Today, the National Medical Insurance Administration and the National Health and Health Commission issued the "Notice on Improving the Supporting Measures for the Centralized Procurement and Use of Nationally Organized Drugs (Insulin Special)"

　　Implement the decision-making and deployment of the CPC Central Committee and the State Council on normalized and institutionalized centralized drug procurement with volume, and steadily implement the results of the state-organized centralized drug procurement (insulin special) (hereinafter referred to as "insulin centralized procurement"), and closely integrate insulin production and procurement. , distribution, use characteristics, implement various supporting measures, promote the timely and stable supply of selected products, safe and smooth use, and ensure that the reform dividends benefit the majority of patients.

The relevant work is hereby notified as follows:

Standardize the online work of insulin platforms

　　The selected products of insulin centralized procurement rely on the national unified medical insurance information platform drug and medical consumables procurement management subsystem, and are listed on the provincial centralized pharmaceutical procurement platforms at the selected price.

The price of pre-filled, special-filled and smooth-filled insulin products can be increased by 3 yuan each on the basis of the selected price of the same type of refill insulin products of the same company.

Non-selected products should follow the principle of matching efficacy and price, fully consider the reasonable price comparison relationship with selected products, and guide and encourage relevant enterprises to adjust the price to a reasonable level.

Do a good job in the connection of medical insurance payment policies

　　The selected products of insulin centralized procurement shall be paid based on the selected online price, and the medical insurance fund shall pay according to the prescribed proportion.

If the non-selected insulin products are covered by the medical insurance fund, the payment standard shall not exceed the highest selected price of the selected products in the same category or the negotiated price of medical insurance. If the patient uses the non-selected product, the part of the price exceeding the medical insurance payment standard shall be paid by the patient.

All localities should coordinate and balance the setting of online price, patient self-payment ratio and medical insurance payment standard, and strive to reduce the burden of patients' expenses.

Promote rational drug use in medical institutions

　　Health departments at all levels should strengthen supervision and guidance to promote rational drug use in medical institutions.

Medical institutions should ensure that the selected products enter the hospital and purchase according to the agreed purchase amount according to the varieties and needs that have been filled in by themselves.

It is necessary to strengthen the management of rational use of selected insulins, strengthen the training of medical staff, standardize clinical drug use behavior, and improve the level of drug use.

Physicians shall issue prescriptions reasonably in accordance with the diagnosis and treatment specifications, drug inserts, and medication guidelines, etc., and medical institutions shall give priority to the use of selected insulin products under the premise of ensuring the quality and safety of medical care.

Comprehensive medical institutions with strong diagnosis and treatment capabilities in the region and medical institutions with national, provincial and municipal key specialties in the field of diabetes treatment should work with relevant academic groups to strengthen the guidance, education, training and quality control of insulin in the region.

It is necessary to combine the work of graded diagnosis and treatment and the construction of medical alliances. For prescriptions issued in higher-level medical institutions and drug use in grass-roots medical institutions, the higher-level medical institutions should strengthen guidance and medication connection.

Insulin use education materials are distributed to patients in various forms, so that patients can receive scientific medication guidance and promote medication safety.

Implement incentive and restraint policies for medical institutions

　　All provincial medical insurance departments should strictly implement the relevant provisions on prepayment of medical insurance funds for centralized procurement of medicines by the state and the retention of balances, strengthen the management of the total fund budget, and guide the coordinating regions to implement the incentive and restraint mechanism for medical institutions to use insulin products within the scope of centralized procurement.

After the medical institution signs the purchase agreement with the selected enterprise, the medical insurance fund shall be prepaid to the medical institution at a rate of not less than 30% of the annual agreement purchase amount, and the medical institution shall settle the payment with the enterprise in time before the end of the next month after the delivery is accepted.

In areas where DRG/DIP payment method reforms are carried out, the medical insurance payment standards for corresponding diseases (disease groups) will not be adjusted in the first year, and subsequent adjustments should take into account cost changes and make scientific and reasonable adjustments.

All localities should guide medical institutions to strengthen the management and use of surplus retained funds, transmit incentive policies to medical staff, and encourage rational and preferential use of selected products.

Strengthen the monitoring of compliance

　　Provincial medical insurance departments should supervise and implement the main responsibilities of the selected enterprises and distribution enterprises, strengthen the connection between the supply and demand sides, and ensure that the selected products and injection equipment are supplied to medical institutions in accordance with the agreement to ensure clinical use.

Consolidate the responsibility of the selected enterprises to ensure supply, record the selected enterprises that fail to perform well in the contract, and substantively incorporate them into the evaluation of the enterprise's supply capacity and contract performance, according to the discretionary benchmarks for drug price and recruitment credit evaluation, and deal with them according to the severity of the situation.

Closely monitor the procurement and distribution of selected products, guide medical institutions to implement procurement in a planned manner according to the agreement, avoid large fluctuations in actual consumption and reported agreement volume, and prevent the phenomenon of replacing selected products with high-priced non-selected products.

The medical insurance department, together with the health department, establishes a feedback and evaluation mechanism for the efficacy of the selected products, and responds to relevant issues in a timely manner.

Medical institutions should actively cooperate with procurement, distribution monitoring and efficacy evaluation, and promptly report any problems that arise in the procurement, distribution, and use of selected products.

　　All localities should have a deep understanding of the importance of the state's organization of centralized procurement and use of insulin, enhance the sense of responsibility and mission, effectively strengthen organizational leadership, implement relevant supporting measures, and steadily promote the implementation of centralized procurement results.

In case of major problems in the implementation, it shall be reported to the National Medical Insurance Bureau and the National Health Commission in a timely manner.

Background news:

　　On November 26, 2021, the National Medical Insurance Bureau completed the sixth batch of nationally organized drug centralized procurement in Shanghai. This time is a special procurement for insulin.

42 insulin products were selected through bidding.

According to the demand proposed by 32,000 medical institutions, the demand for insulin centralized procurement is about 200 million, involving an amount of about 17 billion yuan, which is related to the well-being of 10 million insulin patients nationwide.

According to the regulations, in May 2022, provinces will begin to implement the national centralized procurement results one after another.

　　(Headquarters CCTV reporter Zhang Pingyizhe)