Recently，China Government Network issued the "National Medical Security Bureau about incorporating 17 kinds of anticancer drugs into the national basic medical insurance、Notice of Class B of Work Injury Insurance and Maternity Insurance Drug Catalog "(hereinafter referred to as" Notice ")，officially incorporated 17 kinds of drugs such as Azatoside into the "National Basic Medical Insurance、Work Injury Insurance and Maternity Insurance Drug Catalog (2017 Edition) "category B，and determined the medical insurance payment standard。Provincial (district、City) The competent department of medical insurance shall not call the negotiating drugs out of the directory，You must not adjust the limited payment scope。It is currently not realized in a coordinated area for medical insurance integration in urban and rural residents，It is also necessary to put these drugs into the scope of new rural cooperative medical payment in accordance with regulations。
Medical Insurance Payment Standards must ensure execution before the end of November
"stake online sports bettingNotice" Stake Sports Bettingemphasizes，Payment standards specified in the column of "Medical Insurance Payment Standards" include all expenses paid by basic medical insurance funds and insured persons，Basic Medical Insurance Fund and insured personnel sharing the sharing ratio is determined by all coordinated areas。Payment standards stipulated in the stipulated validity period As of November 30, 2020，Adjust the relevant provisions of the medical insurance payment standard after the validity period expires。During the validity period，If there is a general name drug (generic drug), it is available，The National Medical Insurance Administration will adjust the payment standard of the drug according to the level of generic drug price level and notify it separately。If the actual price of the drug market appears is significantly lower than the current payment standard，The State Medical Insurance Administration will negotiate with the enterprise to re -develop payment standards and notice separately。
"Notice" Requirements，Provincial (district、City) The centralized procurement institution of the drug will publicize the drug on the provincial -level drug centralized procurement platform in accordance with the payment standards by the end of October 2018。Medical Insurance Economic Affairs Office to update the information system in a timely manner，Make sure to start execution before the end of November。
17 kinds of anticancer drugs incorporated into medical insurance
Compared with the 18 varieties list of the special negotiation scope of the 2018 anti -cancer drug medical insurance in 2018，"Medical Economic Daily" reporter discovered，Anticotinib for treating bone marrow fibrosis is not included in，Other 17 products enter the Category B directory of medical insurance。
Take Ositinib (product name: Tyrisa) as an example，It is a targeted medicine for treating non -small stake betting appcell Stake Sports Bettinglung cancer。The current price is expensive，Xinhua News Agency previously reported to point out，Tyrisha, which is 80mg × 30 tablets/box, is 51,000 yuan in Shanghai。This time the medical insurance payment standard regulations，This product is 510 yuan per medical insurance payment standard for this product.。
Nilotinib Capsules (product name: Dahina)，Suitable for the treatment of chronic leukemia，Especially for patients with drug resistance or tolerance, the treatment effect is more prominent。This medicine 0.2g × 120 capsule/box specifications on the Beijing Pharmaceutical Sunshine Purchasing Platform price is 35036.04 yuan，This specification product product medical insurance payment standard is 94.7 yuan/grain。
Hospital costs are excessive to give reasonable compensation, strengthen monitoring is the trend
"Notice" also mentioned，Each region should take effective measures to ensure the supply and reasonable use of negotiating drugs。Due to policy reasons such as negotiating drugs, the actual cost of the medical institution exceeded the total control indicators in 2018，Reasonable compensation when liquidation at the end of the year，and comprehensively consider the factors of the reasonable use of negotiated drugs when formulating the total control indicators of 2019。At the same time，Strictly implement the scope of limited payment of negotiated drugs，Strengthen the management，High cost to the right、Drugs with large dosage must be subject to key monitoring and analysis，Ensure the safety of the medical insurance fund。There are major problems encountered during execution，Timely feedback to the State Medical Insurance Bureau。
Dynamic monitoring of anti -tumor drug development will also be the focus of medical insurance control。Previous Health and Health Commission Medical and Health Management Bureau released the "Principles stake online sports bettingof My stake betting appthe New Anti -tumor Drugs Drugs (2018 Edition)" (hereinafter referred to as "Guidance Principles")，Divided anti -tumor drugs into ordinary use level、Limited use level。Ordinary use level refers to the basic medicine、Medical Insurance Catalog and National Negotiation Variety，The restricted use level is anti -tumor drugs that are not included in the above range，Doctors who need to be sub -high -level or above in this type of medicine can be prescribed。17 anti -cancer drugs entering the medical insurance directory this time，List of ordinary use level。
The "Guidance Principles" also mentioned that medical institutions should regularly confront the basic situation of clinical application of tumor drugs for monitoring。Medical institutions at all levels should establish a clinical application management system for anti -tumor drugs，Formulate the clinical application management system that meets the actual situation of the institution，Clarify the person in charge of the medical institution and various functional departments、The responsibility of the person in charge of the clinical department in the clinical application management of anti -tumor drugs，and incorporate it into the hospital review and evaluation、Evaluation indicators for management and medical quality evaluation，Ensure that the clinical application of anti -tumor drug clinical application is effectively implemented。
Medical institutions shall be in accordance with the requirements of the guidance principle，Determine the variety of anti -tumor drug supply directory、Quantity of product regulations。The selection of anti -tumor drug purchase varieties shall be based on clinical reasonable needs，Prefer to select "National Basic Drug Catalog"、National negotiation varieties、High -level evidence -based medical evidence and the recommended varieties My stake betting apprecommended My stake betting appby authoritative guidelines。Periodic assessment of the supply directory of tumor drug supply should，Timely retreat existing safety hazards、Variety or product regulations with frequent cost -effective and illegal use。Temporary purchase of anti -tumor drug supply directory should have sufficient reasons，and record according to the relevant system and procedures。
In terms of the specific content of monitoring，"Guidance Principles" also clearly stipulates，Courtyard、Directly monitoring of the two levels of subjects includes: (1) the use rate of anti -tumor drugs and restrictions on the use of anti -tumor drugs in hospitalization; Variety、Dosage type、Specification、Use amount、Use amount，Anti -tumor drugs account for the total cost of drugs; (4) the implementation of the hierarchical management system;。
