Six departments including the national health and Health Commission printed and distributed the opinions on Strengthening Drug Administration in medical institutions and promoting rational use of drugs

Drug expenditure is an important part of medical expenditure of the masses To ensure drug supply and promote clinical standard and rational use of drugs is an important link in the whole chain of drug supply guarantee, and also the key to solve the problem of expensive medical treatment At present, the reform of centralized drug purchase and use continues to deepen, providing a strong guarantee for solving the problem of expensive medical treatment at the level of drug supply guarantee It has become the focus of the current work to strengthen the pharmaceutical management of medical institutions, realize the standardized management of the whole process of drug variety selection, procurement, supply, storage, clinical use, ensure the quality and safety of medical treatment, and promote the rational use of drugs In recent years, the level of rational use of drugs has been gradually improved in China, but some local medical institutions still need to improve the control mechanism of irrational use of drugs, and pharmaceutical care can not meet the clinical needs In order to implement the decision-making and deployment of the CPC Central Committee and the State Council, and in accordance with the arrangement of key tasks for deepening medical reform, the national health and Health Commission, together with the Ministry of education, the Ministry of finance, the Ministry of human resources and social security, the state medical insurance Bureau and the State Food and drug administration, formulated the "on strengthening the management of pharmaceutical affairs in medical institutions" With the approval of the State Council, the opinions on promoting rational use of drugs (hereinafter referred to as the "opinions") have recently been printed and distributed to the people's governments of all provinces, autonomous regions and municipalities directly under the central government and the Xinjiang production and Construction Corps for implementation The opinion has six parts First, strengthen the management of drug allocation in medical institutions It includes three measures: standardizing the drug catalogue of medical institutions, improving the drug purchase and supply system of medical institutions, and improving the drug management and pharmacotherapy committee system It is proposed to promote medical institutions at all levels to form a "1 + X" drug use mode with basic drugs as the leading role, "1" as the national basic drug catalogue, "X" as non basic drugs We will strengthen the role of the pharmaceutical affairs management and pharmacotherapeutics Committee in medical institutions, and establish national, provincial and municipal pharmaceutical affairs management and pharmacotherapeutics committees to provide corresponding technical support Second, strengthen the rational use of drugs The measures include strengthening the drug safety management of medical institutions, improving the level of clinical rational drug use of doctors, strengthening the examination of prescriptions by pharmacists or other pharmaceutical technicians, strengthening the management of rational drug use and performance evaluation It is suggested that priority should be given to the selection of national essential drugs, the centralized purchase and use of drugs by national organizations and the drugs listed in the national medical insurance catalogue Indicators related to rational use of drugs are included in the performance appraisal system of medical institutions and medical personnel Third, expand the scope of pharmaceutical care It includes 3 measures: strengthening medical service in pharmaceutical institutions, developing community pharmacy service in the home, and standardizing Internet plus pharmaceutical care We should strengthen the allocation of clinical pharmacists and encourage medical institutions to open pharmaceutical clinics To standardize the management of the key links in the process of Internet circulation of e-prescription, the audit, deployment and verification personnel of e-prescription must adopt the way of electronic signature or information system trace to ensure the traceability of information Fourth, strengthen the construction of pharmaceutical talents The measures include strengthening the cultivation of pharmaceutical talents, reasonably embodying the value of pharmaceutical care, and ensuring the reasonable salary and treatment of pharmacists It is suggested that the cost and value of pharmaceutical care should be considered as a whole in the price of medical services, and pharmaceutical personnel should be encouraged to play an active role in promoting rational drug use and reducing resource waste Medical institutions should embody the value of technical services in pharmacists' remuneration The medical insurance department will include the pharmacist's examination and approval of prescriptions into the performance appraisal system of the designated medical institutions Fifth, improve industry supervision It includes three measures: carrying out the monitoring of drug use and clinical comprehensive evaluation, strengthening the supervision of rational use of drugs, standardizing the promotion of drugs and the management of pharmacies in public medical institutions The national health and Health Commission, together with relevant departments, shall establish a spot check mechanism to organize spot checks on the prescriptions of all provinces (districts and cities) in a certain proportion every year, and all localities shall also increase the intensity of spot checks and announcements accordingly Medical institutions should strengthen the management of participating in academic activities involving the promotion of drug consumables Sixth, strengthen organization and implementation The work requirements are put forward from four aspects: strengthening organizational leadership, strengthening departmental cooperation, strengthening supervision and guidance, and strengthening publicity and guidance According to the characteristics of traditional Chinese medicine, the administration of traditional Chinese medicine should be formulated and implemented separately by the State Administration of traditional Chinese medicine and relevant departments Notice on printing and distributing opinions on strengthening pharmaceutical administration in medical institutions and promoting rational use of drugs (gwyf [2020] No 2 people's Government of each province, autonomous region and municipality directly under the central government, Xinjiang production and Construction Corps: with the consent of the State Council, the "notice on strengthening Pharmaceutical Administration in medical institutions" is hereby issued Opinions on promoting rational use of drugs are printed and distributed to you Please implement them carefully Opinions on Strengthening Drug Administration and promoting rational use of drugs in medical institutions It is an important content of establishing and perfecting modern hospital management system and an important measure of strengthening the comprehensive supervision of medical and health services to strengthen the pharmaceutical management of medical institutions In recent years, China's pharmaceutical management has been strengthened, and the level of rational drug use has been gradually improved At the same time, we should actively promote the reform of centralized purchase and use of drugs, improve the mechanism of drug price formation, and standardize the order of drug production and circulation With the consent of the State Council, the following opinions are hereby put forward in order to further strengthen the pharmaceutical administration and pharmaceutical care of medical institutions, strengthen the reform of drug use, promote the reform of the pharmaceutical field in the whole chain, improve the management level of medical institutions, promote the rational use of drugs, and better protect people's health 1、 To strengthen the management of drug allocation in medical institutions (1) to standardize the list of drug use in medical institutions According to the principles of safe, effective and economic drug use and the characteristics of disease treatment, medical institutions should optimize their drug use catalogue in time Guided by clinical drug demand, the state dynamically adjusts the national essential drug catalogue All localities should make greater efforts to promote the priority allocation and use of essential drugs, and promote medical institutions at all levels to form a "1 + X" drug use mode dominated by essential drugs "1" is the national list of essential drugs; "X" is non essential drugs, which should be fully evaluated and demonstrated by the pharmaceutical management and pharmacotherapeutics Committee of medical institutions, and the priority should be given to the national organizations to purchase and use drugs and drugs listed in the national medical insurance catalogue Encourage urban medical groups and county medical communities to establish a drug linkage management mechanism and standardize the drug use catalogue of medical institutions at all levels The administrative departments of health and health at all levels shall strengthen the monitoring of drug use in medical institutions, regularly analyze the use of drugs in medical institutions within their jurisdiction, guide and urge public medical institutions to continuously optimize the drug use catalogue, and form a scientific and reasonable drug use structure （2） Improve the drug purchase and supply system of medical institutions The pharmaceutical affairs management and pharmacotherapeutics Committee of medical institutions shall, in accordance with the requirements of collective decision-making, open procedures and sunshine procurement, determine the pharmaceutical production enterprise or the holder of the pharmaceutical listing license according to the results of the provincial centralized procurement of pharmaceuticals, and the manufacturer or the holder of the pharmaceutical listing license shall determine the distribution enterprise The Pharmaceutical Department of the medical institution shall be responsible for the unified purchase of drugs in its own institution and strictly implement the system of inspection and acceptance of drug purchase Medical institutions should adhere to the guidance of clinical needs, adhere to the rational use of drugs, and strictly implement the provisions of generic prescriptions Public medical institutions shall earnestly implement the requirements of national and provincial drug centralized procurement, do a good job in drug centralized procurement and use related work; rely on the provincial drug centralized procurement platform, actively participate in the construction of the national unified and open public drug procurement market Encourage medical consortia to explore the unified purchase of drugs To study the management system of dispensing and use of preparations in medical institutions urgently needed in clinical practice in medical consortia, and reasonably promote the sharing and use in medical consortia （3） We will improve the system of drug administration and drug therapeutics committees The administrative departments of health and health at or above the prefecture level shall set up a database of pharmacists and experts In determining the purchasing catalogue and purchasing work, the pharmaceutical management and pharmacotherapeutics Committee of medical institutions shall, under the guidance of the health administration department, randomly select a certain number of pharmaceutical experts from the pharmacists' expert database to participate, and increase the weight of pharmaceutical experts' opinions The administrative department of health and health has established national, provincial and Municipal Drug Administration and pharmacotherapeutics committees to provide technical support for drug administration and pharmaceutical services at the national and local levels We will encourage regions where conditions permit to pilot the establishment of the chief pharmacist system, and include the chief pharmacist in the management of the pharmacist expert database 2、 Strengthen the rational use of drugs (4) strengthen the drug safety management of medical institutions A medical institution shall establish a monitoring system covering the whole process of drug purchase, storage, distribution, deployment and use, strengthen the dynamic monitoring and analysis of drug use, make a scientific estimate of the quantity of drugs used, and realize the traceability of the source and destination of drugs According to the relevant provisions of drug storage, provide places, facilities and equipment consistent with the conditions of drug storage, and regularly carry out maintenance and quality inspection on the stored drugs Follow the principle of first out in the near term to avoid expired drugs We will strictly regulate the management of special drugs and high warning drugs to prevent them from flowing into illegal channels （5） To improve the level of clinical rational drug use Doctors should follow the principle of rational use of drugs, be able to take orally without intramuscular injection and intramuscular injection without infusion, make reasonable prescriptions according to the relevant disease diagnosis and treatment specifications, medication guidelines and clinical routes, and give priority to the selection of national basic drugs, centralized procurement and use of drugs by national organizations and drugs listed in the national medical insurance catalog Give full play to the role of drug quality control centers at all levels, strengthen the monitoring of adverse drug reactions, drug use errors and drug harm events, timely report according to regulations, improve emergency response capacity, and ensure drug safety The higher level medical institutions in medical consortia should strengthen the guidance to the lower level medical institutions, and promote the improvement of the pharmaceutical service level and medical service quality at the grass-roots level The administrative departments of health and health at all levels shall take the training of rational use of drugs as an important part of continuing education, incorporate the clinical application guide and prescription set of drugs into the continuing medical education project, focus on strengthening the training of rational use of basic drugs, and realize the full coverage of the training of doctors and pharmacists in medical institutions （6） Strengthen pharmacists or other pharmaceutical technicians to review prescriptions We will strengthen training, improve management systems, and improve the ability of pharmacists or other pharmaceutical technicians to participate in drug treatment management Pharmacists or other pharmaceutical technicians are responsible for the examination and approval of prescriptions, dispensing and other pharmaceutical services All prescriptions should be approved before entering the link of pricing and dispensing We should strengthen the examination and evaluation of prescriptions, focus on the examination of the legality, standardization and suitability of prescriptions, and timely communicate with prescription doctors and urge them to revise prescriptions that are not standardized, unsuitable for drugs and over normal, so as to ensure the safe, effective, economic and appropriate use of drugs （7） Strengthen the management of rational drug use and performance evaluation The administrative department of health and health should include the indicators related to the rational use of drugs in medical institutions into the performance appraisal system of medical institutions and medical personnel, and refine the indicators and contents related to the purchase and use of essential drugs Pharmacists or other pharmaceutical technicians shall promptly dispose of unreasonable prescriptions in accordance with relevant regulations The medical insurance department finds that it may affect or lose the expenditure of medical insurance fund