(Aug. 25, 2009) On August 18, 2009, the Ministry of Health (MOH) and the National Development and Reform Commission (NDRC) of the People's Republic of China, together with seven other central government departments, published the Implementation Opinions on Establishing the National Essential Medicine System (Opinions). On the same day, the MOH published a list of about 300 designated national essential medicines, which will take effect on September 21, 2009.
The Opinions are issued to direct the establishment of a national essential medicine system as part of the country's health care reform. In China, doctors and public hospitals have long been criticized for prescribing expensive and sometimes unnecessary medicines and treatment, in order to cover their operating expenses. This wastes medical resources and creates a heavy burden on patients. The purposes of establishing the essential medicine system, according to the Opinions, are to ensure the public's access to essential medicines and to cut medical costs (Preamble). The designated essential medicines are those that may satisfy basic health care needs with affordable prices (art. 1). After being published, the list of the national essential medicines will be updated every three years (art. 4). Retail prices of the essential medicines will be regulated by the NDRC (art. 10). In the grass-roots health facilities run by the government, the essential medicines must be sold for their purchase prices, which will be subsidized by local governments (art. 12). All essential medicines will be included on China's basic health care medicine reimbursement list and their costs will be reimbursed at a higher rate than applies to other medicines (art. 16).
According to the Opinions, about 30 percent of grass-roots health facilities run by the government will join the national essential medicine system by the end of 2009. The system will be “initially established” by 2011 and fully established by 2020 (art. 19). (Implementation Opinions on Establishing the National Essential Medicine System [Guanyu jianli guojia jiben yaowu zhidu de shishi yijian] [in Chinese], Central People's Government official website, Aug. 18, 2009, available at http://www.gov.cn/gzdt/2009-08/18/content_1395423.htm; List of the National Essential Medicines [in Chinese], MOH official website, Aug. 18, 2009, available at http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohywzc/s3580/20090