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    Home > Active Ingredient News > Drugs Articles > The three trends of complementary drug use and strict supervision are imperative

    The three trends of complementary drug use and strict supervision are imperative

    • Last Update: 2021-02-05
    • Source: Internet
    • Author: User
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    although the "auxiliary drug catalogue" are provincial or pilot regional catalogues, but the national level issued fee guidelines show that the monitoring of auxiliary drug use is bound to be nationalized. The Notice on Determining the Increase in Medical Expenses issued by the National Health and Planning Commission on June 20, 2016 is a key fee-control guideline that calls for strict control of complementary medications and lists relevant measures. It also mentions the target of the end of 2017 - a reduction in national health-care costs to less than 10 per cent.
    auxiliary drug is demonized as "God medicine", its application is wide, high dosage, sales ranking the forefront, has become the drug control policy in the focus of monitoring drugs. In fact, at a time when the industry's definition of complementary drug use is still controversial, medical institutions have begun to introduce various management measures for the monitoring of complementary drug use. In the future, the "auxiliary drug catalogue" may become the so-called "focused monitoring drug catalogue".health care is urgent: the emergency of auxiliary drug control is imperative
    the deficit crisis of health insurance funds is imminent.
    according to the 2015 Statistical Bulletin on the Development of Human Resources and Social Security issued by the Ministry of Human Resources and Social Security, the total income of the basic urban medical insurance fund for the whole year was 1,119.3 billion yuan, with expenditure of 931.2 billion yuan, an increase of 15.5% and 14.5% respectively over the previous year. Compared to the 19.6% growth rate of expenditure and 17.4% growth in revenue in 2014, the growth rate of expenditure in 2015 was finally lower than the growth rate of income.
    previous data pointed out that in 2014 China has 185 co-ordination areas of urban workers health insurance funds appear to be insolvent. The Fifth Plenary Session of the 18th Central Committee proposed to improve the adjustment mechanism of stable and sustainable financing and reimbursement ratio of medical insurance, and to study the policy of implementing the policy of medical insurance contribution participation for workers and retirees, which means that the three factors of medical expenses increase significantly, the growth rate of medical insurance financing slow down and the aging of the population, the medical insurance fund is about to be unable to carry.
    The urgent pressure of the medical insurance fund has pushed the Health Planning Commission to reduce the behavior of doctors' prescriptions for drugs with unclear clinical efficacy by guiding doctors to use drugs clinically rationally, while the medical insurance authorities have strictly monitored the higher prices and the efficacy of drugs on the basis of ensuring that patients must take drugs, and improved the efficiency of the use of medical insurance funds. "Auxiliary drug use" in the clinical use of large, sales accounted for relatively high, the efficacy is not clear, will inevitably be the focus of health insurance control monitoring objectives.
    Because both the base drug and the medical insurance catalogue contain auxiliary drugs, the Ministry of Human And Social Affairs will certainly strictly control whether doctors in accordance with the instructions prescribed, whether there is a restriction on the use of auxiliary drugs in medical insurance drugs to use auxiliary drugs, warning doctors not to arbitrarily expand the drug instructions prescribed by the adaptive, extended course of treatment, increase the dose and so on. Physicians use drugs that exceed the per capita cost of health insurance, health care centers refuse to pay, and physician over-prescriptions are restricted.
    The Notice of the General Office of the State Council on the Key Tasks for Deepening the Reform of the Medical and Health System in 2016, issued in April 2016, requires the pilot cities for the reform of public hospitals to make specific lists and implement key monitoring of the unreasonable use of high-priced drugs such as auxiliary and nutritional products, in the hope that they will initially curb the momentum of unreasonable growth in medical costs.Classification debate: Drug use is in the hands of medical institutions and doctors
    One of the arguments for complementary medications is that drugs have different roles and meanings under different conditions of use for different diseases, with some products being complementary in some departments or disease treatments, while others may be clinically demanding therapeutic drugs.
    drugs in the list of complementary medications are therapeutic drugs that have clinical needs. For example, according to the "Guidelines for the Clinical Application of Narcotic Drugs" issued by the former Ministry of Health in 2007, some of the drugs have a clear clinical treatment need: nonsteroidal anti-inflammatory drugs on bone metastasis, soft tissue immersion, arthritis and postoperative pain have a clear auxiliary therapeutic effect; Hormones have better relief effects on acute nerve compression, visceral swelling pain, and intracranial hypertension, tricyclycline antidepressants are ideal drugs for treating nerve pain, improving depression and insomnia, and pain caused by bone metastasis, in addition to radiation therapy and aforementioned treatment, calcitonin is a more effective drug used in recent years.
    , the difference between complementary medication and placebo is also a point of contention. Taking a placebo, known as a placebo effect, can improve a person's physical state by producing a psychologically positive response to patients who are eager for treatment and have full confidence in their medical staff. Any drug can have a placebo effect. Complementary medication is generally considered to be wrong cause and treatment, treatment efficacy is not clear, placebo is usually safe and ineffective, then the auxiliary drug is a placebo?
    addition, whether Chinese medicine, especially Chinese medicine injections, is an auxiliary drug has also caused widespread debate. Western medicine doctors using Chinese medicine injections in accordance with western medicine theory application may be auxiliary drugs, but in accordance with chinese medicine dialectical treatment theory using Chinese medicine injections is therapeutic products.
    , such as the chemical in the famous "God medicine" aspirin. When it was launched in 1898, it treated pain, fever and inflammation, often used to relieve headaches, muscle pain, toothache, colds and joint swelling. In 1979, the FDA granted it as a drug to prevent the re-development of cerebral thrombosis, and in 1985 the disease expanded to prevent the re-effigy of myocardial infarction. Subsequently, with the accumulation of clinical data, aspirin can also be used to prevent temporary ischemic attacks (TIA), myocardial infarction, atrial fibrillation, artificial heart valves, venous fistula or other post-surgery thrombosis, but also for the treatment of unstable angina. In 2014, British scientists assessed all available evidence and concluded that taking aspirin daily reduced the risk of developing or dying from stomach or bowel cancer.
    has been on the market for nearly 90 years is similar to aspirin. Metformin is mainly used in the treatment of type 2 diabetes and in the routine treatment of polycystic ovary syndrome. Since then, studies have found that metformin can delay aging, its role in reducing the risk of cancer in diabetic patients has also been confirmed, and can improve the symptoms of alcoholic fatty liver disease, prevent and treat the common blinding disease staphylococcitis, reduce the prevalence of Parkinson's disease, and even expand the adaptation to respiratory diseases for tuberculosis-assisted treatment. Metformin is expected to be used more in clinical applications in the future.
    , however, there is debate about the clinical use of "god medicines" such as aspirin. If aspirin is used to prevent the first onset of a heart attack or stroke? The FDA recommends that patients take aspirin daily to help prevent heart attacks and strokes in high-risk groups, and there is ample evidence to support the effectiveness of aspirin in people at high risk of heart disease and stroke. However, a 2015 study found that one in ten U.S. patients is not suitable for receiving a daily low dose of aspirin to prevent the first onset of heart disease or stroke. Daily aspirin use by healthy people may do "more harm than good": aspirin reduces the risk of major cardiovascular events by 18 percent, but increases the risk of intracranial bleeding by 54 percent.
    There is debate in the pharmaceutical medical community about aspirin, which has a lot of clinical data, so it's never easy to determine whether a drug with ambiguous clinical data is an auxiliary or a therapeutic drug based on its unclear therapeutic effects.
    , it is difficult to clearly define the use of the drug on the basis of its own, so the ultimate right to use the drug is still in the hands of medical institutions and prescription doctors, through clinical needs to determine the status of drug use.: Big data to help monitor drug use
    Currently, medical institutions usually have three steps to supervise complementary drug use: the first step of
    is to focus on the monitoring of key drugs. According to the drug use, the Department of Pharmacy widely reviewed the statistical medical advice, consulted clinical experts, selected the standard of monitoring and the use of the high amount of auxiliary drugs in the medical orders, reported to the Pharmaceutical Committee after discussion and adoption to determine the focus of auxiliary drugs for key monitoring.
    step is to provide comprehensive oversight of the target personnel. The use of key monitoring of the use of auxiliary drugs to monitor the use of auxiliary drugs, the use of auxiliary drugs, frequency of use, the amount as the main monitoring content. Statistical analysis of the results of monitoring data shall be published by the Department of Discipline Inspection and Supervision on a monthly basis.
    step is to consider regulatory behavior in detail. The indicators such as "percentage of total drug amount" and "amount" of auxiliary drug use are ranked, the specific use of each auxiliary drug is accurately grasped, and the governance work is carried out in a targeted way.
    The June 2016 Notice on determining the increase in medical expenses as soon as possible, while not mentioning restrictions on complementary drug use, calls for the establishment of a public hospital medical cost monitoring system to sort the increase in medical expenses in hospitals in the region according to the results of the cost indicator monitoring, and to publish the results regularly each year to strengthen information disclosure and social supervision. It is expected that the establishment of the system will help to monitor the use of complementary medicines.
    Clinical path and single-disease fee management is also the current management methods promoted by the Health planning committee and the human society departments, through the establishment of a set of standardized treatment models and treatment procedures for a disease, with evidence-based medical evidence and guidance as a guide to promote treatment organizations and disease management methods, and ultimately play a role in regulating medical behavior, standardizing the rational use of auxiliary drugs, reducing costs, improving the quality of medical care.
    countries have in recent years established databases to track and analyse the use of certain drugs with particularly large amounts of money, meaning that the use of big data to evaluate the effectiveness of certain drugs is not far off. (Medical Economics)
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