Reduce the burden on the patient! 125 kinds of medicines for


From September 1st, some of the drugs in the new medical insurance drug list will be included in the reimbursement for special diseases of the city's basic medical insurance outpatient clinics. Newly included include 125 kinds of outpatient special diseases including peritoneal dialysate and systemic antibacterial drugs. drug.

Since 2001, Beijing has established a system of “special diseases for outpatients”. Insured persons suffering from “special diseases”, when they are selected for relevant outpatient treatment, the cost of outpatient treatment can be based on the proportion of hospitalization reimbursement. The reimbursement limit is implemented, and the maximum cap line is 300,000 yuan, which is much less than the average outpatient service.

This adjustment is included in the increase of 9 types of outpatient special diseases, involving a total of 125 types of drugs, which will reduce the burden of patients' medication.

Among them, the reimbursement of drugs for the treatment of special diseases in aplastic anemia clinics increased the most.

There are 37 types of drugs for treating gastric acid-related diseases, antiemetics and anti-nausea drugs, drugs for treating functional gastrointestinal diseases, and analgesics;

Special cases of renal dialysis clinics have increased the reimbursement of 22 types of drugs, including diabetes medication, peripheral vasodilators, and peritoneal dialysate;

Liver transplantation, kidney transplantation, combined liver and kidney transplantation, anti-rejection special diseases increased 19 reimbursement drugs, anti-anemia drugs, systemic antiviral drugs.

What is a special disease in outpatient clinic?

The so-called outpatient special disease is for some diseases that require long-term outpatient treatment after surgery, which makes the outpatient medical expenses higher. After completing the special disease filing procedure, the outpatient clinic can enjoy the proportion of reimbursement for hospitalization when the selected designated medical institution conducts relevant outpatient treatment, and only one deductible line is charged within 360 days, which greatly reduces the participation of special diseases. The burden of medical treatment for the outpatient service.

In recent years, Beijing has continuously improved the outpatient special disease policy, and the number of outpatient special diseases has increased from the first three to 11. This adjustment of medication reimbursement covers 9 of them, “multiple sclerosis” and “macular degeneration”. Intraocular injection treatment of these two outpatient special diseases drug reimbursement scope, no adjustment has been made yet, "multiple sclerosis" is included in the outpatient special disease reimbursement scope of the drug limit "recombinant human interferon beta-1b injection"; "macular degeneration eye "Intra-injection therapy" is limited to the scope of drug reimbursement for outpatient special diseases, "Compaq Xipu Ophthalmic Injection" and "Rayjuximab Injection".

It is reported that through the adjustment of outpatient special disease policy, the burden of medical expenses for major patients can be reduced by about 350 million yuan per year. Taking the trastuzumab (Herceptin), a targeted drug for the treatment of breast cancer, as an example, the personal burden of retirees after the reimbursement of outpatient special diseases was reduced to more than 10,000 yuan.

How to apply for outpatient special illness procedures?

The Beijing Medical Insurance Center stated that the current special disease filing process is simplified, and the insured persons suffering from special diseases only need to fill out the application form at the designated special disease hospital, and after signing by the doctor, they will go to the hospital medical insurance office to complete the filing formalities. After the completion of the record, you can go to the hospital for treatment, no need to go to the unit, the agency to go through the formalities.