沈阳市谈判药品纳入医保的实践管理探究  

Practice of adding government-negotiated drugs to the catalog of medicines covered by the medical insurance in Shenyang

作　　者：马冀 张欣[1] 罗蓟[1] Ma Ji;Zhang Xin;Luo Ji(The First Hospital of China Medical University,Shenyang 110000,Liaoning Province,China)

机构地区：[1]中国医科大学附属第一医院,沈阳110000

出　　处：《中国医疗管理科学》2021年第3期85-89,共5页Chinese Journal Of Medical Management Sciences

摘　　要：目的分析沈阳市谈判药品纳入医保范围后的实施现状,为进一步完善谈判药品医保政策的持续推进提供参考。方法总结并分析沈阳市谈判药品报销政策、管理方式及存在的问题。结果沈阳市谈判药品纳入医保切实缓解了恶性肿瘤患者的经济负担,通过加强谈判药品医保政策宣传及临床药师对谈判药品处方的管控,沈阳市谈判药品政策得以顺利落实。结论需要将更多医院纳入谈判药品定点医院,通过加强监管发挥定点药店的作用;未来统一谈判药品报销政策、加强对住院使用谈判药品的政策支持、将更多的谈判药品纳入医保目录以及合理平衡谈判药品纳入带量采购造成的矛盾是沈阳市谈判药品政策改进的方向。Objective To analyze the current implementation of adding the government-negotiated drugs into the medical insurance coverage in Shenyang,and provide reference for further improvement of medical insurance policy related to governmentnegotiated drugs.Methods The drug reimbursement policies,management mode and existing problems were introduced and analyzed.Results The inclusion of negotiated drugs into medical insurance in Shenyang has effectively decreased the economic burden of patients with malignant tumors.By strengthening the publicity of negotiated drugs and medical insurance policies,improving the management and control of negotiated drug prescriptions by clinical pharmacists,the negotiated drug policy has put into practice successfully in Shenyang.Conclusion More hospitals need to be included as designated hospitals to use negotiated drugs and supervision of the role of designated pharmacies should be strengthened;in the future,reimbursement policy for the negotiated-drugs should be unified,policy support for inpatient use of the negotiated drugs should be enhanced,adding more negotiated drugs into the catalog of medicine covered by the medical insurance and balancing contradictions caused by bulk government purchase.

关 键 词：谈判药品 医疗保险管理 政策 沈阳市 

分 类 号：R194[医药卫生—卫生事业管理]