慢性病长期用药处方外配的落地障碍和实现途径

Obstacles and approaches for the implementation of external long-term prescription dispensing for chronic diseases

我国慢性病长期用药处方(以下简称“长处方”)政策逐步完善落实并开始鼓励长处方外配。长处方政策贯穿药品供应端、配备端、使用端及政策端,涉及医疗保障、卫生健康等政府部门及患者、医疗机构、定点零售药店等利益相关方。目前,要实现长处方外配存在以下问题:政策端药品目录不统一、监管各方需协同;配备端参与积极性和服务能力有待提高;使用端处方管理难度增加、流转平台有待完善。长处方政策的推进需要“三医”联动、多方参与和政策协同,其中,国谈药品“双通道”政策、药品集采及药店纳入门诊统筹管理均为慢性病长处方外配的落地起到了积极的推动作用。未来需在政策端完善配套政策、落实监管责任,配备端推进药品分级分类、提升服务能力,使用端完善电子处方流转平台、规范处方管理,以推动长处方外配落地执行。

The policy of long-term prescription for chronic diseases in China is gradually being improved and implemented,and external long-term prescription dispensing is being encouraged.The long-term prescription policy runs through the links of drug supply,equipment,use and policy,involving government departments such as medical security and health,as well as stakeholders such as patients,medical institutions and designated detail pharmacies.There are still some problems in the external dispensing of long-term prescriptions,such as the disunity of drug catalogue and the need for coordination among regulatory parties in the policy link;the need to improve the participation enthusiasm and service ability in the equipment link;the increased difficulty of prescription management,the need to improve the circulation platform in the use link.The promotion of external long-term prescription policy requires health insurance,medical service,and the medicine industry co-development,multi-party participation,and policy coordination.Among them,the“dual channel”policy,the policy of centralized medicine procurement,and the pharmacy included in outpatient overall management policy have all played a positive role in promoting the implementation of external long-term prescription dispensing for chronic diseases.It is necessary to improve supporting policies and implement regulatory responsibilities in the policy link,promote drug classification and service capabilities in the equipment link,improve the electronic prescription circulation platform,and strengthen prescription management in use link,so as to promote the implementation of external long-term prescription dispensing.