2022 National Medical Insurance Catalog Adjustment Plan Solicits Opinions

More rare disease drugs are expected to enter medical insurance

  News from this newspaper (Reporter Wang Weiyan) The National Medical Insurance Bureau recently issued the "2022 National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog Adjustment Work Plan (Draft for Comment)" (hereinafter referred to as the "Work Plan").

According to the "Work Plan", before June 30, 2022, drugs for the treatment of rare diseases approved by the State Drug Administration can be included in the adjustment scope of the National Medical Insurance Catalogue in 2022, which also means that more drugs for rare diseases are expected to be included in the medical insurance.

  The "Work Plan" clarifies that six categories of drugs outside the list can be included in the adjustment scope of the National Medical Insurance Drug List in 2022, including new generic drugs approved by the State Drug Administration from January 1, 2017 to June 30, 2022. ; During the period from January 1, 2017 to June 30, 2022, with the approval of the State Food and Drug Administration, the indications or functions have undergone major changes; drugs included in the latest version of the "New Coronary Virus Pneumonia Diagnosis and Treatment Program"; included in " Drugs listed in the National Essential Drugs List (2018 Edition); drugs that are included in the List of Encouraged Generic Drugs or the List of Children's Drugs Encouraged for R&D and Application, and have been approved by the State Drug Administration for marketing before June 30, 2022.

  Among them, the list adjustment involving rare disease treatment drugs has attracted much attention.

  In the adjustment of the National Medical Insurance Catalogue in 2021, the "high-priced drug" Nosinason Sodium Injection, which is used to treat spinal muscular atrophy, a rare disease, costs 700,000 yuan per injection. After medical insurance negotiation, the price per injection is less than 33,000 yuan. The "floor price" has entered the new version of the medical insurance catalog.

Such "soul bargaining" not only brings hope to patients with rare diseases, but also brings more attention to this group.

  Up to now, more than 60 drugs for rare diseases have been approved for marketing in China, of which more than 40 have entered the national medical insurance list, involving 25 diseases.

  It is reported that since the establishment of the National Medical Insurance Administration, it has carried out the access negotiation of the medical insurance drug catalog for four consecutive times, and a total of 250 drugs have been added to the catalog through medical insurance negotiation, and the average price has dropped by more than 50%.

Through negotiated price reduction and medical insurance reimbursement, the cumulative burden on patients will be reduced by 149.49 billion yuan in 2021.

  According to the "Work Plan", the adjustment of the National Medical Insurance Drug List in 2022 is divided into five stages: preparation, declaration, expert review, negotiation, and announcement of the results. The adjustment results of the National Medical Insurance Drug List will be announced in November 2022.

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