With the fresh release of the national medical insurance drug catalogue (that is, the national medical insurance directory) in 2021, many people have consulted the editor, what is the difference between the national medical insurance directory and the national essential drug list (that is, the basic drug list)? So, now let's continue to read it with Xiaobian~
name
The full name of the National Medical Insurance Catalogue is the National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalogue, which has been released in 2021.
The full name of the National Essential Medicines List is the National Essential Medicines List, and the 2018 edition has been released.
definition
According to the definition of the Measures for the Administration of the National Essential Drugs List, essential drugs are drugs that meet the basic medical and health needs, have appropriate dosage forms, are reasonably priced, can guarantee supply, and are fairly accessible to the public. All primary medical and health institutions run by the government are equipped with and use essential drugs, and other types of medical institutions must also use basic drugs in accordance with regulations.
The drugs in the medical insurance list are the basis for medical insurance reimbursement, and the national essential drugs list is the basis for medical institutions to use drugs, including the use part of primary medical and health institutions and the use part of other medical institutions. The drugs in the basic drug list have the characteristics of adapting to basic medical and health needs, being reasonably priced, and being fairly accessible to the public. There are no significant differences in the requirements of the two catalogues in terms of the safety, efficacy and economics of medicines, but the essential medicines list has stronger attributes in terms of priority and supply guarantee.
Relationship between the two
According to the "Opinions on Improving the National Essential Drugs System" issued by the General Office of the State Council, the medical insurance department will give priority to the therapeutic drugs in the eligible essential drug list into the scope of the medical insurance list or adjust the classification of A and B according to the procedures. It can be seen that for the medical insurance directory, the basic drug directory has a certain guiding effect.
That is, as long as it enters the basic drug directory, there is a great chance to enter the medical insurance directory. However, some drugs are not heavy on both, but most of them are repeated.
For the essential drugs in the basic drug list, the government will take a variety of ways to ensure effective supply, ensure continuous supply, ensure production and supply through fixed points, reserves, etc., and provide high-level protection through special financial funds or medical insurance funds to improve the affordability of patients for essential drugs.
The difference between the two
1. The role is different
The basic drug catalogue is mainly used to guide clinicians to reasonably choose the variety of drugs to ensure the market supply of essential drugs by guiding the production direction of drug manufacturers; the medical insurance catalogue is mainly to control the scope of basic medical insurance to pay for drugs, and is the basis for medical insurance to pay the drug costs of insured persons. Its purpose is to ensure the basic medical needs of the insured and to ensure the balance of payments of the medical insurance fund.
2. The basis for formulation is different
The basic drug catalogue mainly considers the rationality and safety of the clinical use of drugs, as well as the basic drug level of the whole society; while considering the safety and efficacy of the insured's medication, the medical insurance catalogue should focus on the affordability of the medical insurance fund and consider the price factor of the drug.
3. The scope of application is different
The basic drug list is suitable for all groups of people in the whole society; the medical insurance directory is only applicable to the insured persons of basic medical insurance.
4. Enforcement effect is different
The basic drug catalogue plays a guiding role in the use of drugs for clinicians, mainly through social publicity and doctor training, guiding the conscious use of the catalogue; the medical insurance catalogue is implemented when medical insurance pays medical expenses.
Comparison table of the National Medical Insurance Drug List and the National Essential Medicines List
Source: Chinese Journal of Food and Drug Regulation
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