The National Healthcare Security Administration (NHSA) has released the “2022 National Reimbursement Drug List (NRDL) Adjustment Work Plan” along with relevant documents. This official update to the draft proposal issued on June 13th outlines the full details and processes for this year’s NRDL update.
List Adjustment Scope
The scope of the list adjustment remains consistent with previous releases. However, in terms of work procedures, the expert review phase will include “drugs with simplified renewal” for experts to determine payment standards. This phase is expected to take place in August this year.
Revised Simplified Renewal Conditions
The conditions for simplified renewals have been revised. Previously, the draft proposal defined a “reasonable future budget increase” as a budget increase for the next two years not exceeding 200% (compared to the higher of the estimated budget impact two years ago and the actual expenditure value of the medical insurance fund during the period of this agreement). For drugs approved prior to January 1, 2017, the increase should not exceed 150%. Now, the standard has been unified to: “The increase in the budget expenditure of the fund for the next two years shall not exceed 100% (compared to the higher of the budget expenditure of the fund for the period of this agreement and the actual expenditure of the fund for the period of this agreement).” The ratio A of price reduction rules related to simplified renewal has been revised to “actual fund expenditure/fund expenditure budget,” and ratio B to “the increased value of the fund’s expenditure budget due to the adjustment of the payment scope in the next two years/the higher of the fund’s expenditure budget and the fund’s actual expenditure during this agreement period.”
Non-Exclusive Drug Price Bidding
For non – exclusive drug price bidding, experts will calculate the expected medical insurance payment cap, and manufacturers will make their offers. The manufacturer that issues a quote lower than the target price will be used as the reimbursement price for all same – name drugs. However, the reimbursement price reduction is capped at 70% below the target price. A bidder may bid below 70% of the target price, but the unified medical insurance price for other drugs with the same molecule name will not be reduced lower than 70%. For drugs included in price bidding, local healthcare security bureaus are encouraged to involve varieties under the same generic name with prices no higher than the payment standards of designated medical institutions and “dual channel” drug stores where patients can buy the drugs involved in the NRDL and enjoy the same reimbursement policies.-Fineline Info & Tech
