Medical net on July 25 the base of the primary medication release!
On July 20, health and family planning commission of shandong province, shandong province human resources and social security department jointly issued "on the adjustment perfect grassroots medical institutions and drug with use policy notice" (hereinafter referred to as the "notice"), points out that the basic medical institutions of essential medicines procurement amount of drug purchase under our total amount up to 30%.
Learned, after, in shandong province requires basic drug purchasing amount of all grassroots health institutions not less than 80% of the total amount of the drug purchase, that is to say, the base is not higher than 20% of the total amount of purchase.
This time, the notice will adjust the proportion of non-basic pharmaceutical procurement from the primary medical institutions to the proportion of the total amount of the total pharmaceutical procurement to no more than 30%. This means that the availability of non-basic medicines for primary-level medical institutions will increase and the range of non-basic medicines available for primary doctors will be expanded. In order to meet the needs of patients at the grass-roots level, it is of positive significance to promote the use of two-way referral and grading system.
In addition, the notice also specifies which non-basic drugs can be used at the grass-roots level:
In order to guarantee the drug use of patients with chronic diseases, primary medical and health institutions can directly select non-basic medicines from the basic medical insurance contents of the province. The subsidence of non-base drug selection means that primary medical institutions can choose and adjust the range of medicine according to the actual needs of the clinical line, so as to improve the flexibility of the selection of drugs.
Against possible hidden gray transactions, cause drug prices artificially high offline purchase, "notice" requirements, the grassroots medical institutions with the use of all drugs (except traditional Chinese medicine yinpian) must be through the provincial drug centralized purchasing platform for online purchases, and implement in the provinces units unified payment and settlement, zero rate of sales.
Previously, primary-level medical institutions could only be equipped with basic drugs, which began to change gradually with the further development of healthcare reform. Some industry insiders believe that in the future, the drug will be unified in the hospital, and the primary hospital will no longer be restricted by the base drug directory, and the primary hospital can only be formally disintegrated with the basic medicine.
In fact, not only shandong province, these provinces have also liberalized the grass roots.
In July 2016, the jiangxi provincial health and family planning commission, the provincial development and reform commission, the provincial food and drug administration, eight departments jointly issued the regulation on administration of medical institutions equipped with basic drugs use in jiangxi province, explicitly allow grass-roots medical institutions in the health care medicine catalogue with 30% to 40% of basic drugs, medication of patients in chronic illness and recovery, referral requirements, so as to realize grassroots medical institutions and drug cohesion between two tertiary medical institutions.
On August 15, 2016, the Beijing municipal planning commission, the national development and reform commission and other four departments jointly issued the "Beijing grading system construction for the focus of 2016-2017, Beijing will be unified big hospitals and community drug procurement catalogue. By 2017, a total of 2510 drugs in the basic health care drug catalog are expected to be placed in the community. "all the medicines that can be reimbursed by the big hospitals can be reimbursed in the community," he said.
On August 18, 2016, ningxia has released the deepening medical and health system reform in 2016 key tasks (points), the part within the coverage of the basic drugs to sink to the grassroots medical institutions to use, see a doctor to grassroots boot with a chronic illness, secondary and tertiary general hospital and grassroots medical institutions can be cohesive mechanism of drugs.
On September 8, 2016, who in henan development planning commission issued the "two-way referral management of medical institutions of henan province specification (try out)", points out that medical and health institutions at the grass roots level in accordance with the superior orders purchasing medical insurance directory of essential medicines, under guarantee the continuity of patients and drug treatment.
On October 17, 2016, who planning commission of zhejiang province issued "about further consolidate a perfect system for basic drugs work notice", pointed out that according to the requirements of clinical pathway management implementation of the treatment of chronic disease management and treatment of medical and health institutions at the grassroots level can be from the province of the basic medical insurance directory, choose to use drugs commonly used drugs in addition to the national essential drugs and province, its by the original purchase amount shall not exceed the 30% of the total amount of the grassroots medical institutions and drug procurement up to 50%.
On June 30, 2017, the guangdong health development planning commission issued "about further defined the basic drug system in our province announcement concerning the requirements clear, since July 1, 2017, the guangdong health care is no longer for basic drugs at the grass-roots level to limit number of varieties and amount of proportion, plan for three years in 50 billion for the construction of medical treatment, 2019 years ago to promote grassroots health capacity for fundamental improvement.
It is good for pharmaceutical enterprises to expand the primary market. Pharmaceutical companies and agents grassroots medical institutions should be as an important object of public relations in the future, in pay attention to the original, high production and development at the same time, also don't ignore drugs commonly used medicines at the grass-roots level, the common medicine, low-cost production and promotion. In the past, the state has also promoted the establishment of oncology specialty at county level hospitals, and gave chemotherapy to patients with advanced cancer at the grass-roots level. It can be seen that the primary market of low-price medicine and generic drugs will be the new outlet for some high-priced drugs in the future.
Notice on adjustment and improvement of the use policy of medical and health institutions
We will consolidate and expand the implementation of the basic drug system
All the implementation of the basic drug system of grassroots medical institutions according to their function and service ability, rational selection and priority with use of basic drugs (including national essential drugs and provincial supplement essential medicines, hereinafter the same). Public hospitals at all levels should also give priority to basic drugs and increase the proportion of basic drugs. The procurement platform identifies the "restricted use" of drugs not included in the basic drug statistics.
Earnestly implement the "about the basic medical insurance, inductrial injury insurance and maternity insurance in shandong province adjust the list of drugs part of the drug specifications notice (lu SheBan hair [2015] no. 56) the relevant provisions of national and provincial regulations of essential drugs in the catalog of health belongs to b class of pharmaceuticals, no longer leading by the individual pays a proportion, with reference to a class in the catalogue of drugs and drug administration.
To adjust the policy of selection of non-essential medicines for primary medical and health institutions
The grassroots health institutions equipped with use of essential medicines selection permissions to sink, by the grassroots health institutions from the list of drugs of insurance of primary medical treatment in our province autonomous choice, fully enhance the medication choice flexibility. The total amount of non-essential drug purchases should not exceed 30% of the total amount of pharmaceutical procurement.
Grassroots medical institutions of essential medicines selection is used, to ensure patients with chronic diseases, adhere to the prevention and control must, clinical choice, the price is reasonable, the principle of paying equal attention to both Chinese and western medicine, according to the regulations of the pharmaceutical affairs management related after collective research, and implementation of zero rate of sales policy. The priority of the preparation of the dosage form is suitable, the packaging USES convenient medicine, propelling the medicine dosage form, the specification, the packaging standardization.
Third, strictly implement the drug purchasing policy in the province
The implementation of the national system for basic drugs of grassroots medical institutions with the use of all drugs (except traditional Chinese medicine yinpian), must through the provincial drug centralized purchasing platform for online purchases, and implement unified payment settlement for the unit with the province. Non-essential drug contract signing and distribution relationship establishment shall be carried out in accordance with the relevant provisions of basic drugs, and the policy of "two-ticket" shall be implemented as required.
We will implement the procurement policy for drug online classification. If it belongs to the public bidding and procuring drugs, the primary medical and health institutions shall choose the winning products according to the clinical needs; The basic medical and health institutions of the primary care system shall, according to the reference price information displayed by the platform, make a direct agreement with the Internet enterprises, and truthfully fill in the actual transaction price and quantity. We will encourage all localities to combine the joint procurement of medical medias and public hospitals, and organize community-level medical and health institutions to conduct centralized bargaining and joint procurement in cities or counties (cities and districts).
The village health room is equipped with the medicine, in principle the township health hospital unified online purchase, unified settlement, village health room must not purchase medicine by itself.
Fourth, strengthen comprehensive supervision
Adjust improve grassroots medical institutions and drug use policy, is to strengthen the construction of drug supply security system, and ensure grading diagnosis cohesion, the important measures to meet the demand of the basic drugs. Relevant units at all levels should attach great importance to the organization and ensure the smooth landing of policies.
To further improve the basic drug system performance evaluation plan, improve the incentive constraints mechanism, the drug centralized purchasing, zero sales rate, concentration and settlement, equipped with basic drugs used in important evaluation index of performance appraisal.
We will conscientiously implement the policy of medical insurance payment, strengthen the management of medical institutions under the designated medical insurance system, control the unreasonable expenditures of the medical insurance fund, and guarantee the legitimate rights and interests of the insured persons.
Wants to improve the quality of medical services and pharmaceutical affairs management, reasonable set the monitoring indicators, to strengthen the safe drug use, improve the system of drug prescription audit review, to a drug prescription indicators to track the implementation inspection and statistical analysis. Key monitoring assistant drugs, supernormal use of medicine.
Must advance to promote basic drug application and grading diagnosis as the key point, using a variety of forms continue to spread the basic concept of drug rational use, guide the masses change bad drug habits, enhance social understanding of the basic drugs and trust, create a good social atmosphere.
This notice will be implemented from August 1, 2017 and will be valid until July 31, 2020. The notice on the further improvement of the policy on the use of drugs in the primary medical and health care institutions (the government of the state department of public health) shall be abolished as of the date of this notice.
The department of human resources and social security of shandong provincial health and family planning commission
July 13, 2017 |
