The National Health Security Bureau recently released the 2020 National Health Insurance Drug Catalog Adjustment Work Program (Draft) to solicit public opinion. The medicines used in the treatment of respiratory diseases related to the new coronary pneumonia and the second batch of selected medicines in the national collection are expected to be included in the scope of new medicines to be added to the 2020 medical insurance catalog.
According to the Interim Measures for the Administration of Basic Medical Insurance Medicines, Order No. 1 of the National Health Insurance Bureau, which came out on July 30, China has established a mechanism to improve the dynamic adjustment of the medical insurance catalog, which is adjusted once a year in principle. The interim measures from September 1, 2020 shall come into force.
The consultation draft proposes that seven types of medicines outside the medical insurance catalog can be included in the scope of new medicines to be added to the 2020 medical insurance catalog, including medicines for the treatment of respiratory diseases related to new coronary pneumonia; medicines included in the National Essential Drugs Catalog (2018 Edition); medicines included in the list of clinically urgently needed overseas new medicines, the catalog of medicines encouraged to be imitated, or the list of children's medicines encouraged to be researched and developed and declared and approved by the national government by December 31, 2019 by the State Drug Administration approved the listing of drugs; the second batch of state-organized centralized procurement of drugs selected drugs, etc..
It is worth noting that the scope of new drugs to be added this time also includes drugs (including new active ingredients and new dosage forms) that were approved for listing by the State Drug Administration in accordance with the procedure of new drug registration application during the period of January 1, 2015 to December 31, 2019, according to the State Drug Administration. Experts pointed out that this means more new and good drugs are expected to be included in medical insurance, accelerating the guarantee of people's access to quality pharmaceutical services.
In addition, according to the draft for comments, drugs with significantly higher prices/costs compared with other drugs in the same therapeutic area and those that have taken up a larger amount of the fund in recent years are proposed to be included in the scope of adjustment of the 2020 medical insurance catalog.
Since the outbreak of the new coronary pneumonia, the National Health Insurance Bureau has issued ? two ensure? policy, which implements first treatment and settlement for all confirmed and suspected patients. As of July 19, 135,500 patients with confirmed and suspected cases of new coronary pneumonia have had their medical insurance settlements, involving 1.847 billion yuan in medical costs, with 1.232 billion yuan paid out by the medical insurance, a payment ratio of 67%.
Experts pointed out that the adjustment of the health insurance catalog is proposed to include the new range of therapeutic drugs related to the new crown pneumonia, which will provide an important support for the normalization of the prevention and control of the new crown pneumonia epidemic.