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    Home > Active Ingredient News > Drugs Articles > 17 kinds of anti-cancer drugs are included in Shandong Medical Insurance, and the proportion of drugs that are no longer included in medical institutions

    17 kinds of anti-cancer drugs are included in Shandong Medical Insurance, and the proportion of drugs that are no longer included in medical institutions

    • Last Update: 2018-10-30
    • Source: Internet
    • Author: User
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    Municipal Human Resources and Social Security Bureau, health and Family Planning Commission: In order to implement the decision-making and deployment of the special price reduction of anti cancer drugs made by the CPC Central Committee and the State Council, and effectively reduce the burden of drug use on the masses, according to the notice on the inclusion of 17 anti cancer drugs in the category B scope of the national basic medical insurance, work injury insurance and maternity insurance drug catalogue (medical insurance Fa [2018] No The questions are as follows: 1、 Since November 30, 2018, 17 kinds of anticancer drugs (hereinafter referred to as "national negotiation drugs" for the list, see the annex) negotiated by the state have been included into the category B scope of the drug catalogue of work injury insurance and maternity insurance of Shandong Province (2017 version) The payment standard, limited payment scope, drug classification and dosage form of medical insurance shall be implemented in accordance with the national regulations The payment standard of medical insurance includes all expenses jointly paid by basic medical insurance fund and insured personnel Each city shall reasonably determine the share proportion of the basic medical insurance fund and the insured personnel according to the payment ability of the medical insurance fund, etc., and the individual first self payment proportion shall be uniformly formulated by the municipal human resources and Social Security Bureau of each district and reported to the provincial department for the record Each city shall not transfer the national negotiated drugs out of the catalogue, and shall not adjust and limit the scope of payment The stipulated payment standard is valid until November 30, 2020, and shall be adjusted according to the relevant provisions of the national medical insurance payment standard after the expiration of the validity period 2、 Do a good job in linking the serious illness insurance system of our province with the drugs negotiated by the state For the serious illness insurance drugs in our province that have been included in the scope of drugs negotiated by the state, a transitional policy will be implemented, with the transitional period ending on December 31, 2018 During the transitional period, medical insurance payment standards and restricted payment scope shall be implemented in accordance with national regulations For the self paid part after the payment of serious illness insurance, the basic medical insurance fund shall provide subsidies according to the class B drug policy In order to ensure that the actual treatment level of the insured does not decrease, the cities should do a good job in linking up the policies of medical insurance payment and charity assistance during the transitional period 3、 By the end of October 2018, the provincial drug centralized purchasing agency will publicly hang the national negotiated drugs on the provincial drug centralized purchasing platform according to the payment standard Each designated agreement medical institution shall do a good job in drug procurement and take effective measures to ensure the supply and rational use of negotiated drugs The medical insurance agencies of each city shall update the information system in time and realize the timely settlement and payment of drugs within the prescribed time limit 4、 Drugs that have been negotiated by the state and the province to be included in the scope of medical insurance payment will not be included in the proportion assessment of drugs in medical institutions, and will be accounted separately If the actual expenses incurred by the medical institutions in 2018 exceed the total control index of the medical insurance fund due to the policy reasons such as the inclusion of negotiated drugs in the catalogue, reasonable compensation shall be given at the end of the year for liquidation, and the reasonable use of negotiated drugs shall be comprehensively considered when formulating the total control index of the medical insurance fund in the next year At the same time, we should strengthen the management of negotiated drug use, focus on the monitoring and analysis of drugs with high cost and large dosage, and ensure the safety of medical insurance fund 5、 It is an important measure for the implementation of the requirements of the Party Central Committee and the State Council to include anticancer drugs in the scope of medical insurance payment through negotiation All regions should unify their thinking, raise their awareness and ensure that good things are done well In particular, during the period of institutional reform, we should strengthen overall planning and coordination, put them in place within the prescribed time limit, and make the masses benefit as soon as possible Major problems encountered by all localities in the implementation shall be reported to the provincial department in a timely manner Appendix: list of 17 anticancer drugs including azacytidine list of 17 anticancer drugs including azacytidine list of 17 anticancer drugs Shandong Provincial Department of human resources and social security Shandong provincial health and Family Planning Commission October 24, 2018
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