Recently, the relevant departments have solicited opinions on the adjustment of the national essential medicine system for people in the industry. The Exposure Draft has more detailed requirements on the adjustment of the essential drug list, the use of essential drugs in medical institutions, and the procurement and supply of essential drugs, and clearly emphasizes that it can be administered orally without intramuscular injection and can be intramuscularly injected without infusion.
In the adjustment of the essential drug list, the draft for comment has been proposed to be adjusted in principle for three years. For new drugs that have been approved for listing and have a significantly improved efficacy compared with the listed drugs, and reasonable prices, the transfer procedure can be initiated at the appropriate time.
The above-mentioned people introduced that they should pay equal attention to both transfer and transfer, and prioritize the transfer of generic drugs through consistency evaluation, which can cure or effectively improve the quality of life, cost-effectiveness and other effective drugs. At the same time, drugs that have serious adverse reactions and are not suitable for further use as essential drugs, which can be replaced by higher-quality varieties with risk-benefit ratio or cost-effectiveness, are the key points.
“The most important point of this policy is to highlight the clinical value of the drug.” An industry source said that compared with the previous two rounds of institutional adjustments, the system requires basic drugs to be the first choice for public hospitals.
According to the opinion draft, the hospital information system should label the drugs in the essential drug list, prompting the doctor to give priority. At the same time, the prescription review should focus on the use of essential drugs, and notify the basic drugs without proper reasons.
For reasons that emphasize basic medication, the above-mentioned people said that the basic medication can cover 95% of the disease. “Primary care is the basic guarantee, and its curative effect is exact, and it has a high cost performance. ‘The drug control fee’ is an international practice.”
For this reason, the opinion draft proposes that in the future, the use of essential drugs will be linked to the funding of public hospital reform subsidies and the subsidies for the implementation of basic drug system subsidies at the grassroots level. At the same time, deepen the reform of medical insurance payment methods, give priority to the formulation of basic drug medical insurance payment standards, and establish incentive and restraint mechanisms for balance retention and reasonable over-expenditure. The basic drugs used in clinical diagnosis and treatment, after the relevant procedures of the medical insurance department, are all included in the basic medical insurance drug reimbursement catalogue, and the reimbursement rate is significantly higher than that of non-essential drugs. For the national immunization program vaccines and the basic drugs for major public health prevention and control such as anti-AIDS, tuberculosis and parasitic diseases, we will continue to increase financial support at all levels and provide them to the public free of charge.
"Basic medications for chronic diseases such as hypertension, diabetes, and severe mental disorders may be fully guaranteed or fully reimbursed by medical insurance," said the source. Previously, the “Basic Health Care and Health Promotion Law Draft” proposed that all essential drugs should be included in the basic medical insurance drug reimbursement catalogue, and the most favorable reimbursement policy should be implemented.
Previously, China had piloted the full guarantee of essential drugs in 13 provinces and 24 cities (counties) in Shanghai, Jiangsu, Guangdong, Zhejiang and Shandong. In response to the needs of some chronic patient groups, basic medicines are provided as free public goods to residents in the form of full guarantees, so that essential medicines are fair and accessible to all.
For example, the “Notice on the Free Use of Essential Drugs in the General Out-patient Co-ordination of General Basic Medical Insurance for Workers” issued by Jinan proposes that the essential drugs for the treatment of hypertension (captopril tablets, nifedipine tablets, aspirin enteric-coated tablets), The basic medicine for treating diabetes (metformin tablets) and the basic medicine for treating coronary heart disease (isosorbide dinitrate tablets) each determine a product specification, which is paid in full by the employee medical insurance fund.
The "Notice on the Implementation of Family Doctor Contracting Service to Provide Free Treatment of Essential Drugs for Chronic Diseases" issued by the Qingdao Municipal Health Planning Commission proposes that family doctors provide free basic medicines for treating hypertension, hyperlipidemia and diabetes to contracted residents.
In addition, regarding the procurement and distribution mechanism of essential drugs, national procurement, centralized bidding, and sunshine hanging nets are used to classify purchases and guide the formation of reasonable prices. We will do a good job in grading medical institutions to promote drug use, promote the linkage of medical institutions, medical communities and public medical institutions in the city (county), collect and purchase, and harmonize the varieties, dosage forms and specifications of essential drug purchases to meet the needs of the masses. Encourage specialized hospitals such as cancer and children to carry out joint procurement of roads and regions.
It is worth mentioning that Fujian has previously made dynamic adjustments to the purchase of drugs combined with limited price sunshine. Among them, the new application network belongs to the competition group products in the joint mining catalogue, and the production enterprises (including the first-time application enterprise and the network-hanging enterprise) agree to abide by the relevant regulations of Fujian Province, which are 10% lower than the maximum sales price limit of the group products in the catalogue. (At the same time, promise the lowest price in the country) and the lowest actual transaction price of this group, the principle of “depreciation” determines the final price of the net to be connected to the net; the products that have been linked have passed the evaluation of the quality and efficacy of the generic drug, and are transferred from the competition group according to the application of the enterprise. Non-competition group.
The new administration is being implemented, and it is more necessary to increase enforcement than in the past. In the second quarter of this year, Hunan Province conducted a comprehensive assessment of the implementation of the 2017 basic drug system. It was found that there was still an imbalance in the development of the basic drug system in the province. In a few areas, the allocation of basic drug subsidies was unreasonable, and the funds were not allocated. Timely; there are gaps in the management of grassroots pharmacy in some areas, and the situation of irrational drug use is prominent; the implementation of the basic drug system in some village clinics is not satisfactory.