On April 29, the National Healthcare Security Administration and the National Health Commission jointly issued the "Notice on Improving Supporting Measures for the National Centralized Bulk Procurement and Use of Drugs (Insulin Special Program)" (hereinafter referred to as the "Notice"). The Notice clearly states that medical institutions shall prioritize the use of selected insulin products, provided that medical quality and safety are ensured.
The notice specifies that the winning products from the insulin centralized procurement will be listed on provincial-level pharmaceutical centralized procurement platforms at their winning prices, leveraging the drug and medical consumables procurement management subsystem of the nationally unified medical insurance information platform. For pre-filled, special-fill, and long-fill insulin products, an additional 3 yuan per vial may be added based on the winning price of the corresponding cartridge-type insulin products from the same enterprise. Non-winning products must adhere to the principle of aligning efficacy with pricing, carefully considering their reasonable price comparison with the winning products, and guiding and encouraging relevant enterprises to adjust their prices to appropriate levels.
Regarding payment, the notice clearly states that for insulin products selected in the centralized procurement, the winning bid prices listed on the procurement platform will serve as the payment standard, with medical insurance funds covering the costs according to the prescribed proportion. For non-selected insulin products that still fall within the scope of medical insurance fund coverage, the payment standard shall not exceed the highest winning bid price or the negotiated medical insurance price among the selected products in the same category. If patients choose to use non-selected insulin products and the actual cost exceeds the medical insurance payment standard, the additional expenses will be borne by the patients themselves.
Regarding the implementation of incentive and constraint policies for medical institutions, the notice specifies that after medical institutions sign procurement agreements with selected enterprises, the medical insurance fund will prepay no less than 30% of the annual agreed procurement amount to these institutions. Medical institutions are required to settle payments promptly with the enterprises by the end of the following month after delivery and acceptance verification. In regions implementing DRG/DIP payment reform, the medical insurance payment standards for corresponding disease categories (disease groups) will remain unchanged during the first year. Subsequent adjustments should comprehensively consider cost changes and be made in a scientific and rational manner.
Additionally, to promote the rational use of medications in medical institutions, the notice emphasizes that healthcare facilities should ensure the availability of selected products in hospitals and procure them according to the agreed-upon quantities, based on the varieties and demands they have independently reported. Physicians are required to prescribe medications appropriately, adhering to clinical practice guidelines, drug labels, and medication usage recommendations. Meanwhile, medical institutions are encouraged to prioritize the use of selected insulin products, provided that patient safety and treatment quality are fully maintained.
The notice also clearly emphasizes the need to hold winning bidders accountable for ensuring supply. Companies found unable to fulfill their contractual obligations will be recorded accordingly and factually included in the evaluation of their supply capacity and performance. Depending on the severity of the situation, they will be subject to appropriate measures in accordance with the discretionary guidelines for pharmaceutical pricing and procurement credit evaluations.
It is understood that on November 26, 2021, the National Healthcare Security Administration successfully concluded the sixth round of national centralized bulk procurement of drugs in Shanghai. This round specifically focused on insulin procurement. The first-year procurement demand from medical institutions across the country for this batch of insulin was approximately 210 million vials, covering 16 generic drug varieties—both second- and third-generation insulins commonly used in clinical practice. The average price of the selected products is expected to drop by 48%, representing an estimated total value of about RMB 17 billion. According to regulations, provinces across China began gradually implementing the outcomes of the national centralized procurement starting from May 2022.
