Yangcheng Evening News all-media reporter Chen Hui reported: Medical institutions no longer need to worry about prescribing more drugs for national medical insurance negotiations, which will affect the assessment of medical institutions!
The reporter learned from the official website of the Guangdong Medical Security Bureau on the 9th that the bureau forwarded a notice on adapting to the normalization of national medical insurance negotiations and continuing to do a good job in the implementation of negotiated drugs, and clarified that the rational use of national medical insurance negotiated drugs is listed separately and is not included in the proportion of medical institutions. The range of assessment indicators such as average cost per time.
Why don’t the hospitals have to open some negotiated drugs?
The reporter learned in an interview that after the negotiation of medicines landed, some patients happily went to their designated medical institutions to prescribe medicines, but found that the medicine hospitals they wanted to prescribe might not be available.
A person in charge of the hospital explained to reporters that the hospital introduces drugs that are negotiated, mainly based on the characteristics of their own hospitals, and according to their own clinical needs, to introduce drugs that are in relatively large demand.
In this process, the hospital also needs to consider whether the negotiation drug will affect the proportion of drugs and the average cost per time and other hospital assessment indicators.
For example, there are some new anti-cancer drugs in the negotiation drugs. Although the price has dropped greatly, the unit price is still much higher than most commonly used drugs. If the hospital introduces too much, cancer patients will flood in to prescribe the drugs, which will inevitably lead to the proportion of hospital drugs. If the average cost per time increases, it may fail the relevant assessment.
List the negotiated drugs for reasonable use separately
The notice clearly stated that the medical institution is the first person responsible for negotiating the clinical rational use of drugs.
All medical insurance designated medical institutions shall implement the main responsibility of rational drug use, establish a linkage mechanism between hospital drug allocation and medical insurance drug catalogue adjustments, and allocate all negotiated drugs. The total amount of medical insurance shall not be restricted by the total amount of medical insurance, the limit on the number of drugs used by medical institutions, the proportion of medicines, and the average rate of each time. Expenses and other reasons affect the landing of negotiated drugs.
The medical insurance department must strictly implement the regional total budget, and include the rational allocation and use of negotiated drugs by designated medical institutions into the content of the agreement management, and link it with the annual assessment.
The health department should adjust and improve the evaluation mechanism for the use of drugs in medical institutions, list the negotiated drugs that are reasonably used, and exclude them from the scope of evaluation indicators that affect their implementation, such as the proportion of drugs in medical institutions and the average cost per second.
Timely update the scope of "dual channel" drugs
The notice also clarified that all localities should ensure medication use in accordance with the province's unified "dual-channel" drug coverage, and no separate "dual-channel" drug coverage should be formulated.
The Guangdong Provincial Medical Insurance Bureau will update the scope of "dual-channel" drugs in a timely manner based on the adjustment of the national medical insurance drug catalog.
Support qualified regions to improve the separate payment policy for negotiated drugs, and gradually include more negotiated drugs into the scope of separate payment.
All localities should establish a sound prescription circulation mechanism and improve the availability of medicines through "dual channels" and other channels. According to requirements, by the end of November 2021, at least one qualified "dual channel" retail pharmacy will be listed at the local level, and Able to provide corresponding drug supply guarantee services.