New version of national drug directory to be announced in August

The "First Financial Daily" learned from the authoritative sources yesterday that the new version of the National Essential Drug List (hereinafter referred to as the "Basic Drug List") that has attracted much attention for three years will be announced in August this year. Different from the simple classification of chemical drugs and traditional Chinese medicines in the first edition of 2009, the principle of selection of new catalogs will undergo a major shift in direction. It will be determined that the list of selected drugs will increase from the original 307 to 500.

The “big catalog” motives “are all calling for the expansion of the list of basic medicines, and they are eager to do the work of the health bureau and do all aspects of work. There is a very strong incentive for related companies, especially the local government to expand the catalog.” April 10 On the day, Lei Haichao, deputy director of Beijing Municipal Health Bureau, publicly stated at the Ministry of Health Basic Medicine Symposium.

On the same day, it was not an ordinary day for the three-year basic catalog that had already been in dispute. On April 10, 2009 three years ago, the State Council initiated a new round of deepening medical system reform meeting to be held at the Beijing West Hotel. "Establishment of a national essential medicine system" was ranked second in the five major reforms in medical reform.

According to the medical reform plan, the list of national essential medicines released in 2009 includes the use of basic medical and health facilities and the use of other medical institutions. The "National Essential Drug List (Part of Basic Medical and Health Institutions Equipped with Use)" (2009 version) was published in advance, including a total of 307 drug types of chemical drugs and Chinese patent medicines, which will take effect on September 21, 2009.

However, due to the lag in hospital reform, the "National Essential Drug List (Big Hospital Edition)" that originally carried "coordination with pilots for reform of public hospitals" has not yet been introduced three years later, and the reference to "major hospital version" has gradually been introduced. The official weakened, renamed "other parts."

The only base medicine list (grassroots version) introduced has become increasingly complex due to interest disputes such as procurement, procurement and distribution.

Due to the differences in the levels of medicines used and the ability to pay, the medical reform document stipulates that all types of varieties in the national catalogue are allowed to be supplemented in appropriate amounts to meet actual demand for medicines.

Since then, the motives for updating the catalog variety have been completely released. In 2010, the list of supplemental base medicines in various regions was announced in succession. 206 supplements were added in Shandong, including 193 new varieties and 13 new formulations; 260 in Guangdong and 191 in Shaanxi; and 212 in Beijing and 381 in Shanghai. In the end, the final list of actual species rushed to 600.

Taking Shanghai as an example, of the 381 supplements, 236 were added to chemical medicines and 145 were added to traditional Chinese medicines. Among the 236 chemical drugs, more than 20 foreign-funded enterprises such as Pfizer, Bristol-Myers Squibb, Novartis and Sanofi and their joint ventures in China have made short-listed products, and the products of foreign-funded enterprises and joint ventures account for approximately one hundred percent of supplemental chemicals. 27% of the drug catalog has directly increased the government's payment ratio.

"The catalogues in various places are too confusing. Now it is not a matter of saying that there is not enough variety in the catalogue, but there is no standard problem in judging whether it is enough," said Yu Mingde, president of the Chinese Medicine (600056) Enterprise Management Association.

“We have calculated that the per capita GDP of Beijing is 12,000 U.S. dollars, and the national average is 4,000 U.S. dollars, and Beijing is 3 times the national average. Now that 519 basic drugs in Beijing are fully adequate, what I do not understand is that so many other regions have added so much. What is the use of the variety?” Lei Haichao said.

However, opinions are not uniform. Prof. Shi Wenwen, director of the Center for International Management of Pharmaceutical Management at Peking University, said that the current structure of the catalog is not reasonable. The use of drugs such as gynecology and pediatrics is obviously insufficient. Major diseases and frequently-occurring treatment drugs are obviously lacking. Need to add and adjust.

Shortly afterwards, Minister of Health Chen Hao had stated publicly that, in line with the continuous advancement of reforms in public hospitals, the list of essential medicines that had previously only adapted to the needs of the grassroots will be revised. “This year, the protection policy for serious illnesses will gradually be introduced, and HIV infection and drug resistance will be introduced. The protection of eight types of major diseases such as tuberculosis must be promoted throughout the country, and 12 diseases, including hemophilia and lung cancer, should be included in the trials for the protection of major diseases in rural residents. These will increase the demand for essential medicines."

"Now, many of the things we have talked about in the so-called basic drug list may not have much to do with this system. It bears too much pressure for comprehensive reform," Lei Haichao said.

The struggle for Medicare payouts focused on the entanglement of essential medicines is that this is not a matter that the Ministry of Health can decide.

“A job that the Ministry of Health is still doing is calculating whether the medical insurance can afford the cost of the base drug catalog.” The aforementioned informed sources disclosed to this newspaper.

Since the therapeutic drugs in the National Basic List are all covered by Medicare, they will be fully reimbursed. The reporter also learned that the Ministry of Health intends to include some high-priced drugs such as oncology drugs, diabetes drugs and cardiovascular drugs in the catalogue. Therefore, this time, The expansion of the base medicine list will also test the actual payment ability of medical insurance.

In fact, in 2011, Beijing's medical insurance funds were exposed as “deficit.” Although the Beijing Municipal Bureau of Human Resources and Social Security announced the medical insurance work situation, it also predicted that by the end of December of that year, the medical insurance fund could realize the current year’s income and expenditure. Balance, only a slight balance.

In accordance with the existing medical insurance payment system, medical security systems covering all urban and rural residents have been initially established around the country with basic medical insurance for urban employees, basic medical insurance for urban residents, and the new rural cooperative medical system.

With the increase in the insurance rate, increase the proportion of reimbursement, increase the ceiling line, expand the scope of reimbursement and a series of urban welfare policies and measures, the proportion of medical insurance payment gradually increased, the medical insurance fund spending rapidly increased.

However, the views on this issue are not consistent. Yang Hongwei, deputy director of the Health Development Research Center of the Ministry of Health, stated that after calculation, the medical insurance can definitely pay for the supply of the base drug catalog. But Yu Mingde, who has been advocating that basic drugs should all be provided free of charge by the state, insists: “A lot of problems, tendering, and distribution, and if the country replies alone, will become very simple.”