National Health Insurance Board: 2023 to continue to squeeze the water of inflated prices of drugs and supplies

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January 12, 2023, the national medical security work conference was held in Beijing. The meeting was guided by Xi Jinping’s thought of socialism with Chinese characteristics in the new era, in-depth study and implementation of the spirit of the 20th Party Congress, the full implementation of the Central Economic Work Conference deployment, summarizing the work of medical security in 2022 and the past five years, and research and deployment of medical security work in 2023. Secretary of the National Medical Security Bureau party group, Hu Jinglin, director of the work report, the Bureau of party group members, deputy director Shi Zihai presided over the meeting, other members of the Bureau of the party group attended the meeting.

The meeting pointed out that in 2022, the national medical security system resolutely implement the important instructions and instructions of General Secretary Xi Jinping and the Party Central Committee and the State Council’s decision and deployment, always adhere to the people as the center, and promote the work of medical insurance to make positive progress. Continuously reduce the cost of epidemic prevention and control, reduce the price of new coronavirus vaccine in 4 batches, reduce the price of nucleic acid testing in 2 rounds nationwide, and reduce the government guideline price of antigen testing in 2 rounds. Deeply integrated into rural revitalization, the participation rate of rural low-income population was stabilized at over 99%, and the accumulated burden reduction exceeded 100 billion yuan. Promoted the reform of the outpatient medical insurance co-payment guarantee mechanism for employees, covering over 70% of the employees insured. Continuing to promote the collection of drugs and consumables, the average price reduction of the seventh batch of drugs and consumables was 48%, the average price reduction of spinal consumables was 84%, and the selected results of insulin collection were landed, benefiting more than 10 million patients. Solid promotion of fund supervision, the annual inspection of medical institutions 767,000, investigated and dealt with 398,000, recovered 18.84 billion yuan of medical insurance funds, transferred to the public security judicial, discipline inspection and supervision organs 6478 (people). Realize the cross-province direct settlement of general outpatient expenses in the county, and realize the full coverage of cross-province direct settlement of outpatient slow and special diseases in the co-ordinated areas. The number of activation of medical insurance electronic vouchers exceeded 900 million.

In 2018, the Party Central Committee, with Comrade Xi Jinping as the core, made the strategic decision to form the National Health Insurance Bureau. In the past five years, the national medical insurance system has always anchored on the major political task of “relieving all people of their medical worries” given by General Secretary Xi Jinping, running to start, reforming with all its might and fighting hard. The first is to explore the long-term mechanism to prevent and resolve the risk of poverty caused by illness, comprehensive support policies for the needy people to reduce the burden of nearly 600 billion yuan. The second is to reform the outpatient protection policy, promote the establishment of employee medical insurance outpatient coordination, and establish a sound mechanism for outpatient medication protection for hypertension and diabetes. Third, squeeze the water of inflated prices of drugs and consumables, the national organization collects 7 batches of 294 drugs at an average price reduction of more than 50%, and 3 batches of 4 types of consumables at an average price reduction of more than 80%; superimposed on the local union collects, the cumulative reduction of drug consumption costs of more than 400 billion yuan. Fourth, through negotiations to reduce the price of new drugs, 250 new drugs reduced by an average of more than 50% and into the medical insurance reimbursement, the masses faster to use the original can not afford to use life-saving drugs. Fifth, to combat fraudulent insurance, a total of 3,189,000 inspections of medical institutions, 1,543,000 treatment, recovery of medical insurance funds of 77.13 billion yuan, exposure of 245,000 typical cases, 184 pharmaceutical enterprises to assess the level of breach of trust and the implementation of disciplinary action. Sixth, to support the prevention and control of epidemics, the first time to implement the “two ensure” policy, fully protect the cost of patient treatment; fully protect the cost of vaccines and vaccination; promote the reduction of vaccines, nucleic acid testing, antigen testing and other prices over 90%. Seventh, the direct settlement rate of foreign hospitalization for medical treatment has increased to over 60%, with a total of over 60 million people settled. Eight is to expand the pilot long-term care insurance system, the pilot cities to 49, benefiting more than 1.8 million people with disabilities.

The meeting pointed out that in the past five years, under the strong leadership of the Party Central Committee with Comrade Xi Jinping at its core, and under the scientific guidance of Xi Jinping’s thought of socialism with Chinese characteristics in the new era, China’s medical insurance has achieved leaps and bounds, making the past five years the most beneficial to the public medical insurance. Medical insurance against poverty has helped nearly 10 million families out of poverty due to illness, and more than 100 million people out of poverty have been provided with basic medical care. The number of drugs in the medical insurance catalog has increased by 618 kinds compared with 2017. China’s drug price index decreased for the fifth consecutive year. The proportion of patients using high quality drugs in the collected varieties has increased from 50% to over 90%. While the majority of insured people continue to gain a sense of access, the space for “gold sales” of drugs continues to be compressed, and more and more drug manufacturers are embarking on a new path of innovation and quality-oriented development. Medical insurance fund supervision initially formed a strong deterrent to fraudulent insurance, auxiliary drugs, high-value medical supplies, such as the initial reversal of the abuse of the situation, to help push the health care industry on the road to healthy development.

The meeting stressed that the national health insurance system should study and implement the spirit of the 20th Party Congress, combined with the implementation of General Secretary Xi Jinping’s important remarks on medical security work, comprehensive study, comprehensive grasp, comprehensive implementation. To fully understand the relationship between health care and economic development of high quality, the overall role of health care “to protect people’s livelihood” “to promote the economy”. To fully understand the danger of welfarism in the field of health care, deal with the “current” and “long-term” relationship. To fully understand the strategic significance of promoting national health insurance as a whole, and deal with the relationship between “national unity” and “local innovation”. To take participation as a strategic focus, consolidate and expand the results of participation. The medical insurance fund supervision as the key point of medical insurance reform and development, the real and resolute fight against illegal use of medical insurance funds, to further improve the long-term mechanism. Promote the governance of drug and consumable prices as the biggest consensus point of health insurance reform and development, and insist on the mechanism to squeeze the water of inflated prices of drugs and consumables. Take big data empowerment as an important borrowing point for the reform and development of medical insurance, maximize the role of the national unified medical insurance information platform, and use medical insurance big data in a safer, more active and orderly manner.

The meeting requested that the work of medical insurance in 2023 should be implemented in all aspects of the whole process of socialism with Chinese characteristics in the new era of Xi Jinping, with a vigorous and dynamic state of mind, creatively transforming the decisions and deployments of the Party Central Committee into the effectiveness of medical insurance for the people. The first is to further consolidate and expand the results of medical insurance to fight poverty and do a good job of medical protection for rural people. The second is to do a good job of the implementation of the “Class B B tube” after the new coronavirus infection patients treatment costs medical security work to facilitate the masses to enjoy direct settlement services, speed up the cost of clearing the settlement speed, to reduce the pressure of medical institutions to save money. Third, strengthen the protection of maternity medical expenses. Unify and standardize the policy on payment of maternity allowance, and implement the exploration of the inclusion of flexibly employed persons in maternity insurance coverage. Fourth, continue to increase fund supervision. Carry out the fund supervision security standardization year action and health insurance anti-fraud big data supervision pilot. Increase flight inspection efforts, and strive to achieve full coverage of the jurisdiction at all levels of flight inspection. Rely on intelligent medical insurance to empower off-site supervision. Explore the regulatory mechanism to adapt to new payment methods. Focus on strengthening the supervision of foreign medical funds. Fifth, continue to squeeze the water of inflated prices of drugs and consumables. Carry out new batches of state-organized drugs and high-value medical supplies collection, expand local collection coverage varieties, to achieve the number of national and provincial collection of drugs together to 450. Guide the new crown treatment drugs reasonable price formation. Sixth, the implementation of the settlement of medical treatment in different places. Further expand the coverage of general outpatient and outpatient slow special disease costs across the provincial network of designated medical institutions, and steadily increase the rate of direct settlement of inpatient costs across the province. Seventh is to promote the expansion of long-term care insurance system pilot. Explore the establishment of an effective independent funding mechanism and regulatory mechanism, improve the standard system for assessing the level of disability, and guide the standardized development of the nursing service market. Eight is to fully establish the general outpatient coordination of employee medical insurance, planning the outpatient hypertension, diabetes “two diseases” drug protection mechanism to other types of medical expansion. Nine is a steady system to promote the medical insurance system to guide the graded treatment, medical insurance provincial coordination and other basic, long-term major reforms.

The meeting stressed the need to always highlight the party leadership, political leadership, comprehensive strict governance, strengthen the style of construction, and strive to build a “loyal, clean, and responsible” medical insurance high-quality cadres, with a new climate and new role to promote medical insurance work to achieve new developments and new progress.

The meeting was held in the form of video, representatives of the relevant departments of the central state organs, the discipline inspection and supervision group in the National Health and Health Commission, the main responsible comrades of the National Health Insurance Board units in the main venue to participate in the meeting. Provinces, autonomous regions, municipalities directly under the Central Government and municipalities under the plan, Xinjiang Production and Construction Corps, the main responsible comrades of the medical security department in the local sub-court to participate in the meeting.