great importance to the development of Chinese medicine, the National Health Commission actively implement the central decision-making and deployment of the national drug policy and the basic drug system and other related work, focusing on reflecting the characteristics of traditional Chinese medicine, play the role of traditional Chinese medicine, and promote the development of traditional Chinese medicine. The Measures for the Administration of the National Essential Drugs Catalog (State Health and Pharmaceutical Affairs [2015] No. 52) clearly stipulates that when selecting national essential drugs, both Chinese and Western medicines should be emphasized. Our catalog adjustment work plan this time to determine the principles of adjustment also clearly to support the development of Chinese medicine.
When carrying out the adjustment of the basic drug catalog in the early stage, for the selection of national basic drugs of proprietary Chinese medicines, the Commission fully respected the characteristics of traditional Chinese medicine, and together with the State Administration of Traditional Chinese Medicine (SATCM), we separately organized experts in traditional Chinese medicine to carry out full argumentation and evaluation in accordance with the adjustment principles and procedures clearly defined by the management methods of the basic drug catalog and the catalog adjustment work plan determined by the Working Committee on Basic Drugs. After the adjustment, the total number of varieties in the basic drug catalog is 685, of which the proportion of the composition of Chinese and Western medicines is consistent with that of the 2012 version of the basic drug catalog.
The Health Commission will continue to adhere to the principle of giving equal importance to both Chinese and Western medicines in its work related to the national drug policy and the basic drug system, and further improve the mechanism of selection and adjustment of the national basic drugs in accordance with the provisions and requirements of the management methods of the basic drug catalog, taking into full consideration the characteristics of traditional Chinese medicines, and dynamically adjusting and perfecting the varieties and quantity of the basic drug catalog, so as to satisfy the people's basic needs for medicines, and to facilitate the development of the cause of traditional Chinese medicines. The development of the cause of Chinese medicine.
(3) How to play the role of basic drugs and basic medical insurance linkage?
Basic drugs and health insurance drugs have both ****, there are also differences. The two in the safe and effective, cost-effective ratio is no significant difference, basic drugs in the "prevention and treatment of essential, to ensure the supply, priority use" attributes stronger. First, essential medicines not only take into account clinical necessity, but also public **** health necessity, including immunization vaccines, anti-AIDS and tuberculosis medicines. Secondly, essential medicines need to be supplied in a variety of ways to ensure their effective supply; the Government guarantees their production and supply by means of fixed-point, reserve and other means; they are guaranteed at a high level through special financial funding or inclusion in the health insurance fund, so as to improve the affordability of essential medicines for patients. Third, the basic drugs are clinically preferred, priority use of first-line drugs, with the continuous deepening of the reform of the health insurance payment method, according to the payment, total prepayment, etc., from the point of view of guaranteeing the supply and guiding the rational use of clinical medication, the guiding role of the basic drug directory will only be strengthened, will not be watered down.
In terms of linkage between essential medicines and basic health insurance, the Opinion puts forward that, firstly, the health insurance payment policy should be improved, and the health insurance department should prioritize the therapeutic medicines in the catalog of essential medicines to be included in the scope of the health insurance catalog or to adjust the classification of A and B in accordance with the procedures; secondly, the purchasing and distribution mechanism should be improved, and health insurance agencies should allocate health insurance funds to the healthcare organizations in a timely manner according to the agreement and healthcare institutions should settle the payments in a timely manner in accordance with the contract. The medical institutions should strictly settle the payment in a timely manner according to the contract; thirdly, deepen the reform of the payment method of the medical insurance, and establish and improve the incentive and risk-sharing mechanism of "retaining the balance and reasonably sharing the overspending" between the medical insurance administration organization and the medical institutions. Through the formulation of drug health insurance payment standards and other ways to guide medical institutions and medical staff to rational diagnosis and treatment, rational use of drugs.
(4) What are the criteria for transferring in and out of the basic drug list?
In accordance with the requirements of the "National Essential Drug List Management Measures", with reference to the World Health Organization's Essential Drug List and the relevant countries (regions) drug roster selection procedures and principles, according to China's disease spectrum and characteristics of the use of medication, taking into full account the basic conditions of the country and the ability to protect the current stage, summing up the previous directory development and adjustment of the practice of the experience of the directory clearly defined the criteria for the transfer of the transfer of the basic drug list and transfer out of the directory.
The criteria for transferring medicines into the catalog: First, combining the spectrum of diseases, morbidity, burden of disease, etc., to meet the basic medication needs of common and chronic diseases, as well as high-burden and hazardous diseases and critical illnesses, and public ****health, etc., an appropriate number of essential medicines will be selected from the medicines that have already been listed on the market in China's territory. The second is to support the development of traditional Chinese medicine, support the development of innovation in the pharmaceutical industry, tilted toward traditional Chinese medicine (including ethnomedicine), domestic innovative drugs.
The criteria for the transfer of medicines: First, the drug standard is replaced; second, the State Drug Administration revoked its drug approval documents; third, the occurrence of adverse reactions, assessed to be inappropriate for use as a national essential drugs; fourth, according to the evaluation of pharmacoeconomics, can be replaced by the risk-benefit ratio or cost-effective ratio of the better varieties; five is the National Essential Drugs Working Committee believes that it should be transferred out. Other circumstances.
National Basic Medical Insurance Drug List
I. Western Medicines
1 Anti-microbial Drugs
1.1 Antibiotic Anti-infectives
1.2 Synthetic Antibacterial Drugs
1.3 Others
1.4 Anti-mycobacteria Drugs
1.5 Anti-fungals
1.6 Antivirals
2 Antiparasitic Drugs
2.1 Antischistosomiasis Drugs
2.2 Antimalarials Drugs
2.3 Enteric Worm Repellents
2.4 Anti-filarial and Anti-Black Fever Drugs
2.5 Anti-coele and Anti-Tickle Drugs
3 Antipyretic and Non-Steroidal Anti-Inflammatory Analgesic Drugs
3.1 Antipyretic and non-steroidal anti-inflammatory analgesics
3.2 Antigout medicines
4 Anesthetic drugs
4.1 General anesthetics
4.2 Local anesthetics
4.3 Analgesics
4.4 Anesthetic adjuncts
5 Vitamins and minerals deficiencies
6 Nutritional therapy
6 Nutritional therapeutics
7 Hormones and endocrine regulators
7.1 Hypothalamic pituitary hormones and their analogs
7.2 Adrenocorticotropic hormones
7.3 Androgens and anabolic hormone analogs
7.4 Estrogens and progesterone analogs
7.5 Pancreatic hormone and other glucose-affecting drugs
7.6 Thyroid and thyroid hormones 7.6 Thyroid Hormones and Antithyroid Drugs
7.7 Parathyroid and Calcium Metabolism Regulators
7.8 Others
8 Regulators of Immune Function
9 Antitumor Drugs
9.1 Alkylating Antitumor Drugs
9.2 Antimetabolite Antitumor Drugs
9.3 Antibiotic Antitumor Drugs
9.4 Antitumor Agents of Natural Origin
9.5 Hormonal Antitumor Agents
9.6 Others
9.7 Antitumor Adjuvants
10 Antimetabolites
11 Neurological Drugs
11.1 Anti-tremor paralyzers
11.2 Anti-muscle weakness agents
11.3 Antiepileptic Drugs
11.4 Drugs for Cerebrovascular Diseases
11.5 Central Stimulants
11.6 Sedative-hypnotic Drugs
11.7 Others
12 Drugs for Treatment of Mental Disorders
12.1 Antipsychotic Drugs
12.2 Anti-Anxiety Drugs
12.3 Antidepressants
12.4 Antimanic drugs
13 Respiratory drugs
13.1 Expectorants
13.2 Cough suppressants
13.3 Asthma-suppressants
14 Digestive drugs
14.1 Antacids and antiulcer drugs
14.2 Digestive aids
14.3 Gastrointestinal antispasmodic and gastric stimulants
14.4 Laxatives and antidiarrheal drugs
14.5 Adjuvants for liver and gallbladder disorders
14.6 Others
15 Drugs for the circulatory system
15.1 Cardiac stimulants
15.2 Antiarrhythmics
15.3 Anti angina pectoris drugs Drugs
15.4 Antihypertensive Drugs
15.5 Antishock Vasoactive Drugs
15.6 Lipid-lowering Drugs
15.7 Others
16 Urological Drugs
16.1 Diuretic Drugs
16.2 Diuretic Drugs for Prostate Disease
16.3 Other Drugs
17 Hematologic Drugs17.1 Hemostatic Drugs
17.2 Anticoagulants and Thrombolytic Drugs
17.3 Blood Volume Expanders
17.4 Anti-Anemia Drugs
17.5 Leukocyte Boosting Drugs
17.6 Antiplatelet Agents
18 Drugs for the Regulation of Water, Electrolyte, and Acid-Base Balance
19 Specialties
19 Specialty Drugs
19.1 Dermatology Drugs
19.2 Ophthalmology Drugs
19.3 Ear, Nose and Throat Drugs
19.4 Obstetrics and Gynecology Drugs
19.5 Antidotes
19.6 Radioisotope Drugs
20 Diagnostic Drugs
20.1 Diagnostic Imaging Drugs
20.2 Others
21 Biological Products
II. Part of Proprietary Chinese Medicines
1 Internal Medicine Drugs
1.1 Exopathogens
1.2 Diaphragms
1.3 Heat-cleansers
1.4 Warming agents
1.5 Phlegm-eliminating and cough suppressants, Asthma Relieving Agents
1.6 Opening the Orifices
1.7 Consolidating Astringency
1.8 Enhancing the Corrective Force
1.9 Tranquilizing Agents
1.10 Hemostatic Agents
1.11 Dispelling Blood Stasis
1.12 Regulating Qi
1.13 Eliminating Qi
1.14 Wind Dispelling Agents
1.15 Expecting Dampness
1.16 Expecting Difficulties in the Expectation of Dysfunction p>1.15 Expectorant of Dampness
1.16 Others
2 Surgical Drugs
2.1 Heat-cleansing Agents
2.2 Warming Agents for Qi and Blood
3 Gynecological Drugs
3.1 Blood-cleansing Agents
3.2 Heat-cleansing Agents
3.3 Enhancing Agents for Positive Effectiveness
4 Ophthalmic Drugs
4.1 Heat-clearing Agents
4.2 Corrective Agents
5 Ear, Nose and Throat Medicines
5.1 Ear Diseases
5.2 Nasal Diseases
5.3 Pharyngeal Diseases
6 Orthopedics and Traumatology Medicines
6.1 Blood-vitalizing and Stasis-relieving Agents
6.2 Blood-vitalizing and Collaterals-opening Agents
6.3 Supplementing the Liver and Kidney Agents
7 Dermatological Drugs
8 Ethnic Drugs
Three: Chinese Medicine Drinks
Related Questions
I. What is included in the Three Catalogs of Basic Medical Insurance?
AnswerThe "three catalogs" of basic medical insurance include the catalog of basic medical insurance medicines, the catalog of diagnostic and therapeutic items, and the standard of medical service facilities.
Basic medical insurance medicines refer to those medicines that are necessary for treatment, inexpensive, and have good therapeutic effects on the basis of the national basic medicines, and exclude those medicines that are not necessary for basic medical treatment, are more expensive, and have average therapeutic effects. In practice, this is determined through the development of a catalog of medicines for use in basic medical insurance.
Basic medical insurance diagnosis and treatment program means that in the process of medical service, the routine methods of examination and treatment with good effect should be selected, while the use of highly sophisticated and expensive equipment should be properly controlled and restrained. In practice, through the development of basic medical insurance treatment program to determine.
Basic medical insurance service facilities means that in the process of providing medical services such as hospitalization, the necessary and appropriate amount of medical service facilities and environment should be selected as the scope of medical insurance benefits. In practice, this is determined through the establishment of standards for basic medical insurance service facilities.
The "three major catalogs" of basic medical insurance are not fixed, but are adjusted as the economy develops and people's standard of living improves and technology advances.
Second, what is the relationship and difference between national essential drugs and medical insurance?
Answer "National Essential Drugs" is the State Drug Administration in accordance with the recommendations of the World Health Organization, in accordance with the principle of clinical treatment is necessary, efficacy of the formulation of the drug directory used to guide clinicians to rational use of medicines, to guide the direction of the production of drug manufacturers. The main differences between the National Essential Drugs and the Basic Medical Insurance Drug List are as follows:
(I) The roles of the two are different
The National Essential Drugs are mainly used to guide clinicians to rationally select medication varieties, and to ensure the supply of essential drugs to the market by guiding the direction of production of drug manufacturers. The main role of the Basic Medical Insurance Drug Catalog is to control the scope of the basic medical insurance payment for drugs, and is the basis for social insurance agencies to pay for the drug costs of the insured. Its purpose is to safeguard the basic medical needs of the insured and to ensure that the medical insurance fund balances its income and expenditure.
(2) Different bases for formulation
The National Essential Drugs mainly takes into account the rationality and safety of the clinical use of medicines, as well as the basic level of medicines used by the whole society. While the Basic Medical Insurance Drug List takes into account the safety and efficacy of the medicines used by the insured, it focuses on the affordability of the basic medical insurance fund and takes into account the price of the medicines.
(C) the scope of application is different
The National Essential Drugs are applicable to all groups of people in the whole society, while the Basic Medical Insurance Drug Catalog is only applicable to the participants of the basic medical insurance coverage.
Third, the national basic medical insurance drug list in the category B list of what organization to develop?
AnswerThe reimbursement rates for Class A and Class B are the same, 100% for Class A and 90-98% for Class B. However, the reimbursement rates are not the same, and the reimbursement rate for urban health insurance is high, while the reimbursement rate for agricultural cooperative is slightly lower.