引用本文:李晓娜,朱 慧,蒋 阳,顾锦旭.[cn_title][J].[journal_cn_name],2019,[volume]([issue]):873-875.[点击复制]
Li Xiaona,Zhu Hui,Jiang Yang,Gu Jinxu.[en_title][J].[journal_en_name],2019,[volume]([issue]):873-875.[点击复制]
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南通市靶向药物纳入医保特药管理制度实施现状分析
李晓娜,朱 慧,蒋 阳,顾锦旭
0
(南通市第三人民医院医保办;医务科;南通市医疗保险基金管理中心稽核科;南通大学附属医院医保办)
摘要:
目的:分析靶向药物纳入医保范围后实施现状,为进一步完善靶向药物医保政策的持续推进提供参考。方法:对南通市靶向药物实施医保特药管理制度过程中存在的问题进行归纳分析。结果:特药管理制度切实缓解了恶性肿瘤患者的经济负担,促进定点医院和药店的建设发展,但给医保基金监管带来风险,仍需进一步完善。结论:需强化责任医师把关审核制度,进一步完善医保患者准入条件,同时增加县区定点医院和药店资质。
关键词:  靶向药物  医疗保险  特殊药品  管理政策
DOI:
基金项目:
Study on the Implementation Status of Special Medicine Management System enrolling Targeted Drugs into Medical Insurance in Nantong
Li Xiaona,Zhu Hui,Jiang Yang,Gu Jinxu
(Medical insurance Office,Nantong Third People’s Hospital;Department of Medical Affairs;Audit section of Nantong Medical Insurance Fund Management Center;Medical insurance Office,the Affiliated Hospital of Nantong University)
Abstract:
Objective:To analyze the management status of targeted drugs after being enrolled in medical insurance,and to provide reference for improving the insurance management policy of targeted drugs. Methods:The practice and exploration of special medicine management in Nantong was analyzed. Results:The special medicine management policy has relieved the economic burden of tumor patients and promoted the development of designated hospitals and pharmacies,but brung a risk for supervision of health care fund. Conclusions:It is necessary to strengthen the auditing system of responsible physician,to perfect the access conditions for patients with health insurance and to increase the qualifications for hospitals and pharmacies in district.
Key words:  targeted drugs  medical insurance  special medicine  management policy

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