Baidu
map

医保结算放开?山东省明确54种高值药品双渠道购买

2018-04-27 药店经理人 健康界

54种重大疾病治疗所需的高值药品,采取协议定点医疗机构和定点零售药店“双渠道”销售模式,并要求各地市要尽快将定点特药零售药店收费纳入医保结算系统,实现即时联网结算。

54种重大疾病治疗所需的高值药品,采取协议定点医疗机构和定点零售药店“双渠道”销售模式,并要求各地市要尽快将定点特药零售药店收费纳入医保结算系统,实现即时联网结算。

近期,根据新华社消息,山东省人社厅为避免出现医院特药紧缺,患者无法及时购药问题,近日出台规定,明确54种重大疾病治疗所需的高值药品,采取协议定点医疗机构和定点零售药店“双渠道”销售模式。

山东省人社厅职工医保处相关负责人对此介绍,此次新规中包含的药品为靶向治疗肿瘤药物和其他疾病特药。划定范围主要参照去年人社部确定纳入基本医保支付的36种国家谈判药品,以及山东纳入大病保险报销范畴的18种特殊药品。

山东省18种纳入大病保险报销范围的药物范围:注射用地西他滨、培门冬酶注射液、注射用硼替佐米、来那度胺胶囊、达沙替尼片、吉非替尼片、盐酸厄洛替尼片、盐酸埃克替尼片、重组人血管内皮抑制素注射液、贝伐珠单抗注射液、西妥昔单抗注射液、注射用雷替曲塞、注射用曲妥珠单抗、甲磺酸阿帕替尼片、苹果酸舒尼替尼胶囊、波生坦片、注射用重组人凝血因子Ⅸ、富马酸替诺福韦二吡呋酯片、甲磺酸伊马替尼片(胶囊)。

对于这54种药品,定点医疗机构暂未备药的,可按规定由责任医师开具处方,患者凭处方、病历和药品审核备案表,持社保卡到定点特药零售药店购取药。

山东还要求,各地市要尽快将定点特药零售药店收费纳入医保结算系统,实现即时联网结算。同时,协议管理医药机构、责任医(药)师要认真落实医保相关政策规定,规范诊疗行为。对于超适应症、超医保限定支付范围用药和违规配药等情形,医保基金不予支付。

定点特药零售药店早已展开

2017年3月16日,山东省下发《山东省人力资源和社会保障厅山东省财政厅关于大病保险合规医疗费用补偿有关问题的通知(试行)》明确规定将特药纳入补偿范围,并实行“三定”管理(定责任医师、定医疗机构和定零售药店)。

“三定"管理政策明确规定:在责任医师和定点医疗机构完成相应服务后,定点零售药店负责药品的外配处方配药供应及慈善赠药有关事宜的落实等服务工作。

业内相关人士反馈:“三定”管理政策本质上是减少患者购药的时间和交通成本,但从实施上来说,因为多数特药价格高昂,又需要长期服用,如果不能保证纳入医保结算系统,则可能意味着,大部分患者依然只能到定点医疗机构购药,这样一来,定点特药零售药店没有发挥相应的作用,也没有真正的满足患者用药需求。

而这次山东省人社厅要求“各地市要尽快将定点特药零售药店收费纳入医保结算系统,实现即时联网结算”的规定,无疑是对之前“三定”管理政策的及时补充,患者或患者家属在药店购买相关高值药品时,结算上有了保障,保证了特药的双渠道购药模式尽快实现,方便的还是老百姓!

分析观点认为:在多地放开处方药销售,试行电子处方购药背景下,相关高值药品双渠道购买,并及时纳入医保结算系统,有望成为打开处方外流最后关闸的有力手段!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2006108, encodeId=cb2d200610820, content=<a href='/topic/show?id=269f3388e6a' target=_blank style='color:#2F92EE;'>#医保结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33887, encryptionId=269f3388e6a, topicName=医保结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Thu Dec 06 10:57:00 CST 2018, time=2018-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908103, encodeId=39aa1908103f3, content=<a href='/topic/show?id=96334e74810' target=_blank style='color:#2F92EE;'>#山东省#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47748, encryptionId=96334e74810, topicName=山东省)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 09 01:57:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670255, encodeId=966616e025574, content=<a href='/topic/show?id=c50be87281c' target=_blank style='color:#2F92EE;'>#结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78728, encryptionId=c50be87281c, topicName=结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=178c26602075, createdName=vividelife, createdTime=Sat Aug 11 15:57:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771984, encodeId=623d1e71984ce, content=<a href='/topic/show?id=a70f10218197' target=_blank style='color:#2F92EE;'>#高值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102181, encryptionId=a70f10218197, topicName=高值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7f5e38357689, createdName=guguangxiang, createdTime=Mon Jun 18 03:57:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257547, encodeId=6038125e54721, content=<a href='/topic/show?id=839910218ec0' target=_blank style='color:#2F92EE;'>#高值药品#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102187, encryptionId=839910218ec0, topicName=高值药品)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Apr 29 03:57:00 CST 2018, time=2018-04-29, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2006108, encodeId=cb2d200610820, content=<a href='/topic/show?id=269f3388e6a' target=_blank style='color:#2F92EE;'>#医保结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33887, encryptionId=269f3388e6a, topicName=医保结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Thu Dec 06 10:57:00 CST 2018, time=2018-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908103, encodeId=39aa1908103f3, content=<a href='/topic/show?id=96334e74810' target=_blank style='color:#2F92EE;'>#山东省#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47748, encryptionId=96334e74810, topicName=山东省)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 09 01:57:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670255, encodeId=966616e025574, content=<a href='/topic/show?id=c50be87281c' target=_blank style='color:#2F92EE;'>#结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78728, encryptionId=c50be87281c, topicName=结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=178c26602075, createdName=vividelife, createdTime=Sat Aug 11 15:57:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771984, encodeId=623d1e71984ce, content=<a href='/topic/show?id=a70f10218197' target=_blank style='color:#2F92EE;'>#高值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102181, encryptionId=a70f10218197, topicName=高值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7f5e38357689, createdName=guguangxiang, createdTime=Mon Jun 18 03:57:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257547, encodeId=6038125e54721, content=<a href='/topic/show?id=839910218ec0' target=_blank style='color:#2F92EE;'>#高值药品#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102187, encryptionId=839910218ec0, topicName=高值药品)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Apr 29 03:57:00 CST 2018, time=2018-04-29, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2006108, encodeId=cb2d200610820, content=<a href='/topic/show?id=269f3388e6a' target=_blank style='color:#2F92EE;'>#医保结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33887, encryptionId=269f3388e6a, topicName=医保结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Thu Dec 06 10:57:00 CST 2018, time=2018-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908103, encodeId=39aa1908103f3, content=<a href='/topic/show?id=96334e74810' target=_blank style='color:#2F92EE;'>#山东省#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47748, encryptionId=96334e74810, topicName=山东省)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 09 01:57:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670255, encodeId=966616e025574, content=<a href='/topic/show?id=c50be87281c' target=_blank style='color:#2F92EE;'>#结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78728, encryptionId=c50be87281c, topicName=结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=178c26602075, createdName=vividelife, createdTime=Sat Aug 11 15:57:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771984, encodeId=623d1e71984ce, content=<a href='/topic/show?id=a70f10218197' target=_blank style='color:#2F92EE;'>#高值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102181, encryptionId=a70f10218197, topicName=高值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7f5e38357689, createdName=guguangxiang, createdTime=Mon Jun 18 03:57:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257547, encodeId=6038125e54721, content=<a href='/topic/show?id=839910218ec0' target=_blank style='color:#2F92EE;'>#高值药品#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102187, encryptionId=839910218ec0, topicName=高值药品)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Apr 29 03:57:00 CST 2018, time=2018-04-29, status=1, ipAttribution=)]
    2018-08-11 vividelife
  4. [GetPortalCommentsPageByObjectIdResponse(id=2006108, encodeId=cb2d200610820, content=<a href='/topic/show?id=269f3388e6a' target=_blank style='color:#2F92EE;'>#医保结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33887, encryptionId=269f3388e6a, topicName=医保结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Thu Dec 06 10:57:00 CST 2018, time=2018-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908103, encodeId=39aa1908103f3, content=<a href='/topic/show?id=96334e74810' target=_blank style='color:#2F92EE;'>#山东省#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47748, encryptionId=96334e74810, topicName=山东省)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 09 01:57:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670255, encodeId=966616e025574, content=<a href='/topic/show?id=c50be87281c' target=_blank style='color:#2F92EE;'>#结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78728, encryptionId=c50be87281c, topicName=结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=178c26602075, createdName=vividelife, createdTime=Sat Aug 11 15:57:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771984, encodeId=623d1e71984ce, content=<a href='/topic/show?id=a70f10218197' target=_blank style='color:#2F92EE;'>#高值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102181, encryptionId=a70f10218197, topicName=高值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7f5e38357689, createdName=guguangxiang, createdTime=Mon Jun 18 03:57:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257547, encodeId=6038125e54721, content=<a href='/topic/show?id=839910218ec0' target=_blank style='color:#2F92EE;'>#高值药品#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102187, encryptionId=839910218ec0, topicName=高值药品)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Apr 29 03:57:00 CST 2018, time=2018-04-29, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2006108, encodeId=cb2d200610820, content=<a href='/topic/show?id=269f3388e6a' target=_blank style='color:#2F92EE;'>#医保结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33887, encryptionId=269f3388e6a, topicName=医保结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac782500066, createdName=12498768m13(暂无昵称), createdTime=Thu Dec 06 10:57:00 CST 2018, time=2018-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908103, encodeId=39aa1908103f3, content=<a href='/topic/show?id=96334e74810' target=_blank style='color:#2F92EE;'>#山东省#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47748, encryptionId=96334e74810, topicName=山东省)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 09 01:57:00 CST 2019, time=2019-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1670255, encodeId=966616e025574, content=<a href='/topic/show?id=c50be87281c' target=_blank style='color:#2F92EE;'>#结算#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78728, encryptionId=c50be87281c, topicName=结算)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=178c26602075, createdName=vividelife, createdTime=Sat Aug 11 15:57:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771984, encodeId=623d1e71984ce, content=<a href='/topic/show?id=a70f10218197' target=_blank style='color:#2F92EE;'>#高值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102181, encryptionId=a70f10218197, topicName=高值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7f5e38357689, createdName=guguangxiang, createdTime=Mon Jun 18 03:57:00 CST 2018, time=2018-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1257547, encodeId=6038125e54721, content=<a href='/topic/show?id=839910218ec0' target=_blank style='color:#2F92EE;'>#高值药品#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102187, encryptionId=839910218ec0, topicName=高值药品)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sun Apr 29 03:57:00 CST 2018, time=2018-04-29, status=1, ipAttribution=)]
Baidu
map
Baidu
map
Baidu
map