In 2012，the reform on national medical and health care system has entered in a critical stage. Promote separation of pharmaceuticals from medical care，and refine the channel of medical transaction，as well as encourage pharmaceutical chain store to taking up responsibilities in medical service are the main direction of reform. Hierarchical management of Medical Insurance Designated Pharmacy is the key to standardize supervision system and refine the channel for medical transaction. Based on a survey of all the medical insurance designated pharmacy in Guangzhou in 2012，this paper analyses the basis of Guangzhou to carry out hierarchy management. It also explores the feasibility and evaluation of the choice of indicators and management measures