Health Times reporter Qiu Yue
Mr. Jiang is a fabre patient with a rare disease. On January 1, 2022, the new version of the National Medical Insurance Drug Catalogue was officially implemented, and Repuga, a special drug for Fabre disease, was among them. "But the new version of the medical insurance directory has been landed for more than a month, and at present, there is no hospital in Handan to enter this drug, and I have also contacted a number of top three hospitals in Shijiazhuang, and there is no medicine yet." The sooner Fabre's disease is used, the better, and we are all looking forward to using the drug as soon as possible. Mr. Jiang told the Health Times reporter.
Fabre patients in Huizhou, Guangdong Province, injected Prijia for the first time in January this year, and the interviewee provided a picture.
Unbeaten Medicare special drugs
"Hello, do you know that there is a hospital in Handan that has entered Ruipujia or plans to enter Ruijia?" On February 10, Mr. Jiang of Handan, Hebei Province, sent a message to a health times reporter asking for help.
On February 10, the Health Times reporter learned from the First Hospital of Handan City, Handan Central Hospital and many other top three hospitals that Rui Pujia has not yet entered the pharmacy of the above hospital, and the pharmacy staff does not understand the hospital's drug plan.
In this regard, the staff of the Handan Municipal Medical Insurance Bureau told the Health Times reporter that the situation of drugs entering the hospital needs to consult the relevant hospitals. On February 11, the Health Times reporter consulted the staff of the Shijiazhuang Medical Insurance Bureau as a patient about Pu Ruijia's admission to the hospital, and the staff said that whether the hospital had a special channel for purchasing drugs for a certain drug.
Mr. Jiang told reporters that he heard that a third-class hospital hospital in Hebei will lead the advanced Prijia, but he does not know when it will really land. The pharmacy staff of the top three hospitals told the Health Times reporter: At present, the hospital does not have this drug, and it is not clear when it will be medicated.
Huang Zhenghui, president of the China Fabre Patient Association, told the Health Times reporter, "Hebei is not the only province where the admission procedure of Prijia has not yet been completed, and there are many provinces with similar situations." ”
Admission challenges need to be solved one by one
"The difficulties faced by negotiating the 'dual channel' of drugs entering hospitals and pharmacies are problems that governments at all levels have tried their best to solve in recent years." Fabre drugs are faced with a daunting challenge due to the small number of patients used, etc. Wang Lin, secretary general of the Joint Conference of the Chairmen of the National Rare Disease Academic Society, said in an interview with the Health Times reporter, "Medical insurance negotiation drugs are generally patented innovative drugs, the number is small and the price is high, the conditions for transportation and preservation are relatively high, and the professional level of medical personnel who use the drug is also put forward higher requirements, so the hospital has a series of hardware and software preparations that need to be promoted and implemented before entering related drugs." On the other hand, although the negotiated drugs do not account for the proportion of drugs in the hospital in principle, they are uneven in the implementation process, which further exacerbates the difficulty of high-value negotiated drugs to enter the hospital. ”
"Especially for drugs for rare diseases like Fabre, there are fewer patients who are originally taking drugs, and if the hospital wants to take medicine for the only patient, this decision is obviously not easy to make, in addition, how to establish the working mechanism of medical staff? Ripga needs cold chain transportation and preservation, how is the hospital pharmacy managed? How to prescribe? Which doctors have permission to prescribe? Which nurses are qualified to inject such high-value drugs? How to train at the technical level and so on these problems are all difficult problems and need to be solved one by one. Wang Lin said.
In May 2021, the National Medical Insurance Bureau and the Health Commission issued guidance on establishing and improving the "dual-channel" management mechanism for drugs negotiated by the national medical insurance, through the two channels of designated medical institutions and designated retail pharmacies, to meet the supply of drugs negotiated by the state, and implement the same medical insurance reimbursement policy.
Ding Jie, member of the National Committee of the Chinese People's Political Consultative Conference and former vice president of peking university first hospital, said in the live broadcast of the "Health Policy of the Two Sessions" on the health client of the People's Daily that to accelerate the landing of negotiated drugs, one is to include special drugs and rare disease negotiated drugs into outpatient special disease drugs; the second is to improve the management of special drugs through dual channels; the third is to negotiate the proportion of drugs that are not included in the performance appraisal of hospitals; the fourth is to simplify the identification and approval process for outpatient special diseases of special drugs and rare disease patients; fifth, to establish a one-stop medical insurance settlement system for hospitals and special drug pharmacies. It is convenient for patients to purchase drugs nearby.
