What are the characteristics of the new version of the directory? What does it affect the insured? Yao Hong, director of the Medical Insurance Department of the Ministry of Human Resources and Social Security。
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Added 260 drugs in total;
Chronic disease medication In principle, no one can be used to be transferred
Compared with the 2004 version of the drug directory，The new version of "Drug Catalog" adds 260 drugs，increase to 13.7%，Among them, category A medicine increased 53，increase to 11.8%。The added medicines are all the precise effects of clinical verification in recent years、New medicine with high safety。Ethnic medicine and Chinese medicine tablets will continue to be implemented in accordance with existing policies。
Class A medicine began to use use in December this year。and category B medicine，Adjustment of all places。According to regulations，Provincial provinces (district、City) The local basic medical insurance should be released before March 31, 2010、Work Injury Insurance and Maternity Insurance Drug Catalog。At that time，The insured can use the new version of the drug directory。Yao Hong said: "The update of the computer information management system drug database may not be completed on June 30, 2010。But，Databases in various places may not be updated with the cost of refusing to pay for participants。”
At the same time，This adjustment has also been transferred out of the original directory that can be replaced by better drugs or unpopular medicines。"Let's consider，The original reimbursement medicine suddenly said that it may not be possible。So we collected the database of medication，Chronic disease medicine only needs to use，In principle, it is retained。”
Why do you need to increase the restrictions on medication?
Drug restrictions increased 12 percentage points，and propose the principle of antibiotic grading，To avoid drug abuse
Introduction to Yao Hong，New version of "Drug Catalog" western medicine and Zhongcheng medicine varieties a total of 2151，Among them, 843 restrictions are made，Including insurance types、Medical institution level、Indications limit, etc.，12 percentage points from the 2004 version of the "Drug Catalog"。
The Ministry of Human Resources and Social Affairs clearly proposed，All places must strengthen the management of fixed -point medical institutions and retail pharmacies to use the "Drug Catalog" management，For each minimal classification of similar drugs, in principle, it should not be used in principle。Positive Chinese medicine for diagnosis of western medicine、Postering unreasonable medication such as western medicine such as Chinese medicine、Repeated medication and drug abuse, etc.，To clarify the corresponding punishment measures and incorporate it into the fixed -point agreement management。To take measures to encourage physicians to follow Class A and then Class B、Injecting preparations after taking the first oral preparation、First -time release dosage form and then relieve (control) release dosage form and other principles. Select medicine，Encourage pharmacists to choose the same variety of dosage types with low -cost medicines when preparing drugs。
"We discovered when we conducted a survey of 150,000 people，‘San Su, One Soup’ is the most evil。"Yao Hong said，"‘ San Sua ’refers to antibiotics、Abuse of vitamins and hormones，‘Yitang’ refer to the situation where people see people in some places。So this time we manage it according to antibiotics，Put forward the grading principle，Clarified which antibiotics can be used when other antibiotics are ineffective; which antibiotics can only be used when bacterial support; which antibiotics can only be used under the guidance of acute or severe or higher doctors or hospitals。”
Yao Hong said，The Ministry of Human Resources and Social Affairs will be with relevant ministries and commissions，Make full use of the basic data of the drug use，Analysis of various drugs and expenditure expenditures of various drugs and insurance expenses，Enhanced the amount of large amount、Key monitoring of expenditure expenditure Multi -drug，There are key points、Take supervision measures in a targeted manner，Control of adverse behaviors such as drug abuse in medical processes。
Can the medicines in "Drug Catalog" be reimbursed?
Category A is a affordable drug, which can be reimbursed 100%;
Class B drug reimbursement ratio is set by themselves
In the medical insurance drug directory，Class A directory is a guarantee directory，The medicines where are 100%reimbursement。Yao Hong introduced: "The principle of determination of the category A drug directory is that the poorest county in the country can also be used。We guarantee that there are medicines in each minimal classification directory，But the choice is cheaper。"It is understood，Therapeutic drugs in "National Basic Drug Catalog"，All included in the new version of "Drug Catalog" category A medicine。
Pharmaceuticals in Class B directory，15%of the right to adjust。Yao Hong said: "The most important thing is to consider different medication habits in various places，For example, common wind and cold in the north，while the south is more windy and cold。""，Each region can also be able to bear the ability of the fund，Set a certain personal self -payment ratio for category B medicine，Payment in accordance with the provisions of basic medical insurance。That is to say，Class B drugs may not be able to reimburse 100%。
It is worth noting that it is，Work Injury Insurance、The catalog of maternity insurance drugs is regardless of class A and B，All can be reimbursed。Chinese medicine drinking tablets adopt the exclusion method，Pharmaceuticals stipulated that the fund does not pay fees。For the anti -AID virus drugs provided by the country for free and anti -tuberculosis drugs involved in the national basic public health project、Anti -malaria drugs and anti -blood absorbing diseases，The insured person used and conforms to the scope of public health payment，Basic medical insurance、Work Injury Insurance and Maternity Insurance Fund will not be paid; not in line with the scope of public health payment，Basic medical insurance、Work Injury Insurance and Maternity Insurance Fund pays in accordance with regulations。
Pharmaceuticals other than Drug Catalog，Is it not reimbursed if it is not given?
Special diseases and emergency rescue drugs can also be reimbursed;
It will also determine the drug category of negotiating access
"Orphan disease" refers to a special disease that is only one million or 10 million in the disease of the disease。According to regulations，Pharmaceuticals outside the catalog for clinical emergency rescue and special disease treatment，The application system of a fixed -point medical institution will be established and clarify the corresponding review and management measures。That is to say，If it is declared and passed the review，This kind of medicine can also be reimbursed。
Another，The "Drug Catalog" released this time does not include drugs that are negotiated。Yao Hong introduced: "Our ministry will study the relevant rules of the drug negotiation mechanism with relevant departments， Establish a corresponding working organization system，Determine the category of drug access for negotiation，Organize social insurance agencies and drug suppliers，It has a significant innovative value for clinical efficacy but expensive to negotiate some pharmaceutical varieties and their expense payment methods and standards for the fund.。”
