Address: No.308, Fengshixing Road, Beibei District, Chongqing

Tel: 023-60309383; 023-60309 140

People's Republic of China (PRC) National Health Insurance Bureau is an institution directly under the State Council, with a deputy ministerial level, which was established on March 20 18.

Its main functions are to formulate policies, plans and standards for medical insurance, maternity insurance, medical assistance and other medical security systems and organize their implementation, supervise and manage relevant medical security funds, improve the national platform for medical treatment management and expense settlement in different places, organize the formulation and adjustment of prices and charging standards for drugs and medical services, formulate bidding and purchasing policies for drugs and medical consumables and supervise their implementation, and supervise and manage related service behaviors and medical expenses of medical institutions included in medical insurance.

I. Historical evolution

In order to improve the unified basic medical insurance system and serious illness insurance system for urban and rural residents, continuously improve the level of medical insurance, ensure the rational use, safety and controllability of medical insurance funds, promote the reform of "three-medical linkage" of medical care, medical insurance and medicine as a whole, and better protect the sick people, the State Council proposed an institutional reform plan. Integrate the responsibilities of basic medical insurance and maternity insurance for urban workers and urban residents in Ministry of Human Resources and Social Security, the responsibilities of the National Health and Family Planning Commission for the new rural cooperative medical care, the responsibilities of the National Development and Reform Commission for the price management of drugs and medical services, and the responsibilities of the Ministry of Civil Affairs for medical assistance, and set up the National Medical Security Bureau as a directly affiliated institution of the State Council.

2065438+In March, 2008, the first meeting of the 13th National People's Congress passed the Decision on the Institutional Reform Plan of the State Council, and established the National Health Insurance Bureau of People's Republic of China (PRC).

In the past, the health department and the human society department argued endlessly about who was responsible for drug procurement. Now that the country has given the answer, the medical insurance bureau will take over the whole problem.

As early as 2065438+June 28th, 2007, the State Council promulgated "Guiding Opinions on Further Deepening the Reform of Payment Mode of Basic Medical Insurance", which emphasized its importance and urgency and promoted the reform of medical insurance payment mode to a new height.

The Guiding Opinions proposes to improve the medical insurance payment mechanism and interest adjustment mechanism, implement refined management, stimulate the endogenous motivation of medical institutions to standardize behaviors, control costs, rationally treat and refer patients, guide the rational allocation of medical resources and orderly medical treatment for patients, support the establishment of graded diagnosis and treatment mode and the healthy development of primary medical and health institutions, and effectively protect the basic medical rights and interests of the majority of insured personnel and the long-term sustainable development of the medical insurance system. It can be seen that the establishment of the National Health Insurance Bureau will greatly promote the implementation of this document and will have a very important impact on medical institutions and pharmaceutical companies.

The medical insurance bureau has become the most concerned department for pharmaceutical companies and medical device companies.

After the establishment of the Medical Security Bureau, it will become the most concerned government department for pharmaceutical companies and medical device enterprises. There are three reasons:

1, market access

What is market access for domestic pharmaceutical industry? In a narrow sense, it can be understood as: bidding, entering medical insurance.

If the drug fails to pass the tender, it means losing the whole hospital market. Furthermore, if the drug fails to enter the medical insurance catalogue, even if it passes the bidding, it will have a very huge impact on its market.

Bidding and medical insurance catalogue are both market access, but now these two rights are in the hands of medical insurance bureau, and their importance is self-evident.