Recently, the National Healthcare Security Administration ("NHSA") has issued the Interim Measures for the Administration of Use of Drugs Covered by the Basic Medical Insurance (the "Measures"), with effect from September 1, 2020.
The Measures consist of six chapters, covering the formulation and adjustment of the Catalog of Drugs Covered by the Basic Medical Insurance (the "Drug Catalog"), the use of the Drug Catalog, and the payment for drugs covered by the medical insurance. In particular, the Measures clarify that eight types of drugs, including "drugs which are mainly nourishing in function" and "health care drugs", are excluded from the Drug Catalog. Meanwhile, a mechanism for connecting the access for drugs to be included in the Drug Catalog and the payment standards for drugs covered by the medical insurance shall be established. In principle, the payment standards for drugs newly included in the Drug Catalog shall be determined simultaneously, except for prepared slices of traditional Chinese medicines. The payment standards for exclusive drugs shall be determined through the negotiation on drug access. In principle, the valid period for an agreement on the negotiated drug lasts for two years. During the agreement period, the negotiated drugs are directly purchased online according to the payment standards in principle. The Measures also require that the preparation rate of drugs covered by the medical insurance and the utilization rate of drugs uncovered by the medical insurance shall be linked to the fund payment of designated medical institutions. A supervisory mechanism for enterprises manufacturing drugs listed in the Drug Catalog shall be established.