Nine kinds of drugs or meet the outbreak!

On July 7, Hainan Health Commission issued the notice on printing and distributing the long-term prescription management standard of medical institutions in Hainan Province (for Trial Implementation) and the list of long-term prescription drugs in Hainan Province (for Trial Implementation). Among them, the long-term prescription drug list covers 137 varieties, and is divided into 9 categories of drugs, including hypertension, diabetes, dyslipidemia, COPD, chronic kidney, stroke, chronic prostate, chronic heart failure, and other commonly used chronic diseases.

According to the catalogue, it is found that varieties collected from many countries, including atorvastatin, acarbose, clopidogrel and Irbesartan, are listed among them. In addition, many clinical common varieties, such as INSULIN, budesonide and Metformin, are also included. In addition, there are also some new drugs, such as losartan. It is worth noting that, in accordance with the latest requirements of the National Health Commission, all localities are encouraged to make clear the list of diseases for which long-term prescriptions can be issued, the scope of medication and the management system. In the future, more provinces and cities will publish long-term prescription drug lists.

In the view of the industry, the long-term prescription policy is conducive to increasing the compliance of drug use, and the drugs included in the long-term prescription list may meet the expectation of increment. Priority should be given to medical insurance, basic drugs and state-owned drugs. According to the latest notice on the management of long-term prescriptions for chronic diseases issued by the medical treatment group of the State Council in response to the joint prevention and control mechanism of the new epidemic situation, it is encouraged to formulate and improve the long-term prescription management policies for patients with chronic diseases in combination with the actual situation of various regions, and clarify the disease category and drug use for which long-term prescription can be issued Scope, management system, safety notification and other requirements to reduce the number of patients taking medicine.

Medical institutions should take effective measures to meet the medical service needs of patients with chronic diseases who need long-term medication (including narcotic drugs, psychotropic drugs and other special drugs), hemodialysis and other special treatment. For patients with stable chronic diseases, relevant drugs can be issued within 12 weeks at a time; necessary inspection and routine review can guide patients to stay in the nearby medical institutions. Through telephone follow-up and other ways to strengthen remote guidance. In accordance with the latest requirements of the National Health Commission, Hainan pointed out that the Provincial Health Commission has published the list of diseases and drugs applicable to long-term prescription in the province.

All medical institutions shall, according to the actual situation, formulate a list of diseases and drugs suitable for long-term prescription of their own, and give priority to the national medical insurance drug list, national essential drug list and drugs purchased by the state. And clear: the common drugs used in the treatment of chronic diseases can be used for long-term prescription. The use of toxic drugs, radioactive drugs, precursor drugs, narcotic drugs and psychotropic drugs of category I for medical use shall be implemented in accordance with the prescription management measures. Biological agents and antimicrobial agents (except those for tuberculosis and other chronic bacterial and fungal infections) should not be used in long-term prescriptions.

It is understood that the long-term prescription is suitable for patients with chronic diseases with clear clinical diagnosis, stable medication regimen, good compliance, stable disease control and long-term drug treatment. Hainan also imposes certain restrictions on the qualification of issuing long-term prescriptions: the doctors who issue long-term prescriptions and their medical institutions should have the ability level and equipment and facilities to assess the diseases of patients, so as to ensure the quality and safety of long-term medication for patients. If the primary medical institutions do not have the corresponding conditions, they can be issued through telemedicine under the guidance of the qualified superior medical institutions. The patients who use long-term prescription should sign a family doctor contract service with the community primary medical and health institutions, and the agreement should be within the validity period. In the process of diagnosis and treatment, doctors should take the initiative to put forward long-term prescription suggestions for patients who meet the conditions of long-term prescription.

When prescribing a long-term prescription, the amount of prescription should be determined according to the needs of patients and under the condition of ensuring medical quality and medical safety. The prescription amount of long-term prescription is generally within 4 weeks, and the longest is no more than 12 weeks. The amount of long-term prescription for the first visit should not exceed 4 weeks, and the second visit can be extended to less than 12 weeks after strict evaluation by the attending physician. At the same time, when issuing a long-term prescription for the first time, it should be issued by a doctor with intermediate or above professional and technical post qualification related to disease diagnosis and treatment in the secondary or above hospital where the primary medical and health institution signed by the patient's family doctor.

When prescribing a long-term prescription again, it can be issued in the medical institution where the patient's family doctor signed a contract or other medical institutions according to the principle of proximity, convenience and accessibility. Hainan also stressed that it would inspect the implementation of various units in combination with the work of epidemic prevention and control supervision. If the work is not implemented in place, it will be notified, and those with adverse effects will be held accountable. On the one hand, the introduction of the policy of prescription sinking, speeding up and long prescription allows patients with chronic diseases to "run less errands" and take drugs near their home, which increases the accessibility of patients' drugs, improves the continuity and compliance of patients' medication, and saves the time cost and medical cost of patients. On the other hand, it can also reduce the number of visits for patients with chronic diseases and optimize the outpatient efficiency. In recent years, many places across the country have issued policies to explore the implementation of long-term prescriptions for chronic diseases. The outbreak of a novel coronavirus pneumonia accelerated the rapid implementation of this policy. It is understood that Beijing provides long-term prescription services during the period of epidemic prevention and control.

From January 23 to March 25, community health service institutions provided 967000 person times of long-term prescription service, including 374000 person times of three-month long-term prescription service. The number of long-term prescription services is 29 times that of the whole year in 2019. With the spread of the long prescription policy, it will be combined with the hierarchical diagnosis and treatment policy of adhering to the primary diagnosis, two-way referral, rapid and slow treatment, up and down linkage. At the same time, according to the long-term prescription policy, after doctors issue long-term prescriptions, patients can choose to adjust and take drugs in medical institutions or social retail pharmacies, and prescription outflow will release positive signals. However, some pharmacies said that most of the long-term prescriptions are still in the hospital, and there are not many opportunities to get long prescriptions. With the implementation of the long prescription policy, as well as the possible increase in the consumption of related drugs, pharmaceutical enterprises and pharmacies need to actively adjust their strategies to seize this wave of market dividends.