Objective:This study examines Zhejiang Province's DRG exclusion payment policy for innovative technologies, analyzing its design logic, selection pathways, and outcomes, with the aim of providing insights for nationwide healthcare payment reforms to support medical innovation. Methods:Combining literature review and policy practice analysis, the study first provides a theoretical analysis of the DRG exclusion payment policy. It then focuses on Zhejiang Province's incentive catalog management system for innovative medical technologies under medical insurance payment and its first incentive catalog, exploring the three core mechanisms of application, evaluation, and payment. Finally, it summarizes the characteristics of catalog selection and the implementation effects of the system, identifying key challenges in policy operation. Results:Zhejiang Province has established a payment incentive mechanism centered on healthcare institutions as the applicants, multi-dimensional evaluation indicators, and a three-year degressive point-based supplementary compensation system. The first incentive catalog includes 25 drugs, 3 medical service items, and 2 medical consumables. Conclusion:Zhejiang Province’s DRG exclusion payment practice offers a referential model for promoting the clinical application of innovative medical technologies under the DRG payment. Meanwhile, addressing challenges in policy optimization and implementation supervision, the study proposes recommendations such as establishing a dynamic evaluation mechanism and enhancing digital-intelligent supervision to further improve policy sustainability and precision.
Key words
pharmaceutical innovation /
DRG /
exclusion payment /
Zhejiang Province
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