国家谈判准入药品在各地的医保管理政策梳理与分析

目的：对两轮国家谈判准入药品在各地的医保管理政策进行梳理和分析,以不断完善相关政策,并为后续国家医保准入谈判药品政策的落地实施提供依据。方法：以“谈判药品”、“抗癌药”、“药品目录”为关键词,检索各地人力资源与社会保障厅（局）和政府官方网站,筛选2017年7月—2019年4月发布的相关文件,从谈判准入药品的特药管理、医保报销、鼓励使用三个方面进行归纳分析。结果：各省已完成将2017年国家谈判准入的36种药品和2018年国家谈判准入的17种抗癌药纳入本地医保药品目录。由于各地医保政策、运行和管理情况存在较大差异,故对于国家谈判准入药品的管理和保障也有较大的地区差异。结论：国家谈判药品的落地实施不仅需要国家层面的宏观指导和监督,也需要各地因地制宜出台具体的管理政策加以保障。

Summarizing and analyzing the policy implementation for nationally negotiated drugs

Objective:To analyze and continuously improve the health management policy the implementation for nationally negotiated drugs, and provide evidence basis for the follow-up of all implementation stages. Methods:The relevant policy documents stipulating on "negotiating drugs", "anticancer drugs" and "drug list" were systematically retrieved as the key words from the official websites of local human resources and social security departments (bureaus) and the local governments of every province and city. The screening of those documents was conducted between July 2017 and April 2019 from three aspects including the management strategies, relevant reimbursement policies, and the incentive to promote their utilization. Results:The nationally negotiated drugs have been basically brought into the local health insurance drug list of every province, whereby 36 medicine categories were negotiated in 2017 and 17 anticancer drugs were negotiated in 2018 to be included in the local medical catalogue. Due to the large differences in the policy, operation status and management of the local health insurance in various regions, there were also significant regional differences in terms of the management strategies and reimbursement levels of the nationally negotiated drugs. Conclusions:The implementation of the national negotiated drug access in every province not only requires the guidance and supervision at national level, but also requires the local governments to introduce specific management policies to adapt to local situation.