Multiple follow-up key monitoring, 166 varieties limited! Traditional Chinese medicine injection is still the key to supplement!

The key monitoring area is expanding On October 8, the Xinjiang health and Health Commission issued the notice of the first batch of autonomous region key monitoring and rational drug use catalogue (chemical and biological products), which clearly defined the customized drug use guidelines or technical specifications included in the catalogue and stipulated the conditions and principles of clinical application Previously, the health and Health Commission of Shanxi Province also issued a notice on September 29, announcing the list of the first batch of drugs (chemical and biological products) that focus on the monitoring of rational use of drugs in the province, and at the same time publishing the detailed rules for the management of related drugs It can be seen that the published catalogue in Shanxi and Xinjiang has increased the number of drugs in varying degrees compared with the national key monitoring catalogue in early July Shanxi Province increased proton pump inhibitors and Ginkgo biloba extract, while Xinjiang increased 12 kinds of drugs, such as Guhong injection, compound three-dimensional B oral liquid for injection, spleen ammonia titanium oral liquid dry frozen powder, thymus method, etc Most of these drugs are large varieties with annual sales of over 100 million, and the total market size can reach 10 billion At the same time, the industry noted that although the public directory does not include traditional Chinese medicine, the notice focuses on the management of non traditional Chinese medicine prescriptions and the standardization of the use of traditional Chinese medicine injections From the list of local key monitoring that has been publicized before, traditional Chinese medicine, especially traditional Chinese medicine injection, is the focus of supplement According to statistics, at least 20 provinces (cities) and cities in China have followed up the national version of the key monitoring directory, including 20 common names of the national version, 166 varieties have been listed in the national or local key monitoring list, at least 35 of which are proprietary Chinese medicine varieties, most of which are traditional Chinese medicine injection agents According to the notice issued by Shanxi and Xinjiang, the drugs not included in the catalogue are not worry free The health and Health Commission and medical institutions will monitor them Once problems such as abnormal increase in use, no indication, excessive use, etc are found, investigation will be carried out, and those suspected of violating laws and regulations will be seriously dealt with This also means that almost all drugs are under the focus of monitoring, and there is no hiding place for irregular behaviors such as clinical overuse In fact, since the national health and Health Commission announced the first batch of 20 key monitoring varieties in early July, many provinces and cities have responded positively At present, at least 20 provinces (cities and cities) such as Hebei, Inner Mongolia, Guangdong and Jiangsu have issued key monitoring catalogue At the same time, some medical institutions, such as Qingdao Municipal Hospital, the second hospital of Hebei Medical University, the Affiliated Hospital of Shaanxi University of traditional Chinese medicine, Zhejiang Zhoushan hospital and so on, also released their own key monitoring varieties In terms of varieties, in addition to Jiangxi, Jiujiang and other provinces and cities that have previously released key monitoring catalogue, at least 166 varieties have been under key monitoring (turn to the end of the article to see the details) Many of them are the varieties with large clinical dosage and great controversy For example, the spleen extract of calf in the key monitoring directory of the above six places The product is a sterile water solution extracted from the spleen of healthy dairy cattle within 24 hours of birth The indications in the manual are: for improving the immunity of the body It can be used in the treatment of aplastic anemia, primary thrombocytopenia, radiation-induced leukopenia, all kinds of malignant tumors and improving the cachexia of tumor patients In clinical use, the problem of super indications is more prominent According to a survey, of the 12693 prescriptions of calf spleen extract in a top three hospital in 2016, more than 7000 prescriptions were non indications, accounting for nearly 60% of the total At the same time, about 2% of the drugs were not safe enough On this basis, the income of calf spleen extract is considerable In recent years, the sales volume of calf spleen extract has decreased by 9.67% under the influence of policies, but it is still one of the main products in Aodong, Jilin Province According to the industry analysis, the market of the above varieties will continue to be affected in the future by key monitoring policies and new policies such as the adjustment of medical insurance catalog Strengthening the assessment of traditional Chinese medicine injections is doomed At the same time, the expansion of the key monitoring directory, the refinement and strengthening of the assessment system is also the focus of the health sector It can be seen that in the notice of Shanxi provincial health and Health Commission, there are not only varieties that need to be monitored, but also management rules Indications, evidence and management requirements are listed for each key monitored variety For example: ganglioside, its indications are strictly limited to the treatment of vascular or traumatic central nervous system injury; Parkinson's disease According to the management requirements, if such drugs need to be used, they need to be confirmed by consultation, signature of the president in charge, establishment of use information registration form and other processes If they need to be purchased, they need to be signed by the president for confirmation Besides the catalogue, the prescription of traditional Chinese medicine, especially the injection of traditional Chinese medicine, is also under strict control According to the requirements of Shanxi health and Health Commission, doctors of traditional Chinese medicine should prescribe traditional Chinese medicine according to the corresponding norms and the basic principles of syndrome differentiation and treatment of traditional Chinese medicine Other categories of physicians, however, require rigorous training This is also consistent with the previous requirements of the National Health Commission With regard to traditional Chinese medicine injection, Shanxi health and Health Commission stressed that the administrative departments and medical institutions at all levels of health and health should attach great importance to the use of traditional Chinese medicine injection, strictly follow the use principle of traditional Chinese medicine injection, highlight the characteristics and standardize the use, "not only to ensure the safety and effectiveness of clinical medication, but also to fully consider the actual needs of the people, and promote the healthy development of traditional Chinese medicine injection" 。 In terms of wording, it seems to be more relaxed, but in terms of the specific deployment of follow-up enhanced monitoring and assessment, the industry believes that traditional Chinese medicine injection is still doomed According to the requirements of Shanxi health and Health Commission, not only the clinical use management of drugs for rational use will be included in the assessment of medical institutions and their main principals, but also the drugs not included in the catalog will be monitored Shanxi health and Health Commission requires that it should strengthen early warning and find out the reasons for the problems such as abnormal increase of usage, no indication and excessive dosage use Those who violate laws and regulations shall be dealt with seriously Combined with the medical insurance unified information network under construction, analysts believe that there is no way to hide the problem of clinical drug abuse, so as to achieve the goal of regulating drug use at the national level, reducing the waste of medical insurance funds, achieving the goal of vacating cages and changing birds, promoting the smooth progress of medical reform, and truly alleviating the problem of expensive medical treatment Source: Bureau of health and knowledge Author: Shen Haijing