Effective September, eight categories of drugs will no longer be included in the National Basic Medical Insurance Drug List.
Release Date:
2020-08-06
Recently, the National Healthcare Security Administration issued the Interim Measures for the Management of Drugs under Basic Medical Insurance, which explicitly upholds the principle of giving equal emphasis to traditional Chinese medicine and Western medicine and fully leveraging the respective strengths of each, effective September 1.
The Measures specify that the following eight categories of drugs will no longer be included in the National Basic Medical Insurance Drug List: drugs primarily used for tonification; drugs containing medicinal materials derived from nationally protected, endangered wild flora and fauna; health supplements; preventive vaccines and contraceptives; drugs primarily intended to enhance sexual function, treat hair loss, promote weight loss, improve cosmetic appearance, aid smoking cessation, or assist in alcohol abstinence; drugs that, due to their inclusion in clinical diagnosis and treatment items or other reasons, cannot be billed separately; alcoholic preparations, tea-based preparations, various fruit-flavored preparations (except for pediatric medications under special circumstances), orally dissolvable formulations, and effervescent oral formulations (except in cases specifically provided for); as well as any other drugs that do not comply with the regulations governing the use of drugs under basic medical insurance.
According to the Measures, with the exception of traditional Chinese medicine decoction pieces, payment standards for drugs newly included in the National Reimbursement Drug List shall, in principle, be determined concurrently. Adjustments to the reimbursement standards for traditional Chinese medicine decoction pieces shall be made through an expert review process, while the adjustment procedures for other drugs primarily include enterprise applications, expert review, negotiation or access-based bidding, and publication of the results.
The Supplementary Provisions of the Measures explicitly state that the section on traditional Chinese medicinal decoction pieces in the Drug Catalog lists those decoction pieces for which payments will be made from the basic medical insurance fund, and also specifies which decoction pieces are not eligible for such payments.
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