In accordance with the decisions and arrangements of the Party Central Committee and the State Council, the National Medical Insurance Administration, together with the Ministry of Human Resources and Social Security and other departments, organized and carried out the adjustment of the national basic medical insurance, work-related injury insurance and maternity insurance drug catalogs in 2022, which has been successfully completed.

During this adjustment, 111 drugs were added to the catalog and 3 drugs were removed from the catalog.

Judging from the negotiation and bidding situation, 147 drugs outside the catalog participated in negotiations and bidding (including renewal negotiations for drugs in the original catalog), and 121 drugs were successfully negotiated or bid, with an overall success rate of 82.3%.

Negotiation and bidding for newly admitted drugs resulted in an average price reduction of 60.1%.

After this round of adjustments, the total number of drugs in the national medical insurance drug catalog has reached 2,967, including 1,586 Western medicines and 1,381 Chinese patent medicines; there is no adjustment for traditional Chinese medicine preparations, which remain at 892 types.

In this adjustment, the National Medical Insurance Administration has introduced a bidding mechanism, improved renewal rules, and optimized review procedures on the basis of strengthening research and demonstration and extensive solicitation of opinions. The catalog adjustment has reached a new level of scientificity, standardization, and refinement.

During the adjustment, the National Medical Insurance Administration firmly grasps the functional positioning of "guaranteeing the basics", regards the fund's affordability as the "bottom line" that must be adhered to, does its best and within its capabilities, and strives to meet the basic drug needs of the majority of insured persons; pay close attention to

In line with the overall situation of national COVID-19 prevention and control, qualified COVID-19 treatment drugs have been included in the catalog to support epidemic prevention and control with practical actions; varieties with higher clinical value and cost-effectiveness have been introduced to successfully upgrade drug guarantees.

At the same time, on the basis of ensuring the safety of the fund, this adjustment continues to appropriately relax the payment scope of some categories in the catalog, further improving drug accessibility and fairness in drug use.

Since the establishment of the National Medical Insurance Administration, the drug catalog has been adjusted for five consecutive years, and a total of 618 new drugs have been added to the catalog. At the same time, a number of drugs with uncertain efficacy, clinical abuse, or elimination have been removed from the catalog, leading the way in the drug catalog.

There are profound changes on the user side.

The "Blue Book on the Progress and Effectiveness of China's Medical Insurance Drug Management Reform" released by the Chinese Pharmaceutical Association shows that since 2018, the proportion of medical insurance drugs used in medical institutions has increased year by year, its dominant position has been further consolidated, and the rationality of clinical drug use has been actively improved.

At the same time, the entry of innovative drugs into medical insurance has been significantly accelerated, the price level of commonly used drugs has dropped significantly, and the level of drug protection for major diseases and special groups has been greatly improved, significantly reducing the drug burden of the public.

In the next step, the National Medical Insurance Administration and the Ministry of Human Resources and Social Security will conscientiously implement the spirit of the 20th National Congress of the Communist Party of China, work hard and move forward courageously, pay close attention to the implementation of the new version of the catalog, strive to improve the level of drug protection for the broad masses of people, and at the same time do a good job in

Price guidance for new coronavirus treatment drugs and medical expense guarantees will be used to support epidemic prevention and control and the construction of a healthy China with practical actions.

Notice of the Ministry of Human Resources and Social Security of the National Medical Insurance Administration on the issuance of the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2022)" Medical Insurance Development [2023] No. 5 All provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps Medical Insurance Bureau,

Department of Human Resources and Social Security: In order to implement the decisions and arrangements of the Party Central Committee and the State Council and further improve the level of medication protection for insured persons, in accordance with the "Interim Measures for the Administration of Medication for Basic Medical Insurance" and the "2022 National Basic Medical Insurance and Work Injury Insurance

and Maternity Insurance Drug Catalog Adjustment Work Plan" requires that the National Medical Insurance Administration and the Ministry of Human Resources and Social Security organized the adjustment and formulation of the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2022)" (hereinafter referred to as the "2022 Drug Catalog"

Catalog") is hereby issued, please comply with it.

The relevant matters are hereby notified as follows: 1. Make timely adjustments to the scope of payment. The "2022 Drug Catalog" contains 2,967 types of Western medicines and Chinese patent medicines, including 1,586 types of Western medicines and 1,381 types of Chinese patent medicines.

In addition, there are 892 kinds of traditional Chinese medicine pieces that can be paid for by the fund.

All localities must strictly implement the "2022 Drug Catalog" and are not allowed to adjust the drug varieties, remarks, A and B classifications, etc. in the catalog on their own.

The information system and database must be updated in a timely manner, and the drugs newly added in this adjustment shall be included in the fund payment scope as required. The drugs transferred out shall be simultaneously transferred out of the fund payment scope, and shall be maintained in the intelligent supervision subsystem in a timely manner to strengthen fund supervision.

.

2. Standardize payment standards During the agreement period, negotiated drugs (hereinafter referred to as negotiated drugs) and competitively bid drugs shall implement national unified medical insurance payment standards. Each coordinating region shall determine its self-payment ratio and reimbursement ratio based on the fund's affordability.

For competitive bidding drugs, if the actual market price exceeds the payment standard, the excess shall be borne by the insured persons; if the actual market price is lower than the payment standard, the excess shall be borne by the medical insurance fund and the insured persons according to the actual price.

Encourage local medical insurance departments to explore and prioritize the inclusion of generic drugs with prices no higher than the payment standards in designated medical institutions and "dual-channel" pharmacies to support clinical priority use and reduce the burden on patients.

During the validity period of the agreement, if the negotiated drugs or competitively priced drugs have specifications that are not specified in the "2022 Drug Catalog" and need to be included in the scope of medical insurance payment, the enterprise should apply to the National Medical Insurance Bureau, and the National Medical Insurance Bureau will determine the payment standard according to the terms of the agreement.

Implemented nationwide.