National talks about drugs "should be fully equipped". The top three hospitals are no less than 30%!

As the new year of national talks approaches, on November 2, Zhejiang Medical Insurance Bureau issued the "Notice on Implementing the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations" (Zhejiang Medical Insurance Lianfa [2021] No.
24)
.

 

Zhejiang Province requires the establishment of a linkage mechanism between the provision of hospital drugs and the adjustment of the medical insurance drug catalog.
Within three months after the publication of the new version of the national medical insurance drug catalog, a meeting of the Pharmaceutical Affairs Management and Pharmacotherapy Committee shall be held in a timely manner to ensure that the national drug "should be fully dispensed" With"
.
According to medical needs, in principle, to talk about drugs are the country with the rate of three A-level comprehensive public medical institutions is not less than 30%, three B general public medical institutions, three public TCM hospitals (including Integrative Medicine Hospital) does not Less than 20%, and the third-level public specialist medical institutions shall not be less than 60% of the national medicines of the corresponding specialists
.

 

At the same time, it is required that by the end of November 2021, it is ensured in principle that there is at least one "dual channel" pharmacy in the county (city, district) area , and the number of municipal districts can be appropriately increased
.

 

Zhejiang Provincial Medical Security Bureau Zhejiang Provincial Health Commission

 

Notice on Implementing the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations

 

Municipal health care Bureau, Health Health Committee:

 

　　In order to ensure the smooth landing of drugs under the National Medical Insurance Negotiations (hereinafter referred to as the National Medical Insurance Negotiations), and to better meet the needs of insured patients for the rational use of drugs, according to the National Medical Insurance Administration and the National Health Commission on Establishing and Improving the National Medical Insurance Negotiation Drugs "Dual Channel" Management Mechanism The Guiding Opinions of the People’s Republic of China "Notice on Adapting to the Normalization of National Medical Insurance Negotiations and Continuously Doing a Good Job in the Implementation of Negotiated Drugs", the relevant matters concerning the implementation of the "dual-channel" management mechanism of national talks on drugs in our province are hereby notified as follows
.

 

　　1.
Implement "dual channel" management to improve the availability of national talks

 

　　Taking into consideration factors such as clinical value and reasonable medication needs of patients, the National Talks drugs (including generic drugs and biosimilar drugs of the same generic name, the same below) are subject to "dual channel" management
.
"Dual channel" refers to the mechanism that meets the reasonable needs of national drug supply guarantee and clinical use through two channels of designated medical institutions and designated retail pharmacies, and simultaneously incorporates them into the medical insurance payment mechanism
.
State talks drugs are all included in the province's "dual channel" management, and a unified payment policy is implemented in designated medical institutions and designated retail pharmacies
.
Medical insurance departments in all regions should do a good job in linking the "dual channel" management of national drug talks with outpatient chronic diseases and special disease policies to ensure that the benefits are not reduced
.

 

　　2.
Consolidate the main responsibilities of medical institutions and ensure the supply of drugs in the national talks

 

　　The medical institution is the first person responsible for the reasonable clinical use of State Talks drugs
.
All designated medical institutions shall implement the main responsibilities of rational drug use, and shall promptly equip and reasonably use nationally negotiated drugs in accordance with the functional positioning of the medical institution, clinical needs, diagnosis and treatment capabilities, and agreement requirements
.
Establish a linkage mechanism between the provision of hospital drugs and the adjustment of the medical insurance drug catalog.
Within three months after the publication of the new version of the national medical insurance drug catalog, the meeting of the pharmaceutical management and pharmacotherapy committee will be held in a timely manner to ensure that the national drug "should be matched"
.
According to the needs of diagnosis and treatment, in principle, the national drug product allocation rate shall not be less than 30% in the third-level A public comprehensive medical institutions, the third-level B public comprehensive medical institutions, and the third-level public Chinese medicine hospitals (including integrated traditional Chinese and western medicine hospitals) shall not be less than 30%.
Less than 20%, and the third-level public specialist medical institutions shall not be less than 60% of the national drug varieties of the corresponding specialists
.
For medicines that are temporarily unavailable, it is necessary to establish a sound prescription circulation mechanism, and improve the availability of medicines through channels such as "dual channels"
.

 

　　3.
Select retail pharmacies to form a joint force for supply guarantee

 

　　Designated retail pharmacies should give full play to their advantages of wide distribution, high degree of marketization, and flexible service, and complement each other with designated medical institutions to form a synergistic force for supply guarantee
.
Medical insurance agencies in various regions should comprehensively consider population distribution and the convenience of insured patients for medical treatment, and include designated retail pharmacies that meet the requirements of qualification compliance, management practices, good reputation, reasonable layout, and that have achieved electronic traceability of the drugs sold.
"Dual channel" management
.
Before the end of November 2021, in principle, ensure that there is at least one "dual channel" pharmacy in the county (city, district) area, and the municipal districts can increase the number appropriately and actively disclose it to the public in time
.
Establish and improve the "dual-channel" dynamic adjustment mechanism for designated retail pharmacies, moderate competition, and both in and out
.

 

　　The designated retail pharmacies that are included in the “dual channel” management shall be equipped with national drug products according to the supply capacity and agreement requirements, and the national drug drug allocation rate shall not be less than 30%
.
For medicines with special requirements for storage, etc.
, institutions with corresponding qualifications and capabilities shall be selected to undertake the tasks of storage and distribution
.

 

　　4.
Improve policies and measures, and establish a clear direction to promote the implementation of national talks

 

　　The medical insurance department should do a good job in linking the national drug delivery with outpatient co-ordination, payment method reform, and mass procurement policies
.
It is necessary to make reasonable adjustments to the total annual medical insurance coverage of medical institutions in light of the state-of-the-art drug use situation to ensure the basic drug needs of patients
.
In principle, Guotan drugs are not included in the total budget or converted into points when used in outpatient clinics; during hospital use, the cost of drugs can be converted into points for payment or the points of the disease group can be reasonably adjusted according to the actual use of Guotan drugs
.

 

　　The health department should adjust and improve the evaluation mechanism for the use of drugs in medical institutions, and list the costs of rational use of drugs from the National Talks separately, and exclude them from the scope of evaluation indicators that affect their implementation, such as the proportion of drugs in medical institutions and the average cost per second
.
Strengthen the guidance and management of the clinical drug use behavior of designated medical institutions, and urge medical institutions in the jurisdiction to rationally equip and use national drugs, and shall not influence the landing of national drugs on the grounds of total medical insurance restrictions, medical institution drug catalogue restrictions, and drug proportions
.

 

　　5.
Strengthen supervision and management to ensure the safety of medical insurance funds

 

　　Medical insurance agencies at all levels should improve the management of designated medical institutions agreement, sign a "dual-channel" management drug medication security service agreement or add special content to the two agreements
.
Corresponding but not equipped or insufficiently equipped, designated medical institutions that cannot meet the needs of insured patients for using national talks drugs, need to provide reminders, interviews, deadlines for rectification, cancellation of agreements, etc.
, and at the same time pay for the state talks drug provision and DRG points Evaluation, agreement management, annual assessment, etc.
are linked
.
Strengthen the management of the national drug use, refine the medical insurance drug review rules, strengthen intelligent monitoring, supervise the entire process of patient medication behavior, severely crack down on the "dual channel" field of fraudulently obtaining medical insurance funds, and strictly follow the "Supervision and Management of the Use of Medical Security Funds" The Regulations impose penalties
.

 

　　Municipalities and districts to improve the country's health care sector to talk about the drug usage monitoring mechanism, strengthen the statistical monitoring and assessment of the country to talk about the situation with drugs, the use and payment of required regular feedback to the Provincial Medical Insurance Bureau
.

 

　　6.
Strengthen publicity and training, and reasonably guide public expectations

 

　　The implementation of national talks on drug delivery is related to the vital interests of insured patients.
The Party Central Committee and the State Council attach great importance to it, and are widely concerned by all sectors of society.
Medical security and health departments at all levels must strengthen organization and leadership, carefully deploy, refine measures, and consolidate responsibilities
.
Establish and improve communication mechanisms with news media, patients, etc.
, strengthen policy interpretation, respond to social concerns in a timely manner, rationally guide public expectations, and actively create a good public opinion atmosphere in which all parties understand and support the launch of national talks
.
Regularly carry out policy and business training, strengthen the guidance to designated medical institutions and medical personnel, and actively and properly handle the demands and problems reported by patients in accordance with regulations
.

 

　　In case of major problems encountered in the implementation of the national drug delivery, timely feedback to the Provincial Medical Security Bureau and the Provincial Health and Health Commission shall be required
.

 

　　Zhejiang Medical Security Bureau

 

　　Zhejiang Provincial Health Commission

 

　　October 28, 2021

　　As the new year of national talks approaches, on November 2, Zhejiang Medical Insurance Bureau issued the "Notice on Implementing the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations" (Zhejiang Medical Insurance Lianfa [2021] No.
24)
.

 

　　Zhejiang Province requires the establishment of a linkage mechanism between the provision of hospital drugs and the adjustment of the medical insurance drug catalog.
Within three months after the publication of the new version of the national medical insurance drug catalog, a meeting of the Pharmaceutical Affairs Management and Pharmacotherapy Committee shall be held in a timely manner to ensure that the national drug "should be fully dispensed" With"
.
According to medical needs, in principle, to talk about drugs are the country with the rate of three A-level comprehensive public medical institutions is not less than 30%, three B general public medical institutions, three public TCM hospitals (including Integrative Medicine Hospital) does not Less than 20%, and the third-level public specialist medical institutions shall not be less than 60% of the national medicines of the corresponding specialists
.

 

　　At the same time, it is required that by the end of November 2021, it is ensured in principle that there is at least one "dual channel" pharmacy in the county (city, district) area , and the number of municipal districts can be appropriately increased
.

 

　　Zhejiang Provincial Medical Security Bureau Zhejiang Provincial Health Commission

 

　　Notice on Implementing the "Dual Channel" Management Mechanism for Drugs in National Medical Insurance Negotiations

 

　　Municipal health care Bureau, Health Health Committee:

 

　　In order to ensure the smooth landing of drugs under the National Medical Insurance Negotiations (hereinafter referred to as the National Medical Insurance Negotiations), and to better meet the needs of insured patients for the rational use of drugs, according to the National Medical Insurance Administration and the National Health Commission on Establishing and Improving the National Medical Insurance Negotiation Drugs "Dual Channel" Management Mechanism The Guiding Opinions of the People’s Republic of China "Notice on Adapting to the Normalization of National Medical Insurance Negotiations and Continuously Doing a Good Job in the Implementation of Negotiated Drugs", the relevant matters concerning the implementation of the "dual-channel" management mechanism of national talks on drugs in our province are hereby notified as follows
.

 

　　1.
Implement "dual channel" management to improve the availability of national talks

 

　　Taking into consideration factors such as clinical value and reasonable medication needs of patients, the National Talks drugs (including generic drugs and biosimilar drugs of the same generic name, the same below) are subject to "dual channel" management
.
"Dual channel" refers to the mechanism that meets the reasonable needs of national drug supply guarantee and clinical use through two channels of designated medical institutions and designated retail pharmacies, and simultaneously incorporates them into the medical insurance payment mechanism
.
State talks drugs are all included in the province's "dual channel" management, and a unified payment policy is implemented in designated medical institutions and designated retail pharmacies
.
Medical insurance departments in all regions should do a good job in linking the "dual channel" management of national drug talks with outpatient chronic diseases and special disease policies to ensure that the benefits are not reduced
.

 

　　2.
Consolidate the main responsibilities of medical institutions and ensure the supply of drugs in the national talks

 

　　The medical institution is the first person responsible for the reasonable clinical use of State Talks drugs
.
All designated medical institutions shall implement the main responsibilities of rational drug use, and shall promptly equip and reasonably use nationally negotiated drugs in accordance with the functional positioning of the medical institution, clinical needs, diagnosis and treatment capabilities, and agreement requirements
.
Establish a linkage mechanism between the provision of hospital drugs and the adjustment of the medical insurance drug catalog.
Within three months after the publication of the new version of the national medical insurance drug catalog, the meeting of the pharmaceutical management and pharmacotherapy committee will be held in a timely manner to ensure that the national drug "should be matched"
.
According to the needs of diagnosis and treatment, in principle, the national drug product allocation rate shall not be less than 30% in the third-level A public comprehensive medical institutions, the third-level B public comprehensive medical institutions, and the third-level public Chinese medicine hospitals (including integrated traditional Chinese and western medicine hospitals) shall not be less than 30%.
Less than 20%, and the third-level public specialist medical institutions shall not be less than 60% of the national drug varieties of the corresponding specialists
.
For medicines that are temporarily unavailable, it is necessary to establish a sound prescription circulation mechanism, and improve the availability of medicines through channels such as "dual channels"
.

 

　　3.
Select retail pharmacies to form a joint force for supply guarantee

 

　　Designated retail pharmacies should give full play to their advantages of wide distribution, high degree of marketization, and flexible service, and complement each other with designated medical institutions to form a synergistic force for supply guarantee
.
Medical insurance agencies in various regions should comprehensively consider population distribution and the convenience of insured patients for medical treatment, and include designated retail pharmacies that meet the requirements of qualification compliance, management practices, good reputation, reasonable layout, and that have achieved electronic traceability of the drugs sold.
"Dual channel" management
.
Before the end of November 2021, in principle, ensure that there is at least one "dual channel" pharmacy in the county (city, district) area, and the municipal districts can increase the number appropriately and actively disclose it to the public in time
.
Establish and improve the "dual-channel" dynamic adjustment mechanism for designated retail pharmacies, moderate competition, and both in and out
.

 

　　The designated retail pharmacies that are included in the “dual channel” management shall be equipped with national drug products according to the supply capacity and agreement requirements, and the national drug drug allocation rate shall not be less than 30%
.
For medicines with special requirements for storage, etc.
, institutions with corresponding qualifications and capabilities shall be selected to undertake the tasks of storage and distribution
.

 

　　4.
Improve policies and measures, and establish a clear direction to promote the implementation of national talks

 

　　The medical insurance department should do a good job in linking the national drug delivery with outpatient co-ordination, payment method reform, and mass procurement policies
.
It is necessary to make reasonable adjustments to the total annual medical insurance coverage of medical institutions in light of the state-of-the-art drug use situation to ensure the basic drug needs of patients
.
In principle, Guotan drugs are not included in the total budget or converted into points when used in outpatient clinics; during hospital use, the cost of drugs can be converted into points for payment or the points of the disease group can be reasonably adjusted according to the actual use of Guotan drugs
.

 

　　The health department should adjust and improve the evaluation mechanism for the use of drugs in medical institutions, and list the costs of rational use of drugs from the National Talks separately, and exclude them from the scope of evaluation indicators that affect their implementation, such as the proportion of drugs in medical institutions and the average cost per second
.
Strengthen the guidance and management of the clinical drug use behavior of designated medical institutions, and urge medical institutions in the jurisdiction to rationally equip and use national drugs, and shall not influence the landing of national drugs on the grounds of total medical insurance restrictions, medical institution drug catalogue restrictions, and drug proportions
.

 

　　5.
Strengthen supervision and management to ensure the safety of medical insurance funds

 

　　Medical insurance agencies at all levels should improve the management of designated medical institutions agreement, sign a "dual-channel" management drug medication security service agreement or add special content to the two agreements
.
Corresponding but not equipped or insufficiently equipped, designated medical institutions that cannot meet the needs of insured patients for using national talks drugs, need to provide reminders, interviews, deadlines for rectification, cancellation of agreements, etc.
, and at the same time pay for the state talks drug provision and DRG points Evaluation, agreement management, annual assessment, etc.
are linked
.
Strengthen the management of the national drug use, refine the medical insurance drug review rules, strengthen intelligent monitoring, supervise the entire process of patient medication behavior, severely crack down on the "dual channel" field of fraudulently obtaining medical insurance funds, and strictly follow the "Supervision and Management of the Use of Medical Security Funds" The Regulations impose penalties
.

 

　　Municipalities and districts to improve the country's health care sector to talk about the drug usage monitoring mechanism, strengthen the statistical monitoring and assessment of the country to talk about the situation with drugs, the use and payment of required regular feedback to the Provincial Medical Insurance Bureau
.

 

　　6.
Strengthen publicity and training, and reasonably guide public expectations

 

　　The implementation of national talks on drug delivery is related to the vital interests of insured patients.
The Party Central Committee and the State Council attach great importance to it, and are widely concerned by all sectors of society.
Medical security and health departments at all levels must strengthen organization and leadership, carefully deploy, refine measures, and consolidate responsibilities
.
Establish and improve communication mechanisms with news media, patients, etc.
, strengthen policy interpretation, respond to social concerns in a timely manner, rationally guide public expectations, and actively create a good public opinion atmosphere in which all parties understand and support the launch of national talks
.
Regularly carry out policy and business training, strengthen the guidance to designated medical institutions and medical personnel, and actively and properly handle the demands and problems reported by patients in accordance with regulations
.

 

　　In case of major problems encountered in the implementation of the national drug delivery, timely feedback to the Provincial Medical Security Bureau and the Provincial Health and Health Commission shall be required
.

 

　　Zhejiang Medical Security Bureau

 

　　Zhejiang Provincial Health Commission

 

　　October 28, 2021