Beijing: strengthen the monitoring of 4 + 7 alternative products! Seriously investigate and deal with kickbacks

On March 11, the Beijing Municipal Health and Health Commission issued the notice on how to do a good job in the clinical allocation and use of selected drugs in the centralized purchase of drugs organized by the state (hereinafter referred to as the notice), which put forward specific requirements on the priority of the use of selected drugs, the improvement of the reasonable use level of selected drugs, the monitoring of clinical use of selected drugs, and the construction of industry style The notice stressed that it is necessary to strengthen the monitoring of the use of drugs that have alternative relations with the selected drugs, especially the use of high priced alternative drugs The departments and individuals who do not use the selected drugs for no reason shall be publicized, followed up, managed and intervened Serious investigation and punishment shall be carried out in accordance with laws and regulations for drug "kickbacks" and other violations of "nine prohibitions" For chronic patients, the elderly, patients with mental illness and other special groups with high risk of dressing change, the notice requires that there should be a detailed replacement plan, standardize the physician's medication behavior, and gradually use the selected drugs in large quantities For some patients who are highly dependent on drugs or do not accept the drug change program, the notice points out that they should properly handle and respond to patients' complaints according to the principle of "one thing, one discussion", and on the basis of full evaluation, they can independently develop the drug use program and make explanations Notice of Beijing Municipal Commission of health and health of the people's Republic of China on the clinical allocation and use of selected drugs in the centralized purchase of drugs organized by the state In order to implement the notice of the general office of the State Council on printing and distributing the pilot program of centralized purchase and use of national organization drugs (GBF [2019] No We hereby notify the following requirements: 1 Attach great importance to the use of selected drugs The national organization of drug centralized procurement and use pilot is to implement the decision-making and deployment of the Party Central Committee and the State Council Health departments and public medical institutions at all levels should strengthen the "Four Consciousness", strengthen organizational leadership, refine implementation measures, strengthen risk prevention and control, pay attention to personnel training, and do a good job in clinical allocation and use of selected drugs 2、 The health departments at all levels shall strengthen the guidance and supervision on the use of the selected drugs by medical institutions, urge the local public medical institutions to purchase and use the selected drugs preferentially according to the agreed purchase amount, and ensure the completion of the contract amount within one year Each medical institution shall not influence the reasonable use and supply guarantee of the selected drugs on the grounds of cost control, drug proportion and the requirements for drug varieties, specifications and quantities of medical institutions Public medical institutions shall include the selected drugs in the drug prescription set and the basic drug supply catalogue of medical institutions, strictly implement the requirements of prescribing according to the common name of drugs, embed the prescription authority, prescription warning and other contents by means of information technology, and give advice to the doctors of relevant departments, so as to ensure the priority of using the selected drugs under the same conditions 3、 To strengthen the education and training of medical personnel, health departments at all levels and public medical institutions should focus on the training of medical personnel According to the requirements of full coverage of institutions and personnel, a systematic and perfect training plan should be formulated, and the training of medical personnel should be well organized The municipal and district health departments are responsible for the backbone training of leaders of medical institutions and heads of relevant departments according to the division of labor, and each medical institution is responsible for the training of relevant departments and personnel of its own The training focuses on the relevant policies of centralized drug purchase and use pilot work organized by the state, the basic principles and precautions of rational use of drugs, the skills and principles of communication with patients, the methods and requirements of case handling, etc., so as to ensure that all departments and units, especially medical personnel, fully master and skillfully apply the policies, and practically unify the thoughts and actions to the central government The decision-making is deployed 4、 Improve the rational use level of selected drugs Medical institutions shall formulate and improve the clinical medication guidelines for the selected drugs, and analyze one by one based on the "one drug, one policy" of the selected drugs in their own institutions For the special population with high risk of drug change, such as the chronic patients, the elderly and the patients with mental diseases, there shall be a detailed replacement plan, standardize the medication behavior of doctors, and gradually use the selected drugs in large quantities It is necessary to strictly implement the prescription management measures, the regulations on the administration of pharmaceutical affairs in medical institutions, the regulations on the administration of prescription review in hospitals (for Trial Implementation), and the relevant diagnosis and treatment specifications and medication guidelines, strengthen the prescription review and prescription review, give full play to the role of clinical pharmacists, and ensure the medication safety of patients 5、 To monitor the clinical use of the selected drugs, the medical institutions should set up a monitoring and evaluation team for the selected drugs in clinical use, with experts and pharmaceutical personnel of relevant professional departments as the main members, to evaluate the use of the selected drugs in our hospital scientifically On the one hand, we should pay attention to the stability of the source of goods In case of tight supply, we should timely select replacement products and report the shortage information; on the other hand, we should do a good job in monitoring and evaluation of clinical use, continuously monitor the efficacy and adverse reactions of drugs, take the monitoring results as an important basis for rational use of drugs, properly handle adverse events and report them in time 6、 Strengthen the communication between doctors and patients, ensure the medical safety of patients, fully implement the requirements of the 2019 action plan for improving the standard service behavior of medical services in Beijing, and strictly implement the core system of medical quality and safety For the situation that the use of selected drugs may lead to the adjustment of patients' medication, each medical institution should do a good job in clinical risk assessment, plan formulation and material reserve, and do a good job in medication monitoring and emergency disposal We should actively guide patients to actively use the selected drugs under the premise of respecting patients' wishes through outpatient service, drug consultation, drug treatment management and other ways For individual patients who are highly dependent on drugs or do not accept the drug change program, we should properly handle and respond to patients' complaints in accordance with the principle of "one by one" On the basis of full evaluation, we can independently develop the drug use program and make explanations We should strengthen the education and management of medical institutions and medical personnel, and deal seriously with problems or public opinion hype caused by inadequate work 7、 To improve the relevant incentive mechanism and performance appraisal system, the Municipal Bureau of traditional Chinese medicine, the Municipal Medical Administration Bureau and the health and Family Planning Commission of each district should include the implementation of on-the-spot purchasing in public medical institutions into the performance appraisal of medical institutions, which should be included in the performance appraisal of clinical departments and doctors, and establish incentive mechanism and preferential measures to encourage the use of selected drugs For the medical institutions, clinical departments and doctors who give priority to use and guarantee the dosage, they should be inclined in the reform of public hospitals, such as awarding and replenishing funds, appraising and appraising the excellent ones, and evaluating the professional titles; for those who can't be equipped in time according to the requirements or the purchase quantity is insufficient, which affects the patients' drug demand, they should take measures such as informing criticism, rectifying within a time limit, evaluating and evaluating the unqualified ones 8、 We should strengthen all-round and strict management of the party, conscientiously fulfill the main responsibility of the construction of professional ethics, and do a good job of warning education in advance It is necessary to strengthen the monitoring of the use of drugs that have alternative relations with the selected drugs, especially the use of high priced alternative drugs Through the establishment of dynamic monitoring and abnormal early warning system, departments and individuals who do not use the selected drugs for no reason can be publicized, followed up, managed and intervened Serious investigation and punishment shall be carried out in accordance with laws and regulations for drug "kickbacks" and other violations of "nine prohibitions".