高值医用耗材带量采购即将启动!所有公立医院集采行为受限

2019-08-02 白雪(整理) 健康界

继药品之后,高值医用耗材的全面治理行动终于拉开大幕。7月31日,业内期盼已久的《治理高值医用耗材改革方案》(下称《方案》)由国务院正式对外公布。对于文件中部署的4方面重点工作,在8月1日国务院举行的政策例行吹风会上,国家医疗保障局(下称国家医保局)副局长李滔用“促降价、防滥用、严监管、助发展”精准概括。虽短短12个字,但其背后诸多改革措施还亟待完善,且需要多部门共同发力。《方案》中,“要按照带量采

继药品之后,高值医用耗材的全面治理行动终于拉开大幕。

7月31日,业内期盼已久的《治理高值医用耗材改革方案》(下称《方案》)由国务院正式对外公布。对于文件中部署的4方面重点工作,在8月1日国务院举行的政策例行吹风会上,国家医疗保障局(下称国家医保局)副局长李滔用“促降价、防滥用、严监管、助发展”精准概括。虽短短12个字,但其背后诸多改革措施还亟待完善,且需要多部门共同发力。

《方案》中,“要按照带量采购、量价挂钩的方式来探索高值医用耗材的分类集中采购”这一普遍被医疗圈关心的话题,今后将如何实施?《方案》出台后,国家卫生健康委还将如何“打配合”以确保政策落地生效?李滔与国家卫生健康委医政医管局副局长焦雅辉分别作出解答。

国家医保局将建立医药集采平台,适用所有公立医疗机构

不难从《方案》中发现,完善分类集中采购办法是重点任务之一。对于临床用量较大、采购金额较高、临床使用较成熟、多家企业生产的高值医用耗材,《方案》提出按类别探索集中采购,鼓励医疗机构联合开展带量谈判采购,积极探索跨省联盟采购,由国家医保局单独负责。

“集中采购是降低高值医用耗材价格最有效的方法之一。”李滔在会上强调。据她介绍,国家医保局正在探索研究对高值医用耗材开展集中分类采购,重要涉及以下三个方面。

第一是建立医药集中采购平台。未来,于所有公立医疗机构来说,其高值医用耗材采购行为必须在平台上公开交易、阳光采购。

第二是探索适合高值医用耗材的集中带量采购办法。“和药品相比,高值医用耗材有它自身的特殊性。”李滔说道,“比如一部分高值医用耗材在使用时要提供一些增值服务,像手术跟台等,并且现在还缺乏质量和疗效的评价体系。”继而,国家医保局将在借鉴前期药品“4+7”经验的基础上,结合高值医用耗材特点,研究制定相应的集中带量采购方案。

第三是加强政策协同。李滔介绍,近期,安徽、江苏等省份正在国家医保局的指导下,着手开展骨科材料、支架等一些高值医用耗材的带量采购试点,且已取得不错效果。显然,在总结各地试点经验基础上,推动更大范围内的高值医用耗材带量采购,已被国家医保局提上日程。

国家卫生健康委已在确定整顿范围,且会加大处理力度

不仅是国家医保局,《方案》在“负责单位”中还明确标出国家卫生健康委、国家药监局、财政部等多个牵头部门,足以看出国家想要联合多方整顿医用高值耗材的决心。为了切实提高患者的就医获得感,《方案》颁布后,国家卫生健康委将主要在四个方面、共18个字上发力。

一是要确定范围。事实上,高值耗材范围非常广,其品类也不像药品有非常系统的分类。焦雅辉表示,目前,国家卫生健康委按照《方案》要求,正在研究选出一些临床应用量较多、价格较高且占用资源较多的品类,作为这次专项整治的重点。

二是要纠。不难理解,“纠”主要是对于一些不合理的行为和现象加大纠正力度。“我们已牵头建立纠正医药购销领域和医疗服务中不正之风部际联席会议机制。“焦雅辉强调,”今年国家卫生健康委会把高值医用耗材的专项整治,纳入到纠风的重点工作范围,加大不合理应用行为的治理,对违反包括行风规定‘九不准’的行为,加大整治和处理力度。”

三是要建,包括建立一系列规范管理的规章制度。今年6月,《医疗机构医用耗材管理办法(实行)》印发,其中明确对医疗机构从采购、遴选到使用、监控进行全流程管理。在此基础之上,国家卫生健康委将从技术层面突破,进一步修订和完善相关的临床路径、诊疗规范、诊疗指南,加强质控工作。通过质控工作,国家卫生健康委也将对重点医疗技术和医疗行为加强监控,监控范围包括心血管介入科和骨科。

四是要配合。“通过综合措施从根本上解决高值医用耗材合理应用的问题,国家卫生健康委将积极配合相关部门,把改革举措很好地落地。”焦雅辉强调。

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    2019-08-31 xsm929
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    2019-08-04 wolongzxh

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