Category: Medical Insurance Bureau

Address: No. 308, Feng Shixing Road, Beibei District, Chongqing

Tel: 023-60309383; 023-60309140

The National Medical Security Administration of the People's Republic of China is an agency directly under the State Council, at the deputy ministerial level, and was established in March 2018.

Its main functions are to formulate policies, plans, standards and organize the implementation of medical insurance, maternity insurance, medical assistance and other medical security systems, supervise and manage relevant medical security funds, and improve the national off-site medical management and cost settlement platform , organize the formulation and adjustment of prices and charging standards for drugs and medical services, formulate bidding and procurement policies for drugs and medical consumables and supervise their implementation, supervise and manage related service activities and medical expenses of medical institutions included in the scope of medical insurance.

1. Historical evolution

In order to improve the unified basic medical insurance system and critical illness insurance system for urban and rural residents, continuously improve the level of medical security, ensure the rational use of medical insurance funds, safety and controllability, and overall planning To promote the reform of the "three medical linkages" of medical care, medical insurance, and medicine to better ensure that patients have access to medical care, the State Council's institutional reform plan proposes to combine the Ministry of Human Resources and Social Security's basic medical insurance and maternity insurance responsibilities for urban employees and urban residents, and the national health Integrating with the New Rural Cooperative Medical Care responsibilities of the Family Planning Commission, the drug and medical service price management responsibilities of the National Development and Reform Commission, and the medical assistance responsibilities of the Ministry of Civil Affairs, the National Medical Security Administration was established as an agency directly under the State Council.

In March 2018, the First Session of the 13th National People's Congress voted to adopt a decision on the institutional reform plan of the State Council to establish the National Medical Security Administration of the People's Republic of China.

In the past, the health department and the human resources and social security department had been arguing endlessly about who was in charge of drug procurement. Now the country has given the answer, and the Medical Security Bureau will take over the whole thing.

As early as June 28, 2017, the State Council promulgated the "Guiding Opinions on Further Deepening the Reform of Basic Medical Insurance Payment Methods", emphasizing its importance and urgency, and mentioned the reform of medical insurance payment methods as a new high.

The "Guiding Opinions" proposes to improve the medical insurance payment mechanism and interest regulation mechanism, implement refined management, stimulate the endogenous motivation of medical institutions to standardize behavior, control costs, rationally treat and transfer patients, and guide medical resources. Reasonable allocation and orderly medical treatment for patients, support the establishment of hierarchical diagnosis and treatment models and the healthy development of grassroots medical and health institutions, and effectively protect the basic medical rights and interests of the majority of insured persons and the long-term sustainable development of the medical insurance system. It can be seen that the establishment of the National Medical Security Administration will greatly promote the implementation of this document and will have a very important impact on medical institutions and pharmaceutical companies.

The Medical Insurance Bureau has become the department that pharmaceutical companies and medical device companies pay most attention to.

After the establishment of the Medical Security Bureau, it will become the government department that pharmaceutical companies and medical device companies pay most attention to. There are three reasons:

1. Market access

For the domestic pharmaceutical industry, what exactly is market access? We can understand it in a narrow sense as: bidding and entering into medical insurance.

If a drug fails to pass the bidding, it means losing the entire hospital market. Furthermore, if a drug cannot be included in the medical insurance catalog, even if it passes the bidding process, it will have a huge impact on the market.

Tendering and the medical insurance catalog are market access, and now these two rights have fallen into the hands of the Medical Security Bureau, and their importance is self-evident.