Hengqu (Hettropopa ethanolamine tablets) is an innovative drug 1 independently developed by Hengrui Pharmaceutical. In June, 20021,Food and Drug Administration approved it for adult patients with chronic idiopathic immune thrombocytopenia (ITP) and severe aplastic anemia (SAA), who had poor response to glucocorticoid and immunoglobulin in the past because of thrombocytopenia and increased bleeding risk caused by clinical conditions. 202 1, 1, Hengqu (Haiqu Bubai ethanolamine tablets) was officially included in the national drug list of basic medical insurance, industrial injury insurance and maternity insurance (202 1).
Drug reimbursement of basic medical insurance
Drugs included in the basic medical insurance payment range are divided into Class A and Class B ... Class A drugs refer to drugs that are basically unified throughout the country and can ensure the basic needs of clinical treatment. The expenses of such drugs are included in the payment scope of the basic medical insurance fund, and the expenses are paid according to the basic medical insurance payment standard.
The list of Class B drugs shall be adjusted by all provinces, autonomous regions and municipalities directly under the Central Government according to their own conditions. Before such drugs are included in the payment scope of the basic medical insurance fund, the employees shall pay according to a certain proportion and pay according to the basic medical insurance payment standard.
The following drugs do not belong to the basic medical insurance reimbursement scope:
(1) drugs with nourishing and strengthening effects;
(2) Some animals and animal organs and dried fruits that can be used as medicine;
(3) Various wine preparations brewed with Chinese herbal medicines and Chinese herbal pieces;
(4) Fruity preparations and oral effervescent agents in various medicines;
(5) Blood products and protein products (except for special indications and first aid and rescue);
(six) other drugs that are not paid by the basic medical insurance fund as stipulated by the administrative department of social insurance.
Legal basis:
People's Republic of China (PRC) social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.
Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.
Thirty-first social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior.
Medical institutions shall provide reasonable and necessary medical services for the insured.