国家及地方医保目录对肠外肠内营养药品管理的对比分析  

Management comparisons of parenteral and enteral nutrition medications in national and local drug reimbursement policy in China

作　　者：赵彬[1] 周鹏[2] 梅丹[1] ZHAO Bin;ZHOU Peng;MEI Dan(Department of Pharmacy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pharmacy,Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]中国医学科学院北京协和医院药剂科,北京100730 [2]昆明医科大学第二附属医院药学部,昆明650101

出　　处：《临床药物治疗杂志》2019年第9期28-32,共5页Clinical Medication Journal

摘　　要：目的为肠外肠内营养药品的遴选及管理提供参考。方法比较2009版、2017版国家及各地医保目录中营养药品的收载情况,并对其进行统计分析。结果2009版国家医保目录收录17种肠外营养药品和5种肠内营养药品,其中1种药品类别为甲类,其余均为乙类。2017版国家医保目录增加了小儿复方氨基酸(18AA-Ⅰ、18AA-Ⅱ)和结构脂肪乳(C6-24),甲类药品较2009版增加1种;2017版国家医保目录进一步明确了营养药品支付限定范围和肠内营养药品品种。2017版各地医保目录中,广西收录肠外营养品种最多(26种),宁夏、江西、广西、青海收录肠内营养品种最多(8种);北京医保类别为甲类的品种最多(16种)。结论2017版医保目录较2009版更加细化、具体,具有较好的政策导向和临床实用性。各地医保药品目录、报销类型及支付限定范围不尽相同。Objective:To provide reference for the selection and management of parenteral and enteral nutrition medications.Methods:The contents of parenteral and enteral nutrition medications in the 2009 and 2017 national and local medical insurance directories were compared and statistically analyzed.Results:The 2009 national edition of drug reimbursement list included 17 varieties of parenteral nutrition and 5 varieties of enteral nutrition,one of which was Class A and the rest were Class B.2017 national edition of drug reimbursement list increased the children’s compound amino acids(18 AA-Ⅰ,18 AA-Ⅱ) and structured fatty emulsion(C6-24),and the number of Class A medicines increased by one than 2009 edition.More clear nutritional drug payment indications and enteral nutrition medications varieties were indicated in 2017 edition.The numbers of varieties in provinces of drug reimbursement list were different.Guangxi contained the most varieties of parenteral nutrition(26 species).Ningxia,Jiangxi,Guangxi,and Qinghai had the most varieties of enteral nutrition(8 species) in the drug reimbursement list.Beijing had the most varieties of Class A nutritional medicines(16 species).Conclusion:National drug reimbursement list of 2017 is more detailed and specific than 2009 edition,and it has better policy guidance and clinical practicability.Drug reimbursement list,reimbursement ratio and limits of payments in various provinces are different.

关 键 词：肠外营养 肠内营养 医保药品目录 

分 类 号：R459.3[医药卫生—治疗学] R591[医药卫生—临床医学]