摘要
目的:分析《2021版药品目录》限定支付情况。方法:分析限定支付药品在药品数目、中西药占比等方面的基本情况,并与《2020版药品目录》进行对比分析。结果:《2021版药品目录》限定支付药品共计861种,其中单一限定支付药品有655种,与《2020版药品目录》相比,《2021版药品目录》变化较多;但在政策执行过程中也暴露出一些问题。结论:《2021版药品目录》将更多药品纳入医保支付范畴,对限定支付的管理更为规范,在执行过程中要统筹考虑医保基金可持续发展,结合临床诊疗指南和患者实际需要,及时调整和完善限定支付相关政策。
Objective To analyze the limited payment of Medicine List for National Basic Medical Insurance.Methods Number of drugs and proportion of Chinese and western drugs in the limited payment of Medical Insurance Drug List 2021 were analyzed in comparison with Medical Insurance Drug List 2020.Results A total of 861 kinds of drugs were subject to limited payment in Medical Insurance Drug List2021,which was lower than that in Medical Insurance Drug List 2020,and there were differences in the changes of various types of drugs.Conclusion Medical Insurance Drug List 2021 includes more drugs into the scope of medical insurance payment,and limits the payment of new varieties,injection types and other high-risk varieties.The management of limited payment is more standardized.However,there are some problems to be improved in the specific application,in order to further promote the rational clinical use of drugs and the efficient use of medical insurance fund.
作者
张明敏
王国平
ZHANG Mingmin;WANG Guoping(Wannan Medical College,Wuhu Anhui 241000,China)
基金
皖南医学院2022年度校中青年科研基金项目“国家医保药品目录限定支付情况变化研究”(WKS202204)
安徽高校科学研究项目“基于社会期望的公立医院人文关怀制度建设研究”(SK2019ZD19)。
关键词
医保药品目录
限定支付
医保基金
medical insurance drug list
limited payment
medical insurance fund
