基药高出市场价,整改!这省卫计委发文了

2018-04-19 于小渔 基层医师公社

甘肃省卫计委发文,解决基药价格高出市场价问题!

甘肃省卫计委发文,解决基药价格高出市场价问题!

基药政策本是为稳定基层药品价格市场,减轻群众医药费用负担的,但就目前来看,不少基层医生反映基层医疗机构所售的基药比药店的贵不少,患者们对此有诸多误会,这使得基层医生们百口莫辩。

这个问题,引起了甘肃省高度重视。4月18日,甘肃省卫计委发布“关于加强基层医疗机构药品供应保障及使用管理问题的通知”(以下简称《通知》),针对甘肃省委脱贫攻坚工作考核情况通报反馈中指出“乡村两级卫生室部分药品短缺、部分药品价格高于市场价以及药品过期”等问题,提出相关整改措施。

一放宽非基本药物使用比例

为进一步满足基层医疗机构药品采购需求和医联体快速发展以及各级医疗卫生机构之间的用药衔接,甘肃省经研究决定:提高基层医疗机构非基本药物使用“品种、金额”双控标准。

乡镇卫生院使用非基本药物品规比由不高于本医疗机构累计采购基本药物总品规的10%增加至20%,金额比由不高于本医疗机构累计采购基本药物总金额的20-30%增加至45%。

城市社区卫生服务中心非基本药物品规比由不高于本医疗机构累计采购基本药物总品规的10%增加至30%,金额比不高于本医疗机构累计采购基本药物总金额的20-30%增加至50%。以上品规或金额比中任意一项超过限定即限制采购。新的双控比例自2018年5月1日起执行并作为累计起始日。

二调整非基本药物使用范围

允许基层医疗机构选择使用的非基本药物包括:纳入《甘肃省城乡居民基本医疗保险诊疗项目目录(2017版)》和《甘肃省城镇职工基本医疗保险、工伤保险和生育保险药品目录(2017年版)》中的非基药品种,常用低价药品,2014年甘肃省基本药物集中招标中属基本药物品种非基药剂型和规格部分(目录二),原限定为县级以上医疗机构使用的基本药物(简称为“原限用基药”),非医保报销药品。即省级药品集中采购平台、药品阳光采购平台中标(挂网)的所有药品。

此次调整大大放宽了非基本药物的使用范围,基层医生们在开药时不再束手束脚,“少药”问题得以缓解。

三非基本药物使用原则:临床确需原则

虽然比例和范围放宽了,但非基本药物的使用是需要遵循一定原则的。

《通知》规定,应严格按照临床确需、安全有效、剂型适宜,价格合理的原则选择使用非基本药物。基层医疗机构应按照基本药物、常用低价药品、报销药品、非报销药品的顺序选择使用。

基层医疗机构应优先采购使用通过质量疗效一致性评价的仿制药替代原研药,多选择使用常用低价药品,严控非基本药物金额比。严禁滥用损坏患者利益或增加患者负担以及限制使用的非治疗性辅助用药。

另外,基层医疗机构按比例使用的非基本药物,全部实行零差率销售(包括未纳入医保支付的自费药品)。

可见,非基本药物的使用在价格、顺序、比例上都做了严格控制,以保证基层药品市场的稳定性。

部分基药高于市场价现象颇多 急需整改

基药政策实施后,由于过程中存在的基药目录药品匮乏 、厂家配送不及时、垄断下药价虚高等等中间环节问题,使得部分基药价格高于市场价,且基层药品不全,老百姓常埋怨没药,基层医生被这些问题困扰已久,这与基药政策的制定初衷是相违背的,因此急需做出整改。

为此, 2014年国家卫计委印发了《关于进一步加强基层医疗卫生机构药品配备使用管理工作的意见》,规定“城市社区卫生服务中心和农村乡镇卫生院可暂按省级卫生计生行政部门规定和要求,从医保(新农合)药品报销目录中,配备使用一定数量或比例的药品”。

此后,各省陆续出台相关政策,支持基层医疗机构采购非基药。2017年6月30日,广东省更是对基药目录彻底放开,不再对各级医疗机构配备使用国家基本药物(含省增补基本药物,以下统称基本药物)的品规数量和金额比例作具体要求,基层医疗机构可以根据需求从医保目录里自行配备药物使用。

其他地方虽然没有广东省放开的这么彻底,但也都多多少少地开始放宽非基药的使用比例和范围,以缓解基层用药问题。

现在,已经有省级政府开始着手解决基药价格高于市场价的问题了,这让全国备受基药目录限制的基层医生们看到了希望,期待能有更多省份重视和加大力度解决基层用药问题!

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    2018-04-20 周周人

    学习.

    0

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    2018-04-20 871538379

    广东总是走在前沿

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1354458, encodeId=db2e13544589d, content=<a href='/topic/show?id=4d723669096' target=_blank style='color:#2F92EE;'>#卫计委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36690, encryptionId=4d723669096, topicName=卫计委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Apr 21 14:41:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307578, encodeId=d0bc30e57893, content=学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcVAydhtcpjiaxLrZD7Eb5YnKPgf7ypGpfyl7FflFyAenvQLbib6T0LPXIhXo9SPNPXYYFFJbEgykztwJ0HQ61I3F9GxIVKWsgQ/0, createdBy=f38d2052407, createdName=周周人, createdTime=Fri Apr 20 10:39:25 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307554, encodeId=149230e55434, content=广东总是走在前沿, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri Apr 20 08:23:01 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307529, encodeId=d72e30e52973, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Apr 20 07:32:50 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307456, encodeId=9dd430e456db, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Fri Apr 20 05:56:08 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307444, encodeId=0ce630e444f4, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Apr 20 05:53:35 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307399, encodeId=36be30e399f7, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Thu Apr 19 23:46:32 CST 2018, time=2018-04-19, status=1, ipAttribution=)]
    2018-04-20 明月清辉

    谢谢分享.学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1354458, encodeId=db2e13544589d, content=<a href='/topic/show?id=4d723669096' target=_blank style='color:#2F92EE;'>#卫计委#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36690, encryptionId=4d723669096, topicName=卫计委)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Apr 21 14:41:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307578, encodeId=d0bc30e57893, content=学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcVAydhtcpjiaxLrZD7Eb5YnKPgf7ypGpfyl7FflFyAenvQLbib6T0LPXIhXo9SPNPXYYFFJbEgykztwJ0HQ61I3F9GxIVKWsgQ/0, createdBy=f38d2052407, createdName=周周人, createdTime=Fri Apr 20 10:39:25 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307554, encodeId=149230e55434, content=广东总是走在前沿, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35e76003, createdName=871538379, createdTime=Fri Apr 20 08:23:01 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307529, encodeId=d72e30e52973, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Fri Apr 20 07:32:50 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307456, encodeId=9dd430e456db, content=了解了解.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Fri Apr 20 05:56:08 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307444, encodeId=0ce630e444f4, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Apr 20 05:53:35 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307399, encodeId=36be30e399f7, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Thu Apr 19 23:46:32 CST 2018, time=2018-04-19, status=1, ipAttribution=)]
    2018-04-20 1dd8c52fm63(暂无匿称)

    了解了解.继续关注

    0

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    2018-04-20 飛歌

    厉害了我的哥

    0

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    2018-04-19 清风拂面

    谢谢分享学习

    0

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