2009年版和2017年版《国家基本医疗保险、工伤保险和生育保险药品目录》对比及发展研究
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篇名: 2009年版和2017年版《国家基本医疗保险、工伤保险和生育保险药品目录》对比及发展研究
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摘要: 目的:为我国医疗保险药品相关政策和目录的完善提供参考。方法:采用描述性分析方法,比较2009年版和2017年版《国家基本医疗保险、工伤保险和生育保险药品目录》的目录项目、药品分类(包括分类代码、分级与名称)、药品品种(包括新增品种、剔除品种)、药品剂型(包括新增剂型分类、调整剂型)以及支付和使用限制等变化,探讨其发展变化趋势及存在问题。结果:2017年版目录比2009年版增加“药品分类代码”项,减少“英文名称”项。药品分类代码中新设置“药品分类代码”项,分级由六级精简为四级,四级分类的编码和名称与解剖学-治疗学-化学(ATC)分类系统的前四级分类规律一致。2017年版收录药品品种2 535个,较2009年版实际新增362个(化学药151个、中成药211个),此外,化学药剔除15个品种、转至中成药目录4个品种,中成药剔除11个品种、转至化学药目录1个品种。2017年版目录实际比2009年版多20个剂型、涉及31个品种,调整剂型的有231个(化学药143个、中成药88个)。支付和使用限制的化学药从239个增加到302个、中成药从72个增加到115个。结论:2017年版目录增加了收载药品数量,扩大了临床用药范围,调整完善了目录分类结构,医保控费品种数呈增长趋势。
ABSTRACT: OBJECTIVE: To provide reference for improving related policy and list about medical insurance medicines in China. METHODS: The descriptive analysis method was used to compare 2017 and 2009 edition of Medicine List for National Basic Medical Insurance, Employment Injury Insurance and Maternity Insurance in respects of item, medicine classification (including classification code, grading and name), medicine types (including new type, removed type), dosage (including new dosage classification, adjusted dosage form), the limit of payment and use. The trend of its development and the existing problems were discussed. RESULTS: Compared with 2009 edition, 2017 edition of medicine list added the item of “drug classification code” and removed the item of “English name”. The grading of drug classification code was reduced from six grades to four grades. The code and name of four grades classification were in accordance with the first four grades classification rules of the anatomical- therapeutic-chemistry (ATC). A total of 2 535 types were included in 2017 edition, increasing by 362 types compared to 2009 edition (151 chemical medicines, 211 Chinese patent medicines). 15 types of chemical medicines were removed, and 4 types were transferred to Chinese patent medicine list; 11 types of Chinese patent medicines were removed, and one type was transferred to chemical medicine list. 2017 edition was actually 20 more dosage forms than 2009 edition, involving 31 types; dosage forms of 231 types were adjusted (143 chemical medicines, 88 Chinese patent medicines). Chemical medicines of usage and payment restriction increased from 239 to 302, and Chinese patent medicines increased from 72 to 115, respectively. CONCLUSIONS: 2017 edition of list increases the number of medicine, expands the scope of clinical medication and improves the classification structure of the list. The number of medical insurance cost control type shows a growing trend.
期刊: 2018年第29卷第9期
作者: 沈怡雯,王永庆,张海涛,吴德芹,陈安九,孟玲
AUTHORS: SHEN Yiwen,WANG Yongqing,ZHANG Haitao,WU Deqin,CHEN Anjiu,MENG Ling
关键字: 国家基本医疗保险、工伤保险和生育保险药品目录;2009年版;2017年版;对比;发展
KEYWORDS: Medicine List for National Basic Medical Insurance, Employment Injury Insurance and Maternity Insurance; 2009 edition; 2017 edition; Comparison; Development
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