In June 2022, China’s National Healthcare Security Administration proposed in the Non-exclusive Drug Bidding Rules that if non-exclusive drugs were successfully included in the drug catalogue through bidding, the medical insurance payment standard for the generic name drug would be set according to the rules. Drugs with prices lower than the payment standard shall be reimbursed based on the actual price while drugs with prices higher than the payment standard, the part exceeding the standard would be paid out of pocket. This method for formulating medical insurance payment standard integrates pricing and payment, with initial practice in the 2022 adjustment of national medical insurance catalogue and far-reaching impact on China's pharmaceutical market. Internationally, Germany was the first country to establish the fixed reference price (FRP) system and may provide key learning for others. This article summarizes the design and implementation experience of the FRP system in Germany, and provides suggestions for improving relevant policies in China.
Key words
adjustment of national medical insurance catalogue /
non-exclusive drug bidding /
medical insurance payment standard /
Germany /
fixed price system
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