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 on 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 for controlling fees，Requirement of strict control and control auxiliary 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 to & ldquo; Shen medicine & rdquo;，Its applicable symptoms are wide、High dosage、Sales Ranking Leaders，Pharmaceuticals 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 becomes the so -called & ldquo; Key monitoring drug catalog & rdquo;。

 

  Medical Insurance Urgent:

 

  Auxiliary medication is imperative

 

  The deficit crisis of the medical insurance fund is imminent.

 

  According to the "Statistics of the Development Statistics of the 2015 Human Resources and Social Security Development of Human Resources and Social Security" 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, respectively。Compared with the expenditure growth rate of 19.6%in 2014 and the 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 stake betting appMy stake betting appCommittee proposed to improve medical insurance stable sustainable funding and reimbursement ratio adjustment mechanism，Research Policy for Payment of Payment of Medical Insurance of employees and retirees，It means a significant increase in medical costs、The slowdown in the growth rate of medical insurance funding and the aging of the population aging is superimposed.，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 rational medication to reduce the behavior of doctors' clinical efficacy of unclear drugs;，On the basis of ensuring that patients must use medicine，higher price、Drugs with uncertain effects are strictly monitored，Improve the use efficiency of the medical insurance fund。& ldquo; Auxiliary medication & rdquo;，Sales accounted for higher，The efficacy is not clear，It will inevitably be a key monitoring goal for medical insurance control。

 

  Because the basic medicine and medical insurance directory both include auxiliary 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 medication for the restrictions on the auxiliary medication in the medical insurance drug，Warning doctors not to expand the indications specified in the drug specifications 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，Doctors' excessive medicine 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，Public hospital reform pilot cities must list specific lists，Auxiliary、Nutritional high -priced drugs are unreasonable to implement key monitoring，It is expected that the momentum of unreasonable growth of medical expenses can be preliminarized。

 

  Classification dispute:

 

  Medical institutions and doctors control

 

  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 therapeutic medication。

 

  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 clear clinical treatment needs: non -steroidal anti -inflammatory drugs Stake Sports Bettingto stake online sports bettingbone metastasis、Soft tissue infiltration、Fasciitis and postoperative pain have obvious auxiliary treatment effects; glucocorticoids against acute nerve compression、Internal organs swelling pain、higher intracranial pressure increases, all have a good relief effect; tri -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 above 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 thirst for treatment、Patients fully trusting medical staff，Can have a good positive response 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，Whether the Chinese medicine injection is auxiliary drugs, especially the Chinese medicine injection, also causes widespread controversy。Doctor Western medicine uses Chinese medicine injection according to Western medicine theory may be auxiliary medication，But the use of traditional Chinese medicine injection in accordance with the theory of traditional Chinese medicine syndrome is the therapeutic product。

 

  Another example，Famous & ldquo; God Medicine & RDQUO; Aspirin。In 1898, it was treated with pain when it was listed、fever and inflammation，Usually used to relieve headaches、muscle pain、Toothache、Cold and joint swelling, etc.。1979 US FDA allowed it to prevent it as a cerebral thrombosis and send drugs，In 1985, the indications were expanded to prevent myocardial infarction and then sent。Later，With the accumulation of clinical data，Aspirin can be used to prevent temporary brain ischemia (TIA)、myocardial infarction、Atrial fibrillation、Artificial heart valve、Dynamic 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，Take aspirin every day can reduce or die in gastric cancer、The chance of bowel cancer, etc.。

 

  The situation of the two -year -on -two -year -old two -year -old two -year -old two -year -old two -year -old two -year -old is similar to Aspirin。Two -metal dual -dual -dual -胍 is mainly used for the treatment of type 2 diabetes and conventional treatment of polycystic ovary syndrome。After that, some studies have been discovered，Two -metal dual -胍 can delay aging，stake online sports bettingIt stake betting apphas also been 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 expanded indications to respiratory diseases for tuberculosis auxiliary treatment。It is expected that the dual -duplex will have more uses in the clinical application in the future。

 

  But，& ldquo; God Pharmaceutical & RDQUO; Rusupin's clinical use plan also controversy。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 in high risk people，For heart disease and stroke high -risk group，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.，but increased 54%intracranial hemorrhage risk。

 

  There is still controversy for the pharmaceutical medical community such as aspirin with a large number 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 auxiliary 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

 

  At present, there are usually three steps for medical institutions for supervision auxiliary medications:

 

  The first step is to monitor key drugs。The Ministry of Pharmacy according to the use of medicines，Visited the statistical doctor's order，After consulting clinical experts，Choose auxiliary medication that meets the monitoring conditions and uses the top volume in the doctor's order，The Medical Commission is discussed and 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 use of auxiliary medications、Use frequency、The amount is used as the main monitoring content。Statistical analysis of monitoring data results，Public announcement by the Discipline Inspection and Supervision Office every month。

 

No. 1  Three steps are fine considerations for regulatory behaviors。The percentage of the total amount of drugs in the auxiliary medication & rdquo; and & ldquo; amount & rdquo;，Accurately grasp the specific use of each auxiliary medication， Carry out the governance stake sports betting appMy stake betting appwork in a targeted manner。

 

  In June 2016 "Notice on Determining the Growth of Medical Expenses as soon as possible", although it did not mention the restrictions on the auxiliary medication，But it is required to establish a public hospital medical expense monitoring system，Monitoring results according to the expense index，Sorting the growth of 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 assistance for assistance。

 

  Payment of clinical paths and single disease payment 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，Eventually, it will regulate medical behavior、Standardize the auxiliary medication reasonably、Reduce cost、The role of improving medical quality。

 

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