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《关于建立完善国家医保谈判药品“双通道”管理机制的指导意见》
政策解读
日期:2022-05-11 08:31 来源:医保局网站 浏览次数: 视力保护色:

  一、制定出台《指导意见》的背景

  GUOJIAYIBAOJUCHENGLIYILAI,DALITUIJINYAOPINMULUGUANLIGAIGE,JIANLIJIANQUANMULUDONGTAIDIAOZHENGJIZHI,YIBAOYAOPINMULUDIAOZHENGZHOUQICONGYUANLAIDEZUIZHANG8NIANDAFUSUODUANZHIMEINIAN1CI,SHENZHIYIXIEXINYAOSHANGSHIDANGNIANJIUBEINARUYIBAOYAOPINMULU。YIBAOMULUZHUNRUPINLVDAFUJIAKUAI,ERYILIAOJIGOUYAOPINZHUNRUDEMOSHISHANGWEIMINGXIANBIANHUA。GAIGEQIAN,DABUFENYAOPINSHANGSHIHOUDOUSHI“XIANJINYIYUAN,HOUJINYIBAO”,YAOPINYOUZUGOUDESHIJIANJINGLISHICHANGTUIGUANG、LINCHUANGSHIYONGJINGYANJILEI、LINCHUANGZHUANJIARENKE、GUANGFANSHIYONGZHEIYIGUOCHENG。GAIGEHOU,BIANCHENGLE“XIANJINYIBAO,ZAIJINYIYUAN”,DUIYILIAOJIGOUKUAISUZHUNRUHELINCHUANGYISHENGDUANQINEIGUANGFANSHIYONGTICHULEGENGGAODEYAOQIU。KEGUANSHANGJIANG,BUFENTANPANYAOPINCHUXIAN“JINYUANNAN”XIANXIANG,ZAIYIDINGCHENGDUSHANGSHISHENHUAYIBAOYAOPINMULUGUANLIGAIGEDEJIEGUO。

  WEIPOJIE“JINYUANNAN”,NIJIANGDINGDIANLINGSHOUYAODIANNARUTANPANYAOPINGONGYINGBAOZHANGFANWEI,YUDINGDIANYILIAOJIGOUYIQI,XINGCHENGTANPANYAOPINBAOXIAODE“SHUANGTONGDAO”,NULITISHENGYAOPINKEJIXING。

  二、《指导意见》的主要内容

  ANZHAOYANGEGUANLI、BAOZHENGGONGYING、DAIYUSHIDU、GUIFANSHIYONG、QIANGHUAJIANGUANDESILU,《ZHIDAOYIJIAN》BAOHAN7FANGMIANDENEIRONG:YISHIFENLEIGUANLI,TISHENGGONGYINGBAOZHANGSHUIPING。DUITANPANYAOPINJINXINGFENLEIGUANLI,ZHONGDIANJIANGLINCHUANGJIAZHIGAO、XUQIUPOQIE、FEIYONGGAODEYAOPINNARU“SHUANGTONGDAO”GUANLI。ERSHIMINGQUEYAODIANLINXUANCHENGXU,DONGTAIDIAOZHENG。MINGQUEDINGDIANLINGSHOUYAODIANLINXUANDEYUANZEHECHENGXU,SHIDUJINGZHENG、YOUJINYOUCHU。SANSHIGUIFANSHIYONG,QUEBAOANQUAN。ZHUYAOCONGQUEBAOYAOPINZHILIANGANQUAN、LINCHUANGHELISHIYONGDENGJIAODUTICHUYAOQIU。SISHIWANSHANZHIFUZHENGCE,QUEBAOSHIYIDEBAOZHANGSHUIPING。QUEBAOYAOPINDEDAOHELIZHIFU,JIANQINGHUANZHEFUDAN。WUSHIYOUHUAJINGBANGUANLIFUWU,TISHENGQUNZHONGHUODEGAN。TUIDONG“SHUANGTONGDAO”YAOPINZHIJIEJIESUANDENGZHENGCECUOSHI,WEIHUANZHETIGONGBIANJIEFUWU。LIUSHIQIANGHUAJIANGUAN、FANGFANFENGXIAN。JIAQIANGYONGYAOQUANGUOCHENGJIANGUAN,FANGFANJIJINFENGXIAN,QUEBAOJIJINANQUAN。QISHIJIAQIANGLINGDAO,ZHASHITUIJIN。“SHUANGTONGDAO”SHIYIXIANGQUANXINDEZHENGCEANPAI,SHEJIBAOXIAOQUDAOHEZHENGCEDEDIAOZHENG,XUYAOJIAQIANGZUZHILINGDAO,BINGZUOHAOYUXIANGGUANZHENGCEDEXIANJIE。

  三、确定“双通道”管理药品范围时考虑的主要因素

  NARU“SHUANGTONGDAO”GUANLIYAOPINFANWEI,YUANZESHANGYOUSHENGJIYIBAOXINGZHENGBUMENANCHENGXUQUEDING。YAOZONGHEKAOLVBENDIQUJINGJIFAZHANSHUIPING、YIBAOJIJINCHENGSHOUNENGLIHEHUANZHEYONGYAOXUQIUDENGFANGMIANDEYINSU,DUITANPANYAOPINSHISHIFENLEIGUANLI,DUIYULINCHUANGJIAZHIGAO、HUANZHEJIXU、TIDAIXINGBUGAODEPINZHONG,YAOJISHINARU“SHUANGTONGDAO”YAOPINGUANLIFANWEI。“SHUANGTONGDAO”YAOPINKEGENJUQINGKUANGBIANHUADINGQIJINXINGDIAOZHENG。

  四、“双通道”管理机制的建立,对定点零售药店提出的新要求

  YUPUTONGDINGDIANLINGSHOUYAODIANXIANGBI,DUIFUHENARU“SHUANGTONGDAO”GUANLIDEDINGDIANLINGSHOUYAODIANTICHULEGENGGAODEYAOQIU。YISHIXINXIHUAFANGMIAN。DINGDIANLINGSHOUYAODIANYAOYUYIBAOXINXIPINGTAI、DIANZICHUFANGLIUZHUANPINGTAIDENGDUIJIE,QUEBAOYAOPIN、YIBAOZHIFUDENGFANGMIANXINXIQUANMIAN、ZHUNQUE、JISHIGOUTONG。ERSHIYAOPINGUANLIFANGMIAN。BUFENTANPANYAOPINDUICHUCUNYOUTESHUYAOQIU,DINGDIANLINGSHOUYAODIANXUJIANLIFUHEYAOQIUDECHUCUN、PEISONGTIXI,QUEBAOYAOPINZHILIANGANQUAN。TONGSHI,PEIBEIZHUANYERENCAIDUIHUANZHEHELIYONGYAOJINXINGZHIDAO,QUEBAOLINCHUANGYONGYAOANQUAN。SANSHIYIBAOJIJINJIANGUANFANGMIAN。DINGDIANLINGSHOUYAODIANYINGCAIQUGENGJIAYANGEDECUOSHI,DUIHUANZHESHENFENJINXINGHESHI,QUEBAO“CHUFANGHUANZHE”HE“SHIJIYONGYAOHUANZHE”YIZHI,DUSAI“QIZHAPIANBAO”LOUDONG,QUEBAOJIJINANQUAN。

  五、双通道”管理机制建立后,在谈判药品的医保支付管理方面作出的调整

  (YI)TONGYIZHIFUZHENGCE

  DUIYUNARU“SHUANGTONGDAO”GUANLIDEYAOPIN,ZAIDINGDIANYILIAOJIGOUHEDINGDIANLINGSHOUYAODIANSHIXINGTONGYIDEZHIFUZHENGCE,BAOZHANGHUANZHEHELIDAIYU。DUISHIYONGZHOUQIJIAOZHANG、LIAOCHENGFEIYONGJIAOGAODETANPANYAOPIN,KETANSUOJIANLIDANDUDEYAOPINBAOZHANGJIZHI。GEDIYIBAOBUMENJIANGGENJUJIJINCHENGSHOUNENGLI、ZHUYUANBUCHANGSHUIPINGDENGQINGKUANG,QUEDINGSHIYIDEBAOZHANGSHUIPING。

  (ER)QIANGHUAJIJINJIANGUAN

  “SHUANGTONGDAO”JIZHIDEJIANLI,JIANGYUANLAIYAOPINYUANNEIGUANLIDEYIBUFENZHINENGZHUANYIZHIYUANWAI,GUANLIHUANJIEMINGXIANZENGDUO,DUIJIJINANQUANFENGXIANGUANKONGTICHULEXINDETIAOZHAN。YICHUFANGLIUZHUANZHONGXINWEIHEXIN,LIANTONGYIBAOJINGBANJIGOU、DINGDIANYILIAOJIGOU、DINGDIANLINGSHOUYAODIAN,LUOSHI“DINGJIGOU、DINGYISHI、KEZHUISU”DENGYAOQIU,SHIXIANHUANZHEYONGYAOXINGWEIQUANGUOCHENGJIANGUAN。WANSHANXIHUAYIBAOYONGYAOSHENHEGUIZE,YINRUZHINENGJIANKONG,YANLIDAJI“SHUANGTONGDAO”LINGYUTAOPIANQUYIBAOZIJINDEXINGWEI。JIAQIANG“SHUANGTONGDAO”YONGYAOFEIYONGHEJIJINZHICHUCHANGGUIFENXIHEJIANCE,JISHIDIAOZHENGWANSHANJIANGUANZHENGCECUOSHI,QUEBAOJIJINANQUAN。

  (SAN)YOUHUAJINGBANGUANLIFUWU

  “RANGXINXIDUOPAOLU,HUANZHESHAOPAOLU”,ZHENGHEJIBENYIBAO、DABINGBAOXIAN、YILIAOJIUZHUFUWU,DALITUIJIN“SHUANGTONGDAO”YIZHANSHIJIESUAN。ZAIYOUXIAOGUANKONGFENGXIANDEJICHUSHANG,TANSUOTUIJINJIANG“SHUANGTONGDAO”TANPANYAOPINNARUYIDIJIUYIZHIJIEJIESUANFANWEI。

  六、在破解谈判药品“进院难”方面,除建立“双通道”管理机制外,国家医保局开展的主要工作

  (YI)JIANLIWANSHANTANPANYAOPINLUODIJIANCEJIZHI,JISHIZHANGWOLUODIJINZHAN

  2020NIANYILAI,GUOJIAYIBAOJUJIANLILETANPANYAOPINLUODIQINGKUANGJIANCEJIZHI,ZUZHIGESHENGFENDINGQIBAOSONGTANPANYAOPINDEYONGLIANG、FEIYONGHEBAOXIAOQINGKUANGDENGSHUJU,DINGQIFENXIGEDIJINZHAN,YIJILUODIGUOCHENGZHONGFAXIANDEZHUYAOWENTI,JISHIXIANGGEDITONGBAO,TUIDONGLUODI。

  (ER)JIAQIANGDUCUZHIDAO,TUIDONGTANPANYAOPINLUODI

  YOUFENGUANJULINGDAOHUOSILINGDAODAIDUI,FENBIEFUBEIJINGDENG7GESHENGFEN,DUDAODIAOYANTANPANYAOLUODIDEJINZHANHEZUOFA,SHENRULEJIE“JINYUAN”FANGMIANCUNZAIDEKUNNANHEWENTI,JIAQIANGDUIGEDIDEDUCUHEZHIDAO。DIAODULEJIE32GESHENGJIYIBAOJU(HANBINGTUAN)ZAITUIDONGTANPANYAOPINLUODIFANGMIANDEZUOFAHECHENGXIAO,SHULIZONGJIESICHUANDENGJINGYANZUOFA,FAHUIDIANXINGSHIFANHEFUSHEDAIDONGZUOYONG。

  (SAN)SHOUJIBINGFABUBUFENTANPANYAOPINYIPEIBEIJIGOUMINGDAN,GONGGONGZHONGCHAXUN

  JINQI,GUOJIAYIBAOJUZUZHILILIANGCONG2020NIANXINZENGDETANPANYAOPINZHONGSHAIXUANCHUSHOUPILINCHUANGXUQIUPOQIE、KETIDAIXINGBUQIANGDE19ZHONGYAOPIN,ANPAIXIANGGUANQIYEBAOSONGLEYIPEIBEIDEDINGDIANYILIAOJIGOUHEDINGDIANLINGSHOUYAODIANXINXI,ZAI“GUOJIAYIBAOFUWUPINGTAI(APP)”ZHONGKAITONGGONGZHONGCHAXUNQUDAO,ZHAOKAIMEITIFABUHUIXIANGSHEHUIGONGKAIFABU,YIFANGBIANYOUXUQIUDECANBAORENYUANJIUYIGOUYAO。XIAYIBU,GUOJIAYIBAOJUJIANGJIXUZUZHIQIYEBAOSONG、GENGXINXIANGGUANXINXI。


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