基于2019年版医保药品目录的变化探讨医院用药管理策略

目的：探讨2019年版《国家基本医疗保险、工伤保险和生育保险药品目录》(以下简称《药品目录》)调整后对医院用药管理的影响及加强医保用药管理的途径和办法。方法：比较2019年版与2017 年版《药品目录》的差异，分析2019年版《药品目录》的特点及变化，对如何加强《药品目录》调整后医院的用药管理提出建议。结果：2019年版《药品目录》常规准入部分共2643个品种，在2017年版《药品目录》基础上调出150个品种，调入148个品种，谈判成功并纳入目录97个品种。调整后药品结构发生了较大变化，对支付范围的限定更加精准，利于医院药品结构的优化、规范用药管理和减轻医保患者负担。结论：医院药学、医保、医政等部门要形成联动，强化医保用药管理，促进临床合理用药，加快医保智能审核系统建设，确保《药品目录》的贯彻落实。

Discussion on the Strategy of Hospital Medication Management Based on the Changes of Medical Insurance Drug Catalogue in 2019

Objective: To explore the influence of the 2019 edition of National Basic Medical Insurance, Employment Injury Insurance and Maternity Insurance Drug Directory (hereinafter referred to as the Drug Directory) on the management of drug use in hospitals and the ways and methods to strengthen the management of drug use. Methods: The differences between the 2019 edition and the 2017 edition were compared, the characteristics and changes of the 2019 edition were analyzed, and suggestions on how to strengthen the medication management of the hospital after the adjustment of the Drug Directory were put forward. Results: There were a total of 2,643 varieties in the routine access part of the 2019 edition, 150 varieties were transferred out and 148 varieties were transferred in based on the 2017 edition, and 97 varieties were successfully negotiated and included in the list. After the adjustment, the drug structure has undergone great changes, and the scope of payment is more precise, which is conducive to the optimization of hospital drug structure, the standardization of drug use management and the reduction of the burden of insured patients. Conclusion: Hospital pharmacy, medical insurance, medical administration and other departments should form a linkage, strengthen the management of medical insurance drug use, promote rational clinical drug use, accelerate the construction of intelligent medical insurance audit system, and ensure the implementation of the Drug Directory.