谈国家基本药物遴选原则的有效落实

目的分析国家基本药物遴选中存在的问题,提出相应建议,促进国家基本药物遴选原则的有效落实。方法文献研究法。结果有些地方盲目增补国家基本药物;部分基本药物品种选入不适当;基本药物与基层临床实际用药需求存在差异;遴选程序、方法尚缺乏科学性;遴选的责任不够清晰,过程缺乏透明度等是现行国家基本药物遴选中存在的主要问题。结论从疾病谱入手是落实防治必需原则的重要基础;逐步采用循证医学方法进行处方分析是落实临床首选原则的重要途径;实现基本药物全部报销是落实基本保障原则的最终目标;建立责任制度是基本药物遴选原则有效落实的根本保障。

Discussion on the Effective Implementation of Selection Principles for the National Basic Drug

Objective To analyze the existing problems in the selection system of the national basic drugs,and put forward the corresponding suggestions to promote the effective implementation of selection principles for the national basic drug.Methods The method of literature research was adopted.Results Major problems were discovered.There is irrational inclusion of drugs in the Provincial Essential Medicine Supplement Lists;some of the basic drugs selected are not of proper varieties.There is disaccord between basic drugs and the clinical practical medicine needs.Moreover,the selection procedures and methods are lack of scientific evidence,and the responsibilities in the basic drug selection are not clarified.Besides,process of the basic drug selection is lack of transparency.Conclusion It is an important basis to begin with disease spectrum development to carry out the ＂ Prevention and control for necessity＂ principle.It is also an important approach to conduct prescription analysis by evidence-based medicine methods for carrying out the ＂ Clinical preferred＂ principle,an ultimate goal to realize the entire reimbursement of basic drugs for implementing,and an essential guarantee to establish responsibility system for effective implementation of basic drug selection.