Medical network - February 23 

 

Provinces, autonomous regions and municipalities directly under the central government and xinjiang production and construction corps of human resources social security department (bureau), fujian medical insurance: 

 

The national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue (2009 edition) "issued by the, the human resources social security departments at all levels to carry out drug catalogue asked earnestly, specification and continued health care medicine management, to ensure the basic medical needs of ginseng to keep staff, maintenance funds run smoothly, and promote the healthy development of the pharmaceutical industry has played an important role. For implementing national health and health conference spirit, to establish a more equitable and sustainable social security system, steadily improve the level of basic medical insurance, medical services and pharmaceutical production technology progress and innovation, and gradually establish a perfect basic medical insurance drugs dynamic adjustment mechanism, according to the law of the People's Republic of China social insurance law ", "byelaw of inductrial injury insurance" and "urban employee basic medical insurance drug use scope management interim measures" (labor department is sent [1999] no. 15) and other laws and regulations and the provisions of the documents, our medicine to evaluate the organization experts, established the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue (2017 edition) "(hereinafter referred to as the catalog of medicines). We hereby notice on relevant issues as follows: 

 

A payment rules, strict drugs directory. The catalog of drugs into notice, western medicine, proprietary Chinese medicine, Chinese medicine yinpian four parts. Notice is the format of the catalog of drug dosage forms, name, specification, qualified to pay limits the content such as explanation and illustration, western medicine section includes chemical medicines and biological products, proprietary Chinese medicine section includes proprietary Chinese medicine and ethnic medicine, Chinese medicine yinpian part adopts slices method specifies the fund does not grant to pay. Ginseng protect personnel to use a directory within the directory outside Chinese medicine yinpian, proprietary Chinese medicine and western medicine expenses, according to the basic medical insurance, inductrial injury insurance, birth insurance payment. Countries provide free anti-hiv drugs and public health project involves anti-tb drugs, antimalarial drugs, and drug resistance to schistosomiasis, ginseng protect personnel to use and in public health to pay limits, basic medical insurance, inductrial injury insurance and maternity insurance fund does not grant to pay. 

 

Second, standardize the provincial drug directory. The provinces, autonomous regions and municipalities directly under the department in charge of social insurance for the catalog of drug class a drugs shall not be adjusted, and shall be carried out strictly in accordance with the current laws and regulations and documents b drug adjustment. Need to stick to the catalog of medicine expert evaluation mechanism, adhere to the public, fair and just keep the integrity, risk prevention and control, must not with any items to collect fees, shall not take any form of local protectionism, the competent administrative departments shall not interfere expert evaluation result. 

 

The provinces (autonomous regions and municipalities) should be released on July 31, 2017 local insurance of primary medical treatment, inductrial injury insurance and maternity insurance drug catalogue. Adjust the number of (including call in and out, adjust the limit to pay limits) shall not exceed 15% of the national class b drugs number. The provinces (autonomous regions and municipalities) b drug adjustment. It should be submitted to the ministry by the regulation for the record. 

 

Each region as a whole should be in the province, autonomous regions and municipalities directly under the basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue to perform within a month after the release of the new drug directory, and in accordance with the relevant regulations, update into the list of hospital preparations funds to pay limits. 

 

Three, improve drug directory using the management. Each as a whole the area according to the medical institutions within their respective jurisdictions, and retail pharmacy drug usage, completes the corresponding directory drugs work, drug database update perfect information system. The provinces (autonomous regions and municipalities) to combine different direct settlement work, speed up the application of "social insurance drug classification and code" industry standards, establish and improve the province (area, city) unified drug database, realize provincial scale, proprietary Chinese medicine, western medicine hospital preparations, Chinese medicine yinpian, unified management. 

 

Want to combine the catalog of medicines around the management rules and measures for the management of family planning and other departments of public health prescription, clinical practice, clinical guidelines and clinical drug application guidelines, etc., will be implemented the medical establishment that decide a dot use the catalog of drugs into the designated service agreement scope management and examination. Establish and improve the medical service intelligent monitoring system of insurance of primary medical treatment and social insurance drug use analysis and monitoring system, the key monitoring dosage, expense and there may be more not rational use of medicines, monitoring results to the public in the proper manner. Give play to the role of pharmacists, motivate medical institutions to take effective measures to promote clinical rational drug use. 

 

The provinces (autonomous regions and municipalities) to accelerate the according to the requirements of drug price reform in accordance with the general standards for health care medicine pay work. The region as a whole can further improve the medical insurance drugs classification management method to pay. Plays a role of adjuvant therapy for class b drugs in main medicines, can be appropriately increase individual pay scale, proportion with other class b drugs pay gap. Necessary to emergency and special disease clinical treatment outside the directory of drugs, can establish a reporting system for the medical establishment that decide a dot, clear the corresponding measures for the management of audit, and be submitted to the human resources of the social security department for the record. 

 

Fourth, explore medicare drug negotiating access mechanism. I will be determined via expert evaluation of negotiations negotiations drugs according to the rules, eligible drug into the medical insurance to pay limits, the list shall be issued separately. 

 

Around in the catalog of medicines to adjust work and organize the implementation process, in case of major issues, should be reported in a timely manner. After printing, this document on the issued by the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue notice (people club department is sent [2009] no. 159) documents shall be repealed simultaneously. 

 

Attachment: the national basic medical insurance, inductrial injury insurance and maternity insurance drug catalogue (2017 edition) 

 

1. The notice 

 

2. The western part of 

 

Part 3. Proprietary Chinese medicine 

 

4. Chinese medicine yinpian part 

 

Human resources social security 

 

On February 21, 2017