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CHEN Ye, DING Jinxi, LIU Ting, TANG Di, WU Fang, WU Liping, DUAN Wanting, XU Yangyan. Status, problems and improvement measures of health insurance reimbursement of national negotiated drugs used in outpatients[J]. Journal of China Pharmaceutical University, 2020, 51(5): 628-634. DOI: 10.11665/j.issn.1000-5048.20200516
Citation: CHEN Ye, DING Jinxi, LIU Ting, TANG Di, WU Fang, WU Liping, DUAN Wanting, XU Yangyan. Status, problems and improvement measures of health insurance reimbursement of national negotiated drugs used in outpatients[J]. Journal of China Pharmaceutical University, 2020, 51(5): 628-634. DOI: 10.11665/j.issn.1000-5048.20200516
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Status, problems and improvement measures of health insurance reimbursement of national negotiated drugs used in outpatients

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  • Received Date: September 15, 2020
  • Revised Date: September 29, 2020
    Graphical Abstract
    • Abstract
  • The access negotiations of National Reimbursement Drug List (NRDL) in China from 2017 to 2019 effectively improved the availability and affordability of high-value innovative drugs. However,the actual outpatient reimbursement of most negotiated drugs is lower,which affects the patients" health insurance funds. In this paper,97 negotiated drugs in 337 overall planning cities were selected as samples to analyze the outpatient reimbursement for negotiated drugs. The results showed that the reimbursement level of 40 negotiated drugs was less than 50% in over 70% cities,which can be mainly interpreted as absence or imperfection of outpatient reimbursement policies for special diseases. Finally,this paper puts forward suggestions and protocols for improving the outpatient medical insurance through realizing outpatient overall planning,improving outpatient reimbursement policies for special diseases,and exploring innovative payment,ensuring the achievement of the access to NRDL.
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    • References (3)
  • [1]
    .［2019-11-29］. http：//finance.sina.com.cn/money/insurance/bxdt/2019-11-29/doc-iihnzhfz 2422958.shtml.
    [2]
    National Health Commission of the People''''s Republic of China. Publication of the first list of rare diseases（关于公布第一批罕见病目录的通知）［EB/OL］.［2018-06-08］.http：//www.nhc.gov.cn/yzygj/s7659/201806/393a9a37f39c4b458d6e830f40a4bb99.shtml.
    [3]
    NHSA. Four national ministries jointly issued the Guiding Opinions on Improving the Medical Insurance Mechanism for Outpatient Use of Hypertension and Diabetes in Urban and Rural Residents（四部门印发《关于完善城乡居民高血压糖尿病门诊用药保障机制的指导意见》）［EB/OL］.［2019-10-10］. http：//www.nhsa.gov.cn/art/2019/10/10/art_37_1842.html.
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