Research on the Linkage Mechanism between Essential Medicine List and Healthcare Insurance List
2021
Objective: To put forward suggestions to improve the linkage mechanism between China’s
essential medicine list and healthcare insurance medicine list. Methods: Comparative study of the organization setting, selection criteria, adjustment
procedures, and reimbursement of essential medicine list and healthcare
insurance medicine list, containing both the foreign experience and China’s status quo. Results: When two lists exist at the same time, they are often managed separately
abroad, setting more selection criteria for the essential medicine, and giving
the essential medicine a higher payment ratio. The two lists in China are managed and adjusted
separately, but lack of connection. As a result, some essential medicines cannot be reimbursed. Conclusion: The two lists’ linkage mechanism needs to be
improved. It is recommended to make it clear that essential medicines should be selected from the healthcare
insurance medicine list, and enhance the consistency of medicine evaluation
through mutually scientific evidence.
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