The adjustment plan for the national medical insurance drug catalog this year has been announced! Children's medication and rare disease medication applications are not subject to approval time restrictions. Medical insurance | medication | drugs
In order to further improve the level of medication security for insured individuals, standardize the management of medical insurance medication, and establish an efficient medical insurance payment mechanism, today, the National Medical Insurance Bureau announced the "2023 National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance Drug Catalog Adjustment Work Plan". This is the sixth consecutive year since the establishment of the Medical Insurance Bureau that it has carried out the adjustment of the medical insurance drug catalog.
The scope of drug catalog adjustment in 2023 includes new generic name drugs approved for market by the national drug regulatory department from January 1, 2018 to June 30, 2023, drugs with significant changes in indications or functional indications, and drugs that have obtained drug approval documents for this change, as well as drugs included in the National Essential Drug Catalog.
Children's medication applications for rare diseases are not subject to approval time limits
Among them, for drugs included in the "encouraged generic drug catalog", drugs included in the "encouraged research and development application for children's drug list", and rare disease treatment drugs, there are no restrictions on the approval time. In addition, this year's work plan for catalog adjustment no longer takes COVID-19 medicine as a separate drug declaration condition, but applies according to the general type of innovative drugs.
The results of the 2023 directory adjustment will be announced in November this year
According to the "Work Plan", the enterprise will officially start the application process from July. For drugs that have passed formal review, the National Medical Insurance Administration will organize joint evaluations by experts in pharmacy, clinical practice, pharmacoeconomics, medical insurance management, and work-related injury insurance management. After evaluation, four types of results have been formed: proposed direct transfer in, proposed negotiation or bidding transfer in, proposed direct transfer out, and proposed to be processed according to the renewal rules. It is expected that the final catalog adjustment results of the relevant drugs will be announced in November this year after on-site negotiations or bidding.
Catalog adjustments have cumulatively reduced patient burden by over 500 billion yuan
Since its establishment, the National Medical Insurance Administration has accelerated the pace of medical insurance negotiations, promoting a large number of exclusive varieties of anti-cancer drugs and rare disease drugs to be included in medical insurance at appropriate prices. With medical insurance reimbursement, it has cumulatively reduced the burden on patients by over 500 billion yuan, effectively reducing the burden of medical treatment for the people.