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On December 30, the State Medical Security Bureau and the State Administration of traditional Chinese Medicine issued the guiding opinions on medical insurance supporting the inheritance, innovation and development of traditional Chinese medicine (hereinafter referred to as the opinions).
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The core contents of the opinions include: ① medical insurance supporting the inheritance, innovation and development of traditional Chinese medicine is to implement the important exposition of the general secretary of Xi Jinping on the work of traditional Chinese medicine, and the specific measures to inherit, develop and make good use of traditional Chinese medicine. ② Timely bring qualified traditional Chinese medicine (including integrated traditional Chinese and Western medicine and minority medicine, the same below) medical institutions and traditional Chinese medicine retail pharmacies into the management of fixed-point medical insurance agreement. Timely bring qualified designated TCM medical institutions into the designated scope of direct settlement for medical treatment in other places. ③ For the traditional Chinese medicine technology derived from ancient classics, which is still widely used and has definite curative effect, as well as the new traditional Chinese medicine technology with outstanding innovative and economic advantages, simplify the review procedure of new price items and open up a green channel. The TCM medical service items with obvious deviation between cost and price shall be included in the price adjustment scope to reflect the value of labor services. Chinese herbal pieces shall be sold in strict accordance with the purchase price plus no more than 25%; The prepared pieces of traditional Chinese medicine and prepared preparations of traditional Chinese medicine processed and used by medical institutions shall be subject to independent pricing. It is encouraged to include the traditional Chinese medicine formula particles purchased by public medical institutions into the online transaction of the provincial centralized pharmaceutical procurement platform, so as to promote the openness and transparency of the transaction. ④ Traditional Chinese medicine decoction pieces, Chinese patent medicines and traditional Chinese medicine preparations of medical institutions meet the conditions and are included in the medical insurance. All localities include the above products in the payment scope of local medical insurance according to the fund affordability and clinical needs. The unconventional dosage of traditional Chinese medicine decoction pieces meeting the regulations shall be included in the payment scope of medical insurance. All localities are encouraged to include appropriate technologies of traditional Chinese medicine with accurate curative effect and reflecting the characteristics and advantages of traditional Chinese medicine into the scope of medical insurance payment. The expenses of traditional Chinese medicine in line with the norms of epidemic diagnosis and treatment shall be included in medical insurance according to regulations. ⑤ Traditional Chinese medicine medical institutions may temporarily not pay by disease diagnosis related grouping (DRG). For areas that have implemented DRG and pay by disease score, appropriately improve the coefficients and scores of traditional Chinese medicine medical institutions and traditional Chinese medicine diseases, so as to fully reflect the characteristics and advantages of traditional Chinese medicine services.
Maintain recommended ratings. After the release of the opinions, we can see that the national policies support the development of traditional Chinese medicine from top to bottom, and various specific measures are constantly being implemented. ① The terminal coverage of medical insurance is fully expanded. It is expected that the coverage of traditional Chinese medicine products by medical insurance will increase, and the prices of some traditional Chinese medicine medical services are expected to increase. Traditional Chinese medicine decoction pieces, Chinese patent medicine and traditional Chinese medicine preparations in medical institutions will enjoy marginal increment, and the positive impact of decoction pieces and traditional Chinese medicine preparations in hospitals will be greater. ② Traditional Chinese medicine decoction pieces still maintain an additive proportion of no more than 25%. Chinese traditional Chinese medicine formula particles are included in decoction pieces management. In the future, traditional Chinese medicine formula particles are expected to continue to maintain a rapid growth trend in hospital channels. ③ Traditional Chinese medicine medical institutions do not implement DRG payment temporarily, and the disease type coefficient and score of traditional Chinese medicine have been appropriately increased in the implemented regions, indicating the government's attitude towards traditional Chinese medicine and the overall support of medical insurance for traditional Chinese medicine. It is recommended to continue to pay attention to Zhangzhou Pientzehuang Pharmaceutical Co.Ltd(600436) (600436), China Resources Sanjiu Medical & Pharmaceutical Co.Ltd(000999) (000999), Shijiazhuang Yiling Pharmaceutical Co.Ltd(002603) (002603), Yunnan Baiyao Group Co.Ltd(000538) (000538), Beijing Tongrentang Co.Ltd(600085) (600085), Guangzhou Baiyunshan Pharmaceutical Holdings Company Limited(600332) (600332), Tasly Pharmaceutical Group Co.Ltd(600535) (600535) with brand value and exclusive product advantages.
Risk statement The implementation progress of traditional Chinese medicine support policies was lower than expected, and the covid-19 epidemic affected the terminal sales of OTC varieties of traditional Chinese medicine.
