The National Healthcare Security Administration (NHSA) has issued a Notification concerning the improvement of the pricing mechanism and the implementation of classified management for COVID-19 therapeutic drugs. This move signifies a new approach to categorizing COVID-19 drugs into A, B, and C classes outside the National Reimbursement Drug List (NRDL).
Category A: Slight Price Variations
Category A includes COVID-19 therapeutic drugs with initial quotes or assessment adjustments made in line with the “Guideline for the Price Formation of COVID-19 Therapeutic Drugs” (hereinafter referred to as the Guidelines). These drugs have course treatment expenses that are only slightly different from similar drugs on the NRDL.
Category B: Significant Price Differences
Category B encompasses COVID-19 therapeutic drugs with initial quotes or assessment adjustments in accordance with the Guidelines, where the course treatment expenses are markedly different from similar drugs on the NRDL.
Category C: Non-Compliant and Unfairly Priced
Category C consists of COVID-19 therapeutic drugs with initial quotes or assessment adjustments that do not adhere to the Guidelines, and whose assessment results indicate significant unfairness and unreasonableness in pricing.
Regulations and Procurement Prioritization
The document specifies that, currently, the maximum treatment cost of low-priced small-molecule COVID-19 treatment drugs within the medical insurance payment scope will serve as the reference benchmark. The treatment cost for Category A drugs should not exceed 1.8 times this reference benchmark. From April 1, 2023, provincial medical procurement platforms are instructed to prioritize the procurement of Category A drugs. Healthcare security bureaus will have the discretion to apply temporary medical insurance payment policies based on pandemic prevention and treatment needs.
Pricing Assessment and Drug Categorization
COVID-19 drugs already available for online procurement will undergo the first round of pricing assessment before April 1 and will be allocated as either Category A, B, or C drugs.-Fineline Info & Tech
