What is the reimbursement ratio for "Guotan Medicine"? Where can I buy "Guotan Medicine"? One article understanding
What is "Guotan Medicine"? Where can I find the organization responsible for equipping "Guotan Medicine"? The National Medical Insurance Administration has recently provided answers to hot topics related to "national drug negotiations".
"National negotiated drugs" usually refer to drugs negotiated by the national medical insurance during the agreement period. By gathering the medication needs of 1.35 billion insured individuals and ensuring that they do not exceed the affordability of the medical insurance fund and the vast number of insured individuals, the medical insurance department and drug manufacturing enterprises negotiate prices, determine payment standards, and include drugs in the medical insurance catalog for reimbursement that are within the agreement period. These drugs are often referred to as "national negotiated drugs". "Guotan drugs" usually have characteristics such as newly approved for marketing in recent years, exclusive production, and lack of competition in the market.
It is reported that currently, "Guotan drugs" are all Class B medical insurance drugs. When basic medical insurance participants use such drugs, they need to personally pay a certain proportion first, and then reimburse according to the prescribed proportion. During the period of the current national medical insurance drug catalog agreement, there are 346 "national drugs", covering many therapeutic fields such as cancer, rare diseases, hypertension, diabetes drugs, such as carrelizumab for tumor treatment, and nosinasine sodium for rare diseases.
In order to further facilitate the insured patients to use the "state talk drugs", the WeChat official account of the National Health Insurance Bureau has opened the query function of the "state talk drugs" allocation institution. The specific query steps are as follows: enter the WeChat official account of the "State Health Insurance Bureau", click the "WeChat service", enter the "state talk drugs" allocation institution query, and enter the query page; Enter the name of "Guotan Medicine" and click search to see information such as medical insurance payment standards and agreement validity period; Click on "Designated Medical Institutions" or "Designated Retail Pharmacy" to check the availability of the drug in various regions.
The National Medical Insurance Administration.
Screenshot of the relevant page of the National Health Insurance Bureau's WeChat official account search for "state talk medicine".
In addition, the public can also click on "Check Institutions" at the bottom of the page to enter the "Designated Medical Institutions" or "Designated Retail Pharmacy" page. After determining the specific medical institution or retail pharmacy, click on "Drug Inquiry" to learn about all the "National negotiated drugs" equipped by the institution.
According to feedback from various parties, the National Medical Insurance Administration has previously reviewed and revised the list of declared drugs that passed the preliminary review of the 2023 National Medical Insurance Drug Catalogue adjustment in accordance with procedures, and issued a notice on the publication of the list of drugs that passed the formal review of the 2023 National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance Drug Catalogue adjustment. The announcement shows that 386 drugs have passed the formal review, including 222 drugs outside the catalog and 164 drugs within the catalog.
The relevant person in charge of the National Medical Insurance Administration introduced that through formal examination, it only represents that the drug meets the corresponding application conditions and has obtained the qualification to participate in the next evaluation. Whether these drugs can ultimately be included in the national medical insurance drug catalog still requires strict evaluation procedures. Subsequently, exclusive drugs need to be negotiated and non exclusive drugs need to be tendered. Only after successful negotiation or bidding can they be included in the catalog. Next, in accordance with relevant requirements, the National Medical Insurance Administration will organize expert evaluations and other work according to procedures.
