秒速赛车控制器

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剛剛!醫保局發布2019年談判藥品目錄解讀
發布時間: 2019-11-29     來源: 國家醫保局

LAIYUAN:GUOJIAYIBAOJU

WEIRANGSHEHUIGEJIEJINYIBULEJIE2019NIANGUOJIAYIBAOYAOPINTANPANGONGZUO,TUIDONGTANPANYAOPINLUODI,GUOJIAYIBAOJUDUI《GUANYUJIANG2019NIANTANPANYAOPINNARUYILEIFANWEIDETONGZHI》(YIBAOFA〔2019〕65HAO,YIXIAJIANCHENG《TONGZHI》)JINXINGLEJIEDU。

一、2019年國家醫保藥品談判準入工作的總體思路和目標是什么?

WEILUOSHIDANGZHONGYANG、GUOWUYUANJUECEBUSHU,GUOJIAYIBAOJURENZHENKAIZHAN2019NIANGUOJIAYIBAOYAOPINMULUDIAOZHENGGONGZUO,CICIDIAOZHENGZONGTISHANGFENWEICHANGGUIZHUNRUHETANPANZHUNRULIANGGEJIEDUAN。GANGGANGJIESHUDETANPANZHUNRUSHIYIBAOZHIDUJIANLIYILAIGUIMOZUIDADEYICI。BENCITANPANSHIZHONGJIANCHIYIWEIHUCANBAORENJIANKANGWEIGENBENCHUFADIAN,JIANCHIBAOJIBENDEGONGNENGDINGWEI,JIANCHITONGCHOUJIANGU,JIANCHIGONGKAI、GONGPING、GONGZHENGDEZHUANJIAPINGSHENZHI,ANZHAO“JINLIERWEI、LIANGLIERXING”DEYAOQIU,QUELILE“TUCHUZHONGDIAN、BUQIDUANBAN、YOUHUAJIEGOU、GULICHUANGXIN”DEDIAOZHENGSILU,ZAIQUEBAOJIJINKECHENGSHOUDEQIANTIXIA,CHONGFENFAHUIGUOJIAYIBAOJUTONGCHOUGUANLICHENGXIANGYIBAODETIZHIYOUSHI、ZHENGCEYOUSHI、SHICHANGYOUSHI,YUXIANGGUANQIYEJINXINGTANPANBINGDACHENGLEXIEYI,SHIXIANLETIGAOJIBENYIBAOYAOPINBAOZHANGNENGLIHESHUIPING,TIGAOYIBAOZIJINSHIYONGXIAOYIDEMUBIAO,YOULIYUGENGHAODIMANZUGUANGDACANBAORENDEJIBENYONGYAOXUQIU,TISHENGGUANGDARENMINQUNZHONGDEHUODEGAN。

二、本次進入談判環節的藥品數量是多少?

YIBAOYAOPINZHUNRUTANPANZHIZHENDUI2018NIAN12YUE31RIYIQIANZAIZHONGGUOSHANGSHIDEDUJIAYAOPIN。ZAIYIBAOYAOPINMULUCHANGGUIZHUNRUJIEDUAN,YOUZHUANJIAPINGSHEN、TOUPIAOLINXUANTICHULE128GETANPANYAOPINBEIXUANPINZHONG,JINGXIANGQIYEQUERENTANPANYIXIANG,ZUIZHONGQUEDING119GEYAOPINZUOWEIXINZENGTANPANPINZHONG。CIWAI,2017NIANTANPANZHUNRUDEPINZHONGZHONG,YOU31GEXUYAOZAICITANPANQUEDINGNENGFOUXUYUE。LIANGZHEXIANGJIAGONGJI150GE,XINZENGTANPANYAOPINSHULIANGHETANPANYAOPINZONGLIANGJUNCHUANGLISHIXINGAO。

三、本次國家醫保藥品談判的結果如何?(談判成功率如何?談判成功的藥品數量、類型、治療領域及價格降幅如何?)

ZAI150GETANPANYAOPINZHONG,119GEXINZENGYAOPINYOU70GETANPANCHENGGONG,BAOKUO52GEXIYAOHE18GEZHONGCHENGYAO,JIAGEPINGJUNJIANGFUWEI60.7%。SANZHONGBINGGANZHILIAOYONGYAOJIANGFUPINGJUNZAI85%YISHANG,ZHONGLIU、TANGNIAOBINGDENGZHILIAOYONGYAODEJIANGFUPINGJUNZAI65%ZUOYOU。31GEXUYUEYAOPINYOU27GETANPANCHENGGONG,JIAGEPINGJUNJIANGFUWEI26.4%。TANPANCHENGGONGDEYAOPINDUOWEIJINNIANLAIXINSHANGSHIQIEJUYOUJIAOGAOLINCHUANGJIAZHIDEYAOPIN,SHEJIAIZHENG、HANJIANBING、GANYAN、TANGNIAOBING、NAIDUOYAOJIEHE、FENGSHIMIANYI、XINNAOXUEGUAN、XIAOHUADENG10YUGELINCHUANGZHILIAOLINGYU。

JINGGUOCHANGGUIZHUNRUHETANPANZHUNRUHOU,2019NIANGUOJIAYIBAOYAOPINMULUDIAOZHENGQUANMIANWANCHENG,ZUIZHONGSHOULUYAOPIN2709GE。YU2017BANMULUXIANGBI,DIAORUYAOPIN218GE,DIAOCHUYAOPIN154GE,JINGZENGYAOPIN64GE。JINGGUOBENCIDIAOZHENG,ZHONGDIANLINGYUBAOZHANGNENGLIJINYIBUTISHENG,JIBENYIBAODEBAOZHANGNENGLIDADAOXINDEGAODU。

四、本次目錄調整方案中提到將優先考慮國家基本藥物中的非醫保品種、癌癥及罕見病等重大疾病治療用藥、高血壓和糖尿病等慢性病治療用藥、兒童用藥等,上述領域的藥品談判準入情況如何?

BENCITANPANSHIZHONGJUJIAOCANBAOHUANZHELINCHUANGZHILIAOXUQIU,JIANGZHONGLIU、HANJIANBING、MANXINGBINGHEERTONGYONGYAODENGZUOWEIZHONGDIAN,JINRUTANPANHUANJIEDEJIBENYAOWUQUANBUTANPANCHENGGONG,BEISHOUGUANZHUDEPD-1LEIZHONGLIUMIANYIZHILIAOYAO、NENGZHIYUBINGGANDEKOUFUYAODENGSHOUCIJINRUMULU,FEIAI、ZHICHANGAI、RUXIANAIDENGYOULEGENGDUOBAXIANGHEHUALIAOYAOXUANZE,BOSHENGTAN、MAIGESITADENGYAOPINDETANPANCHENGGONG,SHIFEIDONGMOGAOYA、CXINGNIMANPIKEBINGDENGHANJIANBINGHUANZHEBAITUOMULUNEIWUYAOKEZHIDEKUNJING,TANGNIAOBING、YIGAN、LEIFENGSHIXINGGUANJIEYAN、NAIDUOYAOJIEHE、MANXINGZUSAIXINGFEIYANDENGHUANZHEYOULEGENGDUOYOUZHIXINYAOKEGONGXUANZE。

CONGZHONGDIANLINGYUKAN,5GEJIBENYAOWUQUANBUTANPANCHENGGONG,22GEKANGAIYAO、7GEHANJIANBINGYONGYAO、14GEMANXINGBING(HANTANGNIAOBING、YIGAN、LEIFENGSHIXINGGUANJIEYANDENG)YONGYAO、4GEERTONGYONGYAOTANPANCHENGGONG,MULUJIEGOUDEDAOJINYIBUYOUHUA,SHIXIANLEYUQIMUBIAO。

五、本次國家醫保藥品談判準入工作的流程是怎樣的?

YISHIZHIDINGTANPANFANGAN,SHOUJIHUIZONGXIANGGUANSHUJU。CHONGFENTINGQUGEFANGMIANYIJIANJIANYIBINGFANFULUNZHENG,ZHIDINGLE《2019NIANYIBAOYAOPINMULUTANPANZHUNRUGONGZUOFANGAN》。TONGGUODIFANGYIBAOBUMEN、QIYEHEYAOPINZHAOCAIPINGTAIDENGDUOQUDAOSHOUJIHUIZONGXIANGGUANSHUJU,WEITANPANGONGZUODAHAOJICHU。ERSHICESUANTANPANDIJIA。ZAIQUANGUOFANWEINEICHOUQUYAOWUJINGJIXUEHEYIBAOGUANLIFANGMIANDEQUANWEIZHUANJIAHEGUGANLILIANG,FENBIEJIANLIYAOWUJINGJIXUEZUHEJIJINCESUANZU,ANZHAOCESUANJISHUYAODIANFENZUPINGXINGCESUAN,XINGCHENGTANPANDIJIA。SANSHIJIAQIANGYUQIYEGOUTONG。ZUZHILIANGLUNJIZHONGGOUTONG,XIANGTANPANQIYEJIESHAOTANPANGONGZUOZONGTIANPAI、JUTIYAOPINTANPANCESUANDEKAOLVYAOSU、TANPANGUIZE、TIJIAOZILIAOYAOQIU,YINDAOQIXINGCHENGHELIYUQI,BINGCHONGFENTINGQUQIYEYIJIANJIANYI。JIANLIGOUTONGJIZHI,JISHIHUIFUQIYEGUANXINDEWENTI,BIYAOSHIZUZHIZHUANJIAZHUANMENLUNZHENG。SISHIKAIZHANXIANCHANGTANPAN。ZHIDINGTANPANGUIZEHECHENGXU,MINGQUETANPANXIZE,TONGYITANPANKOUJINGHEBIAOZHUN。CHOUDIAOXIANCHANGTANPANZHUANJIAYUQIYEMIANDUIMIANTANPAN,DANGCHANGXUANBUJIEGUO,BINGQIANZIQUEREN。WUSHIQIANSHUZHENGSHIXIEYI。GENJUTANPANJIEGUO,YUQIYEZHUYIQIANSHUZHENGSHIXIEYI。

六、針對本次談判工作,國家醫保局采取了哪些措施加強監督,保證醫保藥品目錄調整的公平公正和規范廉潔?

秒速赛车控制器GUOJIAYIBAOJUSHIZHONGGAODUZHONGSHIJIAQIANGYIBAOYAOPINMULUDIAOZHENGZHONGJIANDUJIZHIDEJIANSHE,JULINGDAOZAIGUANJIANHUANJIECHUMIANBUSHU,MINGQUEGONGZUORENWU,QIANGDIAOLIANZHENGJILVYAOQIU,QUEBAOTANPANGONGZUOKEXUE、GUIFAN、LIANJIE、YOUXU。YISHIWANSHANNEIKONGJIZHI,MINGQUEGONGZUOGANGWEIHERENYUANZEREN,WANSHANXINXIBAOMI、LIYIHUIBI、ZERENZHUIJIUDENGZHIDUCUOSHI,JIAQIANGLIANZHENGBAOMIDENGFANGMIANDEJIAOYU、JIANDUHEGUANLI。ERSHIQIANGHUADUIZHUANJIADEJIANDUGUANLI。ZAIQUEDINGZHUANJIAMINGDAN、FENPEICESUAN、TANPANRENWUDENGHUANJIEYANGEJIANCHILIYIHUIBIHESUIJIYUANZE,SUOYOUZHUANJIAJUNSUIJICHOUQUCHANSHENG。JIANLIZHUANJIAFUZE、LIYIHUIBI、ZERENZHUIJIUDENGZHIDU,SUOYOUPINGSHEN、LINXUANGONGZUOQUANCHENGLIUHEN,QUEBAOZHUANJIADULI、GONGZHENGDITICHUPINGSHENYIJIAN。SANSHIJIAQIANGGUIFANYUESHU。SUOYOUGONGZUORENYUANHEZHUANJIAJUNQIANSHU《BAOMIHELIANZHENGCHENGNUOSHU》《WULIYICHONGTUSHENGMING》。SUOYOUZHUANJIAJUNYOUSUOZAIDANWEIDANGZUZHITUIJIAN,BINGRUSHIBAOGAOYUQIYELIYIXIANGGUANDESHIXIANG。SISHIZHUDONGJIESHOUGEFANGJIANDU。JIESHOUSHEHUIGEJIEDETOUSUJUBAO。TANPANXIANCHANGYAOQINGMEITIHEJIJIANJIANCHADENGFANGMIANCANJIA,TANPANGUOCHENGQUANCHENGLUYINLUXIANG,ZUODAOSUOYOUZHENGJUKEZHUISU、GEFANGKESHENSU。ANZHAOYISHANGYAOQIU,BENCITANPANGONGZUOGUIFANYOUXU,WENTUOTUIJIN。

七、本次談判成功的藥品,對患者個人負擔影響如何?

CHUBUGUSUAN,XINZENGDE70GEYAOPINJIANGFUWEI60.7%,RUGUOANZHAO50%DESHIJIBAOXIAOBILIJISUAN,HUANZHEGERENZIFUBILIJIANGJIANGZHIYUANLAIDE20%YIXIA,GEBIEYAOPINDEZIFUBILIJIANGJIANGZHIYUANLAIDE5%。XUYUEDE27GEYAOPINJIANGFUWEI26.4%,HUANZHEGERENZIFUBILIJIANGTONGBUXIAJIANG。

八、本次國家醫保藥品談判工作的亮點和成效如何?

2019NIANGUOJIAYIBAOYAOPINMULUDIAOZHENGSHIDANGHEZHENGFUBUDUANTIGAOQUNZHONGYILIAOBAOZHANGDAIYUDEZHONGYAOJUCUO,TONGGUOBENCITANPAN,YISHIZHONGDAJIBINGBAOZHANGNENGLIMINGXIANTISHENG。YIPIRENKEDUGAO、XINSHANGSHIQIELINCHUANGJIAZHIGAODEYAOPINDIAORUMULU,EXINGZHONGLIU、HANJIANBING、MANXINGBINGHEERTONGYONGYAOLINGYUJUNYOUYAOPINCHENGGONGTANPANZHUNRU,JIBENYIBAODEBAOZHANGNENGLIMINGXIANTISHENG;ERSHIYILIANGHUANJIATUIDONGYAOFEIDAFUXIAJIANG。GUOJIAYIBAOJUFAHUI“ZHANLVEGOUMAIZHE”ZUOYONG,TANPANXINNARUYAOPINHEXUYUEYAOPINDEJIAGEJUNYOUDAFUXIAJIANG,DUOGEQUANQIUZHIMINGDE“GUIZUYAO”KAICHULE“PINGMINJIA”,DUOSHUJINKOUYAOPINJUNGEICHULEQUANQIUZUIDIJIA;SANSHIYIBAOJIJINKEYIBAOCHIWENDINGYUNXING。ZAICHANGGUIDIAOZHENGJIEDUANDIAOCHUDE150GEPINZHONGWEITANPANZHUNRUDEPINZHONGTENGCHULEKONGJIAN,SHIXIANLETONGGUO“TENGLONGHUANNIAO”QUEBAOJIJINYUNXINGKECHIXUHEBAOZHANGNENGLIYOUTISHENGDEMUBIAO;SISHITUCHULEGULICHUANGXINDEDAOXIANG。12GEGUOCHANZHONGDACHUANGXINYAOPINTANCHENGLE8GE。ZHECITANPANCHENGGONGDEYAOPINJUEDADUOSHUDOUSHIJINNIANLAISHANGSHIDEXINYAO,QIZHONGHENDUOSHI2018NIANXINSHANGSHIDE。ZHEXIEXINSHANGSHIDEYAOPINBEIXUNSUNARUMULU,SHIFANGCHUZHICHICHUANGXINDEMINGQUEXINHAO。WUSHIZAITANSUOFUHEZHONGGUOSHIJIDEYIBAOYAOPINMULUDIAOZHENGFANGSHIFANGMIANQUDELEJINZHAN。YIFANGMIAN,JIJITANSUOTONGGUOYINRUJINGZHENGXINGTANPAN、FAHUIYAOWUJINGJIXUEPINGJIAZUOYONGDENGFANGSHI,DAFUTISHENGLETANPANDEKEXUEXING、GUIFANXING、YOUXIAOXING。LINGYIFANGMIAN,WEIYOULIYUYINDAOQIYEDAFUJIANGJIA,WOMENHUANCHANGSHIYINRUJIAGEBAOMIDEZUOFA,DUIBUFENYAOPINDECHENGJIAOJIAGECHENGNUOGUANFANGBUDUISHEHUIGONGKAI。MINGNIANMULULUODIHOU,GUANGDAQUNZHONGHUIYOUQIESHENGANSHOU。

秒速赛车控制器TONGGUOBENCIYIBAOYAOPINTANPAN,JIANGYOULIYUJIANQINGGUANGDACANBAORENYUANYAOPINFEIYONGFUDAN,YOULIYUTISHENGHUANZHELINCHUANGYONGYAOKEJIXINGHEHUODEGAN,YOULIYUTISHENGYIBAOZIJINDESHIYONGXIAOYIHEYIBAOZHIDUDEGONGPINGXING,YEYOULIYUCUJINWOGUOYIYAOCHANYECHUANGXINFAZHAN。

九、本次談判工作在談判形式方面有何創新?

ZAIZUZHIXINGSHISHANG,BENCITANPANZHENDUIBINGGANYAOPINCHUANGXINXINGCAIYONGJINGZHENGXINGTANPANXINGSHI,QUDELIANGHAOXIAOGUO。JIANYU6GEBINGGANYONGYAOPUBIANLIAOXIAOXIANZHU、ZHILIAOXIAOGUOXIANGDANGQIEJIAGEANGGUI(LIAOCHENGFEIYONGDUOCHAOGUO5WANYUAN),YIKAOYAOWUJINGJIXUECESUANHECHANGGUIZHUNRUTANPANNANYIYINDAOQIYEJIANGJIAGEJIANGZHIHELIFANWEI,WOMENCHUANGZAOXINGYINRULEJINGZHENGXINGTANPANDEFANGSHI,MINGQUEJINYUNXU2GEQUANLIAOCHENGFEIYONGZUIDIDEYAOPINJINRUMULU,QIECHENGNUO2NIANNEIBUZAINARUXINDETONGLEIYAOPIN,YINDAOQIYECHONGFENJINGZHENG。TONGGUOJINGZHENGXINGTANPAN,QIYEBAOJIADAFUXIAJIANG,DADAOLEYUQIMUBIAO。

十、談判藥品的支付標準是什么?如何執行?

TANPANYAOPINDEZHIFUBIAOZHUNSHIYAOPINQIYEYUGUOJIAYIBAOJUGONGTONGYUEDINGDEYIBAOZHIFUBIAOZHUN,SHIJIJINZHIFUHEHUANZHEGERENZHIFUDEFEIYONGZONGHE,GETONGCHOUDIQUYITANPANQUEDINGDEYIBAOZHIFUBIAOZHUNWEIJIZHUNZHIFUYAOPINFEIYONG。BENCITANPANQUEDINGDEYAOPINYIBAOZHIFUBIAOZHUNYOUXIAOQIWEILIANGNIAN(CONG2020NIAN1YUE1RIZHI2021NIAN12YUE31RI),LIANGNIANQIMANHOUANZHAOYIBAOYAOPINZHIFUBIAOZHUNYOUGUANGUIDINGJINXINGDIAOZHENG。XIEYIYOUXIAOQINEITANPANYAOPINQIYEXIANGQUANGUOYILIAOBAOXIANDINGDIANYILIAOJIGOUHEDINGDIANLINGSHOUYAODIANGONGYINGGAIYAOPINDEJIAGEBUCHAOGUOYIBAOZHIFUBIAOZHUN。YOUXIAOQIXIANNEIRUYOUQITASHENGCHANQIYEDETONGTONGYONGMINGCHENGYAOPIN(FANGZHIYAO)SHANGSHI,ZIDONGSHUYUMULUFANWEI,YIBAOBUMENYOUQUANGENJUFANGZHIYAOJIAGEDIAOZHENGYIBAOZHIFUBIAOZHUN,YEYOUQUANJIANGGAITONGYONGMINGYAOPINNARUJIZHONGCAIGOUFANWEI。YOUXIAOQIXIANNEIRUYUGUOJIAZHENGCEZHONGDADIAOZHENGHUOSHICHANGSHIJIJIAGEYIMINGXIANDIYUYUEDINGZHIFUBIAOZHUNDE,YIBAOBUMENKEYIYUQIYEXIESHANGZHONGXINZHIDINGZHIFUBIAOZHUN。CHAOGUOYOUXIAOQIXIANHOU,YIBAOBUMENANZHAOYIBAOYAOPINZHIFUBIAOZHUNYOUGUANGUIDINGDIAOZHENGZHIFUBIAOZHUN。

十一、此次談判中有4個續約藥品未談判成功,如何減輕對相關疾病患者用藥的影響?

YAOPINZHUNRUTANPANBUYUSHEMUBIAO,HUIYOUYIDINGDEBUQUEDINGXING。MULUNEIYAOPINDEXUYUETANPAN,BUCHENGGONGHUIDUIHUANZHEYONGYAODEYANXUXINGHEKEJIXINGZAOCHENGYINGXIANG。DANMULUNEIJIBENDOUYOULEISIHUOLIAOXIAOGENGHAODEYAOWUKEGONGTIDAI。WOMENJIANGTUIDONGDINGDIANYILIAOJIGOURENZHENZUOHAOYONGYAOXIANJIEGONGZUO,ANSHIZHIXINGXINDEYAOPINMULUBINGJISHIZUOHAOYAOPINQIEHUAN。TONGSHI,DUIDUANQINEIRENGQUEXUSHIYONGYUANYAOPINDEHUANZHE,CONGZHIDUSHANGKAOLVGEIYUJIAODUANDEGUODUQI,QUEBAOHUANZHESHIZHONGYOUYAOKEYONG。

十二、本次談判不成功的藥品未來是否有機會進入國家醫保目錄?國家醫保藥品目錄在未來如何進行動態調整?

ANZHAODANGZHONGYANG、GUOWUYUANJUECEBUSHU,WOMENJIANGJIANLIYIBAOMULUDONGTAIDIAOZHENGJIZHI。DUIYUSHANGWEINARUMULUHUOBENCITANPANBUCHENGGONGWEINENGZHUNRUDEPINZHONG,ZAIZONGHEKAOLVLINCHUANGXUQIU、YIBAOJIJINCHENGSHOUNENGLI、QIYEJIANGJIAYIYUANDENGYINSUHOU,FUHETIAOJIANDEJIANGYOUJIHUIZAICINARUTANPANFANWEI。TONGSHI,DUIMULUNEIBUFUHETIAOJIANDEYAOPIN,YEJIANGANCHENGXUPINGSHENHOUDIAOCHUMULU。XIANGGUANZHENGCEWENJIANZHENGZAIZHIDINGGUOCHENGZHONG,WOMENJIANGJIAKUAIJINDU,ZHENGQUZAORICHUTAI,SHIXIANMULUMEINIANDONGTAIDIAOZHENG。

十三、完成談判后的新版國家醫保藥品目錄什么時候開始執行,如何執行?

秒速赛车控制器KAOLVDAODIFANGYIBAOGUANLIJINGBANBUMENYIJIDINGDIANYILIAOJIGOUHUANYAOJINXINGXITONGDIAOZHENG,WOMENNIYU2020NIAN1YUE1RIQIZHENGSHISHISHIXINBANMULU,JINZAOHUIJIGUANGDARENMINQUNZHONG。

秒速赛车控制器CICITANPANZHUNRUDEYAOPINJUNNARU2019NIANBANGUOJIAYIBAOYAOPINMULUYILEIYAOPINBUFEN,GESHENG(QU、SHI)BUDEJIANGTANPANYAOPINDIAOCHUMULUHUODIAOZHENGXIANDINGZHIFUFANWEI,TONGYIZHIXINGTANPANQUEDINGDEZHIFUBIAOZHUN,YIBAOJIJINHECANBAORENYUANANZHAOZHIFUBIAOZHUNZHIFUYAOPINFEIYONG。GETONGCHOUDIQUANGUIDINGQUEDINGTANPANYAOPINDEJUTIJIJINZHIFUBILI。