Research on the Linkage Mechanism between Essential Medicine List and Healthcare Insurance List

摘要

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.