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The Notice makes it clear that if the basic medical insurance for urban workers and urban and rural residents in Shanghai and the basic medical insurance for urban and rural residents use "high-priced medicines", the proportion of out-of-payment for medicines shall be increased by 10% (drugs paid for by basic drugs and medical insurance Class A) or 20% (other drugs).
The generic name of the medical insurance catalogue drugs mentioned above, as well as the specific out-of-payment ratio to be increased by individuals, are as follows: The medical institutions may continue to purchase the quality and efficacy of the drugs selected on the premise that the medical institutions may continue to purchase the drugs of quality and efficacy, provided that the quantity does not exceed the selected drugs.
If the original drug is not selected and through consistent evaluation of generic drug enterprises to actively reduce prices to the city's selected price below (including the selected price), then the corresponding selected drug completed the agreed purchase amount, the unseeded drug is not affected by the priority procurement restrictions and related assessment.
medical institutions to purchase unseeded drugs that meet the above conditions shall be deemed to meet the requirements of "one product, two rules".
Medical institutions shall strictly implement the requirements for prescribing under the common name to ensure that the selected drugs are selected on the same conditions, that the selected drugs have the same or equivalent active ingredients (especially similar to the chemical structure) and that the same therapeutic effect (including compound preparations) and clinically replaceable similar drugs shall be given priority over the use of the selected drugs on the basis of rational drug use.
For the use of selected drugs may lead to patient drug adjustment, medical institutions should strengthen clinical risk assessment, planning and material preparation, the failure to select drugs should not take a "one-size-fits-all" approach to drug suspension, strengthen the publicity and training of physicians and pharmacists, and explain to patients. By the end of
, drug listing license holders who have basically realized the traceability of selected drugs should speed up the construction of the drug information traceability system, and by December 31, 2020, according to the technical requirements and construction standards such as the Guidance for the Construction of the Drug Information Tracing System of the State Drug Administration, the basic realization of the selection of drugs can be traced, giving full play to the role of traceability information in quality management, risk prevention and control, product recall and other production and management.
this notice will be effective from November 20, 2020, in which the urban and rural residents of basic medical insurance insured personnel to use "high-priced drugs" need to increase the proportion of drug self-responsibility implementation time by the city's medical insurance department to notify separately.
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