Since the 18th National Congress of the Communist Party of China, China has continuously deepened the reform of the medical and health care system, vigorously promoted innovation in the medical field, continuously increased innovation investment, accelerated the benefits to the people's livelihood, and met the people's diversified drug needs. After the establishment of the National Medical Insurance Administration, the frequency of access to the medical insurance list of drugs has been greatly accelerated. The annual national discussion is a very important part of many policies supporting the medical innovation in the whole chain.

 The National Medical Insurance Administration has continuously optimized the negotiation and continuation rules, and further improved the scientific and normative requirements of the catalogue adjustment, and increases the support for medical innovation. On December 13,2023, the National Medical Insurance Administration released the List of Drugs for National Basic Medical Insurance, Industrial Injury Insurance and Maternity Insurance (2023), adding a total of 126 new drugs to the list in this adjustment. The National Medical Insurance Administration has fully realized the importance of solving the "last mile" of drug use, so it is clear that the next step will pay close attention to implement the implementation of the new catalogue, and strive to improve the level of drug security for the masses. Through combing, it is found that the country has issued a number of documents in recent years to ensure the smooth landing of the national talk products.

 On May 10,2021, the Guidance of the National Health Commission of the National Medical Insurance Administration on establishing and Improving the "Double Channel" Management Mechanism of Drugs for National Medical Insurance negotiation: Designated retail pharmacies were included in the scope of negotiated drug supply guarantee, and the "double channel" of negotiated drug reimbursement was formed together with the designated medical institutions, so as to improve the accessibility.

 On September 10,2021, the national health insurance bureau, the national WeiJianWei two jointly issued the about to adapt to the national health care negotiations normalized negotiations drug landing notice: establish hospital drugs with health care directory adjust linkage mechanism, since the new directory officially released, according to the clinical needs, timely pharmacy held as a whole, "should match". For the time being, it cannot be included in the medical structure supply catalogue, so it can be included in the temporary procurement, simplify procedures and timely procurement. Medical insurance departments should strengthen the agreement management, include the reasonable use of designated medical institutions into the agreement, and link it with the annual assessment. Health departments should adjust and improve the assessment mechanism of drug use in medical institutions, list the negotiated drugs for reasonable use, and not include them in the range of assessment indicators that affect the implementation of the proportion of drugs and the average cost per time in medical institutions. Strengthen the guidance and management of clinical drug use behaviors of designated medical institutions, urge the medical institutions under the jurisdiction to rationally equip and use negotiated drugs, and shall not affect the implementation of negotiated drugs on the restriction of the total amount of medical insurance, the number of drug lists of medical institutions, and the proportion of drugs. The notice clearly stated that "medical institutions are the first person responsible for the clinical rational use of negotiated drugs". With convenient drug use scenarios, professional drug use guidance and complete supervision mechanism, medical institutions are always the most suitable subject for negotiating drug allocation and use.

 The experience of many provinces has proved that refining the time limit requirements for the pharmaceutical meeting of medical institutions and following up the implementation will play a significant role in accelerating the implementation of national drug talks. By finishing the provincial health bureau policy can be found that most of the provinces or actively response to the national policy document spirit, in the provincial health bureau, WeiJianWei departments released 2023 version of medical insurance directory release, implement related documents, clear the series to promote the drug about the ground, in 2024 to at least 24 provinces will hold a time limit for the requirements, 18 provinces in the new directory at 1 to 3 months after the ground, including Beijing mentioned at least four times a year, Zhejiang 3 armour hospital medicine will hold every quarter. For medicine will hold time basic have clear requirements, including 1 month in Jiangsu, Hebei, Guangxi, Shanghai, Beijing, Gansu, held within 2 months of Inner Mongolia, Fujian, Jilin, 3 months of Hunan, Hainan, Shandong, Sichuan, Anhui, Jiangxi, Jiangxi, shaanxi, Zhejiang, Guangdong, held in a timely manner of Qinghai, Hubei, Shanxi, Henan, Guizhou, Tianjin.

 The use of drugs in China mainly depends on terminal medical institutions, while many factors need to be taken into account for the filing and use of medical institutions. Therefore, the coordination of drug implementation policy and drug management assessment policy in China. For example, the dual-channel policy does solve the problem of national accessibility to drugs to some extent, but it also produces some other problems. Such as parts in the process of execution "double channel" become "single channel", part of the hospital from the drug zero addition, drug gauge quantity limit management and cost control, has opened pharmacy supply negotiations prefer not to introduce, such as Jiangsu, in 2023 countries new negotiation drugs into dual channel management and separate payment drug list shows, dual channel management drugs a total of 74, dual channel management and separate payment drugs a total of 36. In the process of landing in various cities, some cities in northern Jiangsu have artificially stipulated that single payment drugs are not allowed to enter the hospital, and the specific reasons can not give a clear one, two and three. The real reason may only know to the hospital itself, but this is indeed different from the original intention of the national "dual channel" policy, and also increases the risk of clinical drug safety for patients.

 On the whole, the medical insurance department is still giving subjective guidance on the allocation of drugs negotiated by medical institutions. In the future, it should be more digital, such as assessing or monitoring the number of drugs. For example, the quantity requirements of the release of the new version of the catalogue, and the evaluation or monitoring of the classification standards of medical institutions according to the medical level and functional positioning. Has been according to the practice of provinces mainly have Zhejiang, require negotiation drugs with rate in three public comprehensive medical institutions not less than 30%, three b public comprehensive medical institutions, tertiary public TCM hospital (including combine traditional Chinese and western medicine hospital) not less than 20%, tertiary public specialist medical institutions is not less than 60% of the corresponding specialized subject about varieties. On the one hand, local medical insurance departments should continue to carry out policy publicity of medical institutions, and improve the understanding and attention of relevant leaders of medical institutions to medical insurance negotiations. After the new drug directory every year, the municipal and key medical institutions at the county level, health care office director, director of the key positions, head of the policy propaganda exchange, negotiation policy background, significance, landing policy propaganda, especially for health care and WeiJian department related "loosen" policy, such as negotiation drugs do not account for total health care, not included in the DRG / DIP payment standard, not product quantity and drug proportion, etc., detailed training, prompting medical institutions to dispel policy concerns, support negotiations drugs fall to the ground.

 In addition to the health insurance department, the health department's policy is also very final, and must cooperate with the health insurance department. National WeiJianWei can negotiate drugs with varieties into the secondary tertiary public medical institutions performance appraisal, the provincial WeiJian department can negotiate drugs equipped with varieties into the assessment of rational drug use, set up quantitative indicators, thus improve the medical institutions with the use of drugs, medical institutions actively equipped with negotiation drugs long-term promotion mechanism. At present, Shanghai has done this, so Shanghai's national drug equipment is very in place, the equipment rate is among the top in the country.We can also consider incorporating the medical meetings held by medical institutions into the assessment system of medical institutions.

 Health departments at all levels should strengthen cooperation with local medical insurance departments and closely participate in the negotiation to promote the implementation of drugs. Establish a long-term cooperation mechanism, such as setting up a cross-departmental special working group around the implementation of negotiated drugs, establish a communication and cooperation mechanism, and clarify the division of labor between the two sides in the work. Actively participate in the publicity meeting of drug negotiation policy organized by the medical insurance department, and give play to the guiding role of health departments in guiding the allocation, procurement and use of drugs in medical institutions. Communicate with the medical insurance department regularly to understand the implementation of the negotiated drugs, and timely solve the problems found. For example, this year, the Beijing Healthcare Security Bureau, the National Health Commission and nine other departments jointly issued several Measures of Beijing to Support the High-quality Development of Innovative Medicine (2024), clarifying that the drug conference will be held within one month after the publication of the national drug list, and the drug conference will be held no less than four times throughout the year. Jiangxi on April 7, is also health bureau and WeiJian department joint post on the continuous national health care negotiations drugs ground execution work notice, published in the new health drug directory held special drug will be 3 months, give full consideration to the new drugs (especially negotiating drugs) and adjust the indications of drugs, timely optimization of medical institutions hospital drug directory, implementation negotiation drugs "should be taken, should match".

Time flies, in the blink of an eye, this year is almost half passed, June is the final month of the new products approved this year, I believe that all the prospective national talk enterprises are working hard, some to get the qualification, some for the results can be more beautiful. This year is also the first time for the country to talk about the bidding products to the agreement period time, the follow-up is not whether directly transferred to the regular medical insurance and so on, this year can get the answer.