The First Time in the Country! The Medical Insurance Bureau Orders: A large Number of Medical Devices Exempted from the DRG
On 13 July, the Beijing Municipal Medical Insurance Bureau issued the Notice on the Issuance of the Management of Excluded Payments for New Drugs and Technologies for CHS-DRG Payments (Trial) (Hereinafter referred to as the Notice). |
The notice proposes a DRG exclusion payment method, specifying that innovative drugs, innovative medical devices and innovative medical service items can be paid separately on an actual basis without being paid under the DRG method.
DRG payment reform, is in recent years, in addition to the Volume purchase, national medical insurance negotiations, another core means of medical insurance cost control, this policy for the first time proposes innovative devices, drugs, etc. can be exempt from cost control means, will undoubtedly greatly encourage the enthusiasm of the pharmaceutical industry innovation.
DRG exemption for innovative devices starts to be paid separately!
According to the notification, innovative drugs/innovative medical devices that meet the requirements need to satisfy two main points of innovation.
1. New generic drugs/medical devices that have been approved by the drug regulatory authorities for marketing within three years (including the year of declaration and the two natural years prior to it); new medical devices that can be charged separately due to price adjustment within three years.
2.The clinical effect is greatly improved compared with traditional drugs/medical devices.
At the same time, for the declaration of innovative drugs/medical devices, the cumulative number of cases of basic medical insurance participants in the city needs to reach at least 50 cases, while rare diseases are not limited in the number of cases.
If the product is confirmed to be eligible, it can be declared by the company to the Beijing Medical Insurance Affairs Management Centre.
CHS-DRG Application Form for Excluded Medical Devices on a Fee Basis.
Name of the firm(sealed) Date of filling the form :
Name of the medical device |
Medical device Registration Certificate Number |
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Time to market |
National medical insurance code (27 digits) |
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Major diagnostic categories of affiliation(MDC) |
Medical device charges |
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Expected sales |
First year: (yuan) Second year: (yuan) |
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It must be used in conjunction with diagnosis and treatment items Yes ¨ No.¨ |
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Name of the diagnosis and treatment items |
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National medical insurance code |
Medical insurance code of the city |
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Medical Insurance Category |
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Designated medical institutions have been established in Beijing |
HIS code of medical device |
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1. |
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2. |
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3. |
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4 |
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5 |
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Specific description1. Scope of application |
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2. Usage method3. Clinical effect4. Innovation or superiority (Including but not limited to the comparison of advantages and disadvantages of traditional devices, including but not limited to comparison materials with alternative drugs, medical devices and related literature materials (Chinese electronic version))5. Other |
