As an important policy tool, real-world evidence is the basis for health insurance catalogue adjustment, and relevant policies and regulations have been issued in foreign countries to guide the use of real-world research for health insurance access, but the field of traditional Chinese medicine (TCM) in China in particular is still in the exploratory stage. Since TCM protocols are widely used in clinical practice and have significant clinical value, this paper takes TCM protocols as an example and systematically constructs a technical pathway based on real-world research to support health insurance access, including clinical needs assessment, basic requirements of protocols, key points for conducting real-world research and evaluating real-world evidence, the process of access, the strategy of access, and the dynamic monitoring of access, with the aim of providing guidance for the application of real-world research in China's health insurance catalogue adjustment. Access to real-world research to provide references for the application of real-world research in China's health insurance.
Citation: WANG Yiming, XU Jiaxin, GUO Manping, ZHU Jiaxu, GAO Rui, DAI Xinyue. Exploration of technical pathways for real-world study to support health insurance access: the case of Chinese medicine protocols. Chinese Journal of Evidence-Based Medicine, 2026, 26(2): 178-184. doi: 10.7507/1672-2531.202505077 Copy
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