Medical Insurance expert
In China's medical insurance system, the role of expert teams is crucial, especially in the process of updating and adjusting the medical insurance drug list. Healthcare professionals in China are generally divided into three main expert groups:
Clinical Group: This group is composed of experts with extensive clinical experience who are mainly responsible for evaluating the necessity and effectiveness of drugs in practical medical treatment. Clinical team experts are drawn from the national designated expert pool and participate in the work by means of extraction. Their clinical judgments are important in determining which drugs should be included or removed from the Medicare drug list.
Panel of Economic experts: This group of experts focuses on the economic benefits of drugs. They are responsible for evaluating the costs and health benefits of using drugs in patients. These experts conduct detailed cost-benefit analyses to ensure that healthcare dollars are spent to maximize health returns.
Health Insurance Fund Measurement Team: This group of experts is responsible for measuring the affordability of the health insurance fund. Their task is to assess whether a drug, once included in the list, will impose a burden on the health insurance fund and ensure the balance and sustainability of the health insurance fund.
These expert groups play a key role in China's health care system, working together in their respective areas of expertise to ensure scientific, fair and sustainable health care drug lists.