Good Practices in Social Security Good Practices in Social Security

The identification and sharing of good practices helps social security organizations and institutions to improve their operational and administrative efficiency.

In the context of the ISSA, a good practice is defined as any type of experience (e.g. an action, a measure, a process, a programme, a project, or a technology) implemented within a social security organization that fosters the improvement of its administrative and operational capacities, and/or the efficient and effective delivery of programmes. The good practices selected by the ISSA focus on topics related to the priorities as defined in the programme and budget of the Association. The good practices are from member institutions of the ISSA and are primarily collected through the work of the  ISSA Technical Commissions and the ISSA Good Practice Awards.

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Application of actuarial technology in the negotiation of National Medical Insurance Drug List

Application of actuarial technology in the negotiation of National Medical Insurance Drug List

Ministry of Human Resources and Social Security | China
Application of actuarial technology in the negotiation of National Medical Insurance Drug List

In order to reduce the personal burden of medical expenses and improve the Chinese patients’ sense of acquisition, happiness and security, the Ministry of Human Resources and Social Security (MoHRSS) organized in 2017 the negotiation of the National Medical Insurance Drug List (NMIDL). For the first time, 44 proprietary drugs with definite curative effect, clinical necessity, safety and reliability but with high prices as determined by experts’ review were negotiated for admission into the medical insurance payment standards, of which 36 medicines were successfully admitted into Category B.

The major objectives of this programme are to significantly improve the security of medical insurance medication usage, greatly reduce patients’ personal burden, effectively control the fund expenditure, strongly support the medicine innovation, and achieve win-win results for multi-parties.

In realizing the above-mentioned objectives, the negotiation has achieved great results by applying actuarial technology to analyse the medical insurance big data, evaluating the supporting capacity of medical insurance fund, and scientifically calculating the standard of medical insurance payment. The average price reduction of 36 admitted drugs was 44 per cent, with a maximum reduction of 70 per cent, giving full play to the group purchasing capacity of basic medical insurance.

Implementation year2019
Topics: Governance, Information and communication technology, Actuarial
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