Although & ldquo; Auxiliary medication catalog & rdquo;，But the guidelines for the Guide of the Guide at the national level，Monitoring of auxiliary drugs is bound to be nationwide。The "Notice My stake betting appon Determining the Growth of Medical Expenses as soon as possible" issued by the National Health and Family Planning Commission on June 20, 2016 can be described as a key guidance，Requires strict control and control My stake betting appauxiliary medication，Tquiring related measures。Among them, the goals at the end of 2017 & mdash; & mdash; national medical expenses increased to less than 10%。

 

  Auxiliary medication was demonized by the demon to & ldquo; Shen medicine & rdquo;，Its applicable symptoms are wide、High dosage、Sales Ranking Leaders，Drugs that have become key monitoring in the drug control policy。Facts，When the industry is still controversial for the definition of auxiliary medications，Medical institutions have begun to introduce various management measures for the monitoring of assistive medications。Future，& ldquo; Auxiliary medication catalog & rdquo; or become the so -called & ldquo; Key monitoring drug catalog & rdquo;。

 

  Medical Insurance Express: Auxiliary medication is imperative

 

  The deficit crisis of the medical insurance fund is imminent.

 

  According to the "Statistics of the Development Statistics of Human Resources and Social Security in 2015" released by the Ministry of Human Resources and Social Security，Total income of urban basic medical insurance funds throughout the year 11,19.3 billion yuan，expenditure 9,31.2 billion yuan，increased by 15.5%and 14.5% from the previous year。Compared to the 2014 expenditure growth rate of 19.6%and income growth rate of 17.4%，The expenditure growth rate in 2015 was finally lower than the income growth rate。

 

  Previous data pointed out，In 2014, there were 185 urban employee medical insurance funds in China in my country.。The Fifth Plenary Session of the Eighteenth Central Committee of the Eighteenth Central Committee proposed to improve medical insurance stable sustainable funding stake online sports bettingstake betting appand reimbursement ratio adjustment mechanism，Research to implement the policy of implementing employees' retirees for medical insurance payment and insurance，It means a significant increase in medical expenses、Under the effect of slowing down the growth rate of medical insurance funding and aging population aging，Medical Insurance Fund is about to carry it。

 

  The pressure of urgency of the medical insurance fund，Promote the Health and Family Planning Commission through guiding doctors 'clinical and reasonable medication to reduce the behavior of doctors' clinical efficacy and unclear drugs;，On the basis of ensuring that patients must use medicine，higher price、Drugs with inaccurate efficacy are strictly monitored，Improve the use efficiency of the medical insurance fund。& ldquo; Auxiliary medication & rdquo;，Sales accounted for higher，The curative effect is not clear，It will inevitably be the key monitoring target of medical insurance fees。

 

  Because the basic medicine and medical insurance directory both include My stake betting appauxiliary medication，The Ministry of Human Resources and Social Security will inevitably control whether the doctor is prescribed in accordance with the instructions，Is there any auxiliary medicine based on the restrictions on the auxiliary medication in the medical insurance medicine，Warning doctors must not expand the indications specified in the drug description at will、Extension of treatment、Add dose, etc.。Physician's medication exceeds the per capita cost of medical insurance，Medical Insurance Center refusal to pay，The behavior of the excessive prescription of the doctor will be limited。

 

  The "Notice of the General Office of the State Council on Deepening the Reform of the Medical and Health System in April 2016" issued by the State Council in April 2016，It is required that the pilot cities of public hospital reforms should list specific lists，Auxiliary、Unreasonable use of high -priced drugs such as nutritionality Implement key monitoring，It is expected that the momentum of unreasonable growth of medical expenses can be preliminarized。

 

  Disputes of classification: medication by medical institutions and doctors

 

  One of the controversy points for the auxiliary medication is，Drugs under different diseases and different use conditions，Its role and meaning are different，Some products are auxiliary in certain departments or disease treatment，The treatment of other diseases may be the treatment of clinical demand -type treatment。

 

  Some medicines in the auxiliary medication directory are therapeutic medications with clinical needs。For example, based on the anesthesia auxiliary medication mentioned in the "Principles of the Clinical Application of Anesthesia Drugs" released by the Ministry of Health in 2007，Some drugs have stake sports betting appclear clinical treatment needs: My stake betting appnon -sterite anti -inflammatory drugs to bone metastasis、Soft tissue infiltration、Fascia and postoperative pain has obvious auxiliary therapeutic effects; glucocorticoids against acute nerve compression、Internal organs swelling pain、High intracranial pressure increases, etc., all have a good relief effect; third -ring antidepressant drugs are the treatment of neuralgia、The ideal drug that improves depression and insomnia; pain caused by bone metastases，Except for radiation therapy and the aforementioned treatment，calcium calcium is the use of more effective drugs in recent years。

 

  In addition，The difference between the auxiliary medication and the placebo is also the main point of controversy。Take a placebo，For those desire for treatment、Patients fully trusting medical staff，Can have a good positive reaction in psychological，to improve the physiological state of the person，This reaction is called a placebo effect。Any drug can produce a placebo effect。Auxiliary medication is generally considered to be wrong or symptomatic.，The effect of treatment is not clear，Placement is usually safe and invalid，So is the auxiliary medication a placebo?

 

  Another，Chinese medicine, especially whether traditional Chinese medicine injection is auxiliary medication, also causes widespread controversy。Doctor Western Medicine uses Chinese medicine injection according to the theoretical application of Western medicine may be My stake betting appauxiliary medication，But the use of traditional Chinese medicine injection in accordance with the theory of traditional Chinese medicine syndrome is the healing product。

 

  Another example，Famous & ldquo; Shenyao & rdquo; aspirin。In 1898, it was treated with pain when it was listed、Heat and inflammation，Usually used to relieve headaches、muscle pain、Toothache、Cold and joint swelling, etc.。In 1979, the US FDA allowed it to prevent it as a cerebral thrombosis and send drugs，1985 indications expanded to prevent myocardial infarction before sending。Later，With the accumulation of clinical data，Aspirin can be used to prevent temporary brain ischemia (TIA)、myocardial infarction、Atrial fibrillation、Artificial heart valve、Early fistula or thrombosis after surgery，It can also be used to treat unstable angina pectoris。2014，British scientists evaluate all available evidence and draw conclusions，Taking aspirin every day can reduce or die in gastric cancer、The chance of bowel cancer, etc.。

 

  The two -year -old dual -dual -dual -two -year -old two -year -old two -year -old two -year -old two -year -old two -year -old。Two -metal doubles are mainly used for the treatment of type 2 diabetes and conventional treatment of polycystic ovary syndrome。I have discovered it since then，Two -metal dual -胍 My stake betting appcan delay aging，It has also Stake Sports Bettingbeen confirmed to reduce the risk of tumor risk in patients with diabetes，and can improve the symptoms of alcoholic fatty liver，Prevention and treatment of common blind disease uveitis，Reduce Parkinson's disease rate, etc.，Even expandable indications to respiratory diseases are used for tuberculosis assist therapy。It is expected that the dual -duplex will have more use in the clinical application in the future。

 

  But，& ldquo; God medicine & rdquo;。If you apply aspirin to prevent the first attack of heart disease or stroke? FDA recommends patients to take aspirin daily to help prevent the seizures of heart disease and stroke of high -risk people，For heart disease and stroke high -risk people，Have enough evidence to support the effectiveness of aspirin。but，A study in 2015 shows，One -tenth American patients are not suitable for accepting the first attack of the daily low -dose aspirin to prevent heart disease or stroke。Healthy people take aspirin daily & ldquo; disadvantages are greater than Yi & rdquo; aspirin can reduce the risk of major cardiovascular events by 18%，but increased 54%intracranial hemorrhage risk。

 

  There is still controversy for the pharmaceutical medical community such as aspirin with a large amount of clinical data，So for drugs with unclear clinical data，According to its unclear treatment effect, it is determined whether it is auxiliary or therapeutic drugs，It is never a simple matter。

 

  To sum up，It is difficult to define based on the My stake betting appauxiliary medication，Therefore, the final use right of the medication is still in the hands of medical institutions and prescription doctors，Determine the status of the drug through clinical needs。

 

  Regulatory method: Monitoring of Drugs for Big Data help

 

  At present, there are usually three steps for supervision assistance drugs for medical institutions:

 

  The first step is to monitor key drugs。The Ministry of Pharmacy is based on the use of drugs，Review of the statistical doctor's order，After consulting clinical experts，Choose auxiliary medication that meets the monitoring conditions and uses the top in the doctor's advice，Reporting the Medical Commission for discussion is determined as a key auxiliary medication for key monitoring。

 

  The second step is to comprehensively supervise the target personnel。Supervise the situation of the use of key monitoring auxiliary medications，Use the amount of auxiliary medication、Use frequency、amount as the main monitoring content。Statistical analysis of monitoring data results，Public announcement by the Discipline Inspection and Supervision Office every month。

 

  The third step is to carefully consider the regulatory behavior。The percentage of the total amount of drugs for the auxiliary medication & rdquo; and & ldquo; amount & rdquo;，Accurately grasp the specific use of each My stake betting appauxiliary medication， Carry out the governance work in a targeted manner。

 

  In June 2016 "Notice My stake betting appon Determining the Growth of Medical Costs as soon as possible", although it did not mention the restriction measures for assisting drugs，But it is required to establish a public hospital medical expense monitoring system，Monitoring results according to the expense index，Sort the increase in medical expenses in hospitals in the region，Regularly publicized sort results every year，Strengthen information disclosure and social supervision。It is expected that the establishment of the system will help monitor the use of auxiliary drugs。

 

  Payment of clinical paths and single -disease species is also a management method promoted by the Health and Family Planning Commission and the Human Resources and Social Security Department，Establish a set of standardized treatment models and treatment procedures through a certain disease，Methods to promote the treatment of tissue and disease management with evidence -based medical evidence and guidelines，Finally, it will regulate medical behavior、Standardized Auxiliary Drugs rationally use、Reduce cost、The role of improving medical quality。

 

  The country has established various databases in recent years，It is used to track and analyze the use of some products with particularly large medications and medical insurance drugs，This means that the effect of evaluating certain drugs through the analysis of big data is not far away。