classification of national basic medical insurance drug list

the national basic medical insurance drug list contains some common drugs that are suitable for basic medical needs and have sufficient supply. The drugs in the catalogue are divided into Chinese patent medicine, western medicine and Chinese herbal pieces, which can be divided into class A and class B by category.

1. There are 1133 kinds of western medicines that can be reimbursed by medical insurance, including 315 kinds of Class A medicines and 818 kinds of Class B medicines;

2. There are 927 kinds of Chinese patent medicines that can be reimbursed by medical insurance, 135 kinds of Class A medicines and 792 kinds of Class B medicines;

3. It also includes 127 kinds and 1 category of Chinese herbal pieces.

The latest national basic medical insurance drug list

Notice on printing and distributing the national basic medical insurance drug list (218 edition)

Guo Wei Yao Zheng Fa [218] No.31

Health and Family Planning Commission (Health and Health Committee) and Chinese Medicine Administration of all provinces, autonomous regions and municipalities directly under the Central Government and Xinjiang Production and Construction Corps:

In order to implement the CPC Central Committee and the State Council, deploy and deepen the medical and health system, According to the Measures for the Administration of National Essential Drugs List (Guo Wei Yao Zheng Fa [215] No.52) and other relevant regulations, the relevant departments have adjusted and improved the National Essential Drugs List (212 Edition) and formed the National Essential Drugs List (218 Edition). Audited by the leading group of the State Council medical reform, it was submitted to the executive meeting of the State Council for deliberation and approval, which is now officially issued and shall come into force as of November 1, 218.

please ask the local health administrative departments at all levels (including the departments in charge of traditional Chinese medicine) to take the lead in the implementation of the National Essential Drugs Catalogue (218 edition) in strict accordance with the relevant requirements of the Opinions of the General Office of the State Council on Improving the National Essential Drugs System (Guo Ban Fa [218] No.88), and report the problems encountered in the implementation process to the Office of the National Essential Drugs Working Committee (Pharmaceutical Administration Department of the National Health and Health Commission) in a timely manner.

interpretation of the national basic medical insurance drug list

(1) what are the characteristics of the 219 edition of the national essential drugs list?

the latest edition of the catalogue is mainly based on the 212 edition. Overall, the 219 edition of the catalogue has the following characteristics: First, the number of varieties has increased from 52 to 685, including 417 western medicines and 268 Chinese patent medicines (including ethnic medicines), which can better serve all kinds of medical and health institutions at all levels and promote the comprehensive equipment and priority use of essential medicines. Second, the structure has been optimized, highlighting the basic drug needs of common diseases, chronic diseases, diseases with heavy burden and serious harm, and public health, and paying attention to the use of drugs by special groups such as children. The new varieties include 12 kinds of drugs for tumors and 22 kinds of drugs for children urgently needed in clinic. The third is to further standardize the dosage forms and specifications. The 685 kinds of drugs involve more than 1,11 dosage forms and more than 1,81 specifications, which will be of great significance for guiding the production and circulation of essential drugs, bidding and purchasing, rational drug use, payment and reimbursement, and whole-process supervision. Fourth, continue to pay equal attention to both Chinese and western medicine, increase the scope of functional indications and cover more clinical symptoms of Chinese medicine. Fifth, the clinical necessity has been strengthened. Among the new drug varieties added in this catalogue adjustment, 11 drugs are non-medical insurance drugs, mainly drugs that are clinically necessary and have definite curative effect, such as the direct antiviral drug SOPHOBWEVI PATARV. Experts agree that hepatitis C can be cured with definite curative effect.

after the publication and implementation of the new catalogue, it will be able to cover the main clinical diseases, better meet the basic medical and health needs, provide basic support for further improving the basic drug system, and meet the people's basic drug demand for disease prevention and treatment with high quality.

(2) how does this catalogue adjustment reflect the equal emphasis on Chinese and western medicine?

The CPC Central Committee and the State Council attach great importance to the development of Chinese medicine, and the National Health and Wellness Commission actively implements the central decision-making arrangements, and pays attention to embodying the characteristics of Chinese medicine, giving full play to the role of Chinese medicine and promoting the development of Chinese medicine in the national drug policy and the basic drug system. The Measures for the Administration of National Essential Drugs Catalogue (Guo Wei Yao Zheng Fa [215] No.52) clearly stipulates that when selecting national essential drugs, both Chinese and western medicines should be attached equal importance. The adjustment principles determined in our catalogue adjustment work plan also clearly support the development of Chinese medicine.

when adjusting the list of essential drugs in the early stage, our Committee fully respected the characteristics of traditional Chinese medicine in selecting the national essential drugs for proprietary Chinese medicines, and jointly organized Chinese medicine experts with the State Administration of Traditional Chinese Medicine to conduct full demonstration and review according to the adjustment principles and procedures specified in the management measures for the list of essential drugs and the list adjustment work plan determined by the Working Committee on Essential Drugs. After adjustment, the total number of varieties in the list of essential drugs is 685, among which the proportion of Chinese and western medicines is consistent with the list of essential drugs in 212.

the health and wellness commission will continue to adhere to the principle of paying equal attention to both Chinese and western medicines in the work related to the national drug policy and the essential drug system, further improve the selection and adjustment mechanism of national essential drugs in accordance with the provisions and requirements of the administrative measures for the essential drug list, fully consider the characteristics of traditional Chinese medicines, dynamically adjust and improve the variety structure and quantity of the essential drug list, meet the people's demand for essential drugs, and promote the development of Chinese medicine.

(3) how to play the linkage role of essential drugs and basic medical insurance?

there are both similarities and differences between essential drugs and medical insurance drugs. There is no obvious difference between the two in terms of safety and effectiveness and cost-benefit ratio. Essential drugs have stronger attributes in terms of "prevention and control is necessary, supply is guaranteed, and priority is given to use". First, essential drugs not only meet clinical needs, but also consider public health needs, including immunization vaccines, anti-AIDS and tuberculosis drugs. Second, the effective supply of essential drugs needs to be ensured in various ways to ensure continuous supply. The government guarantees production and supply through fixed-point and reserve methods, and provides high-level protection through special financial funds or inclusion in medical insurance funds to improve patients' affordability of essential drugs. Third, essential drugs are the first-line drugs for clinical use. With the deepening of the reform of medical insurance payment methods such as disease-based payment and total prepayment, the guiding role of the essential drug list will only be strengthened from the perspective of ensuring supply and guiding clinical rational drug use.

With regard to the linkage between essential drugs and basic medical insurance, the Opinions put forward that, firstly, the medical insurance payment policy should be improved, and the medical insurance department should give priority to the therapeutic drugs in the qualified essential drugs list or adjust the classification of A and B according to procedures; The second is to improve the procurement and distribution mechanism. The medical insurance agency shall timely allocate medical insurance funds to medical institutions in accordance with the agreement, and the medical institutions shall timely settle the payment in strict accordance with the contract; The third is to deepen the reform of medical insurance payment methods, and establish and improve the incentive and risk sharing mechanism of "balance retention and reasonable overspending sharing" between medical insurance agencies and medical institutions. Through the formulation of medical insurance payment standards, medical institutions and medical personnel are guided to make rational diagnosis and treatment and rational drug use.

(4) What are the criteria for importing and exporting the list of essential drugs?

according to the requirements of the administrative measures for the national essential drugs list, referring to the selection procedures and principles of the World Health Organization's essential drugs list and the drug lists of relevant countries (regions), according to China's disease spectrum and drug use characteristics, fully considering the basic national conditions and support capacity at this stage, summing up the practical experience of the previous list formulation and adjustment, and clarifying the standards for transferring in and out of the essential drugs list.

criteria for drug transfer: first, according to the sequence of disease spectrum, incidence rate, disease burden, etc., meet the basic drug demand of common diseases, chronic diseases, diseases with heavy burden, serious diseases and public health, and select an appropriate number of basic drugs from the drugs that have been listed in China. The second is to support the development of Chinese medicine, support the development and innovation of the pharmaceutical industry, and tilt towards Chinese medicine (including ethnic medicine) and domestic innovative medicine.

standards for drug transfer: first, drug standards have been replaced; Second, the State Drug Administration revoked its drug approval certificate; Third, adverse reactions have occurred, and it is not suitable to be used as a national essential drug after evaluation; Fourth, according to pharmacoeconomic evaluation, it can be replaced by varieties with better risk-benefit ratio or cost-benefit ratio; Fifth, other circumstances that the National Essential Drugs Working Committee thinks should be transferred out.

legal basis:

social insurance law of the people's Republic of China article 25 the state establishes and improves the basic medical insurance system for urban residents.

the basic medical insurance for urban residents combines individual contributions with government subsidies.

people who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people over 6 years old and minors from low-income families, etc. will be subsidized by the government.