By Fineline Cube 
The Hebei provincial healthcare security administration has issued the “Notice on Improving the Separate Payment Guarantee for Negotiated Drugs,” set to take effect from August 1, 2025. This policy aims to enhance the accessibility and affordability of high-cost medications for chronic and special diseases.
Eligible Drugs and Payment Scope
The Notice specifies that 57 drugs, selected for their clear indications, high annual treatment costs, and suitability for long-term outpatient use, will be included in the separate payment scope. Cities within Hebei are permitted to adjust their local separate payment lists based on actual conditions and insured individuals’ needs, either retaining or removing drugs beyond the 57 specified or adding new ones.
Reimbursement Details
For outpatient expenses related to separately paid drugs, after the initial self-payment as per the NRDL drug catalog, basic medical insurance will cover a minimum of 60% for employees and 50% for residents. The annual reimbursement limit should be determined based on the annual treatment costs of separately paid drugs, the individual’s initial self-payment proportion, and the reimbursement ratio. The medical insurance payment amount will count toward the individual’s annual maximum payment limit under the basic medical insurance fund. Insured patients using separately paid drugs will not consume their basic medical insurance outpatient fund quota but must first exhaust the outpatient quota for chronic and special diseases corresponding to the drug. Inpatient expenses for separately paid drugs will follow regional hospitalization policies.
Management Mechanism
The “three designations and one filing” management mechanism will continue to be applied to separately paid drugs, involving designated medical institutions, responsible physicians, retail pharmacies, and real-name filing.-Fineline Info & Tech