List of drugs within the scope of medical insurance reimbursement

The drug list for medical insurance reimbursement is issued by the National Medical Insurance Bureau, including the basic drug list and the drug list. The essential drug list is the most basic, economical and effective therapeutic drug list formulated by the government. The drug list is the drug list within the scope of medical insurance payment, including the medical insurance payment standard. When purchasing drugs, patients should pay attention to whether they belong to the medical insurance reimbursement drug list, so as not to cause unnecessary economic losses.

The medical insurance reimbursement drug list is issued by the National Medical Insurance Bureau, which is mainly divided into two parts: the basic drug list and the drug list. The list of essential drugs is the most basic, economical and effective list of essential drugs for treatment formulated by the government, aiming at ensuring the people's demand for basic medical drugs. The drug list is the drug list within the scope of medical insurance payment, and the drugs listed in it are reimbursed according to the medical insurance payment standard. The publication and adjustment of medical insurance reimbursement drug list belongs to the category of national medical insurance policy, which has an important relationship with drug manufacturers, medical institutions and individual patients. When purchasing drugs, patients should pay attention to whether they belong to the medical insurance reimbursement drug list, so as not to cause unnecessary economic losses. Medical institutions and pharmaceutical production enterprises also need to make timely adjustments and responses to the adjustment of drug lists. In addition, there are some drugs in the medical insurance reimbursement drug list that need special explanation. For example, some high-value drugs, rare disease drugs and family planning drugs are used together, and patients applying for reimbursement need to provide corresponding proof materials, which can only be reimbursed after being approved by the hospital.

How is the medical insurance reimbursement standard determined? The payment standard of medical insurance is based on the actual price of drugs, referring to the comprehensive factors such as drug purchase price, special drug management regulations, and unified maintenance of drug lists by public medical institutions at all levels throughout the country. At the same time, in order to ensure the sustainability of the medical insurance fund, the medical insurance payment standard will be adjusted regularly to adapt to the fluctuation of drug prices in different time periods.

The publication and adjustment of the medical insurance reimbursement drug list has an important impact on patients, medical institutions and drug manufacturers. For patients, it is necessary to know and master the drugs in the medical insurance reimbursement drug list to avoid unnecessary economic losses. At the same time, medical institutions and pharmaceutical manufacturers also need to adjust the drug list in time.

Legal basis:

Article 7 of the Measures for the Administration of Drug List of Medical Insurance in Hong Kong The list of essential drugs formulated by the state is the core part of the list of medical insurance drugs, and the rest drugs are included in a certain way, eventually forming a comprehensive drug list. The State Council health authorities are responsible for publishing and adjusting the comprehensive drug list, and formulating drug payment standards in accordance with relevant regulations. According to this article, the formation of drug list and the formulation of medical insurance payment standard belong to the category of national medical insurance policy.