7 pharmacies in Hefei can buy 57 kinds of life-saving drugs before applying

In order to facilitate cancer patients to buy and afford "life-saving drugs", Hefei selected the first seven drugstores to start retailing national negotiating drugs at the beginning of this year. The purchase of 57 kinds of drugs by insured patients can be included in the medical insurance settlement. Recently, the Hefei Medical Security Fund Management Center issued relevant policies, specifying that the purchasing of negotiated drugs should be managed by designated physicians and retail pharmacies, and the insured personnel should file their purchases according to the process.

In order to reduce the burden of drug costs for cancer patients, last October, the National Medical Security Bureau included 17 kinds of anti-cancer drugs in medical insurance. Hefei Medical Reform (Medical Insurance) Office has established seven pharmacies as designated pharmacies negotiated by the state through the process of recommendation of manufacturing enterprises, evaluation of experts, on-site investigation and online publicity of selection results, which are included in the scope of medical insurance reimbursement. Negotiating drugs in designated drugstores cover 17 kinds of anticancer drugs, 36 kinds of national negotiating drugs and 4 kinds of anticancer drugs determined by our province. Among the insured personnel of basic medical insurance for urban and rural workers and basic medical insurance for urban and rural residents in Hefei City, 57 kinds of drugs prescribed by retail drugstores in the medical insurance negotiation agreement can be included in the payment scope of overall fund, major illness relief fund and major illness insurance. Negotiating drugs shall be managed by electronic regulatory codes (one box and one code). Drugs without electronic regulatory codes shall not be included in the medical insurance settlement when purchasing drugs in designated drugstores. Although pharmacies can retail and negotiate drugs, it does not mean that they can buy drugs at will. Reporters learned that Hefei currently negotiates the purchase of drugs to implement the management of designated physicians and designated retail pharmacies. According to the introduction, the state negotiates the use and purchase of drugs to implement the system of responsible physicians. At present, there are 19 designated medical institutions in Hefei that negotiate drug purchase management. The information of specialists in these medical institutions must be filed in the local medical insurance agency. Participants may choose one of the physicians as the responsible physician for negotiating drug use and purchasing. In principle, no change shall be made during a medical period (the same treatment plan).

Responsible physicians are responsible for disease diagnosis, confirmation of negotiating drug use conditions, prescription formulation, review and evaluation, medication guidance and follow-up, and assist insured personnel in negotiating drug use and drug donation procedures. At the same time, in a medical period (the same treatment plan), the insured can choose one designated pharmacy. When purchasing medicines, the necessary materials such as social security card or other valid certificates, the "Record Form of Drug Purchase Application for Negotiation of Basic Medical Insurance in Hefei City" issued by responsible physicians, and the prescription for purchasing medicines should be presented. Before purchasing drugs, patients should first apply for filing insured personnel to purchase negotiating drugs at designated pharmacies, first of all, they need to fill in the application form, provide relevant medical documents and apply to responsible physicians in medical institutions. Responsible physicians should review the materials submitted by patients according to the conditions for the use of negotiated drugs. If they meet the conditions for use, they should issue out-sourcing prescriptions. Participants will submit the Application Form and the prescription purchased to the Medical Insurance Office of the medical institution for the record. < div>< div> In terms of settlement, the insured staffs are hospitalized in designated medical institutions under the management of drug outsourcing in the medical insurance negotiation. When purchasing negotiated drugs in designated pharmacies during the period, their expenses are settled in real time with reference to the standard of general hospitalization payment of corresponding medical institutions, and the standard of starting payment for one stay is paid; when purchasing drugs in the non-medical insurance negotiation, the insured staffs are in hospital. In order to manage the hospitalization of designated medical institutions, the negotiating drug fund purchased out of hospital will not be paid during the period of hospitalization (in accordance with relevant regulations), and the negotiating drugs purchased in designated pharmacies during non-hospitalization period will be settled in real time according to the Interim Measures for the Management of Special Diseases Outpatient Clinic of Hefei City.