Shandong serious illness insurance payment scope expansion next month, a variety of anticancer drugs into medical insurance
http://news.jnnc.com//jinan/2018/0707/698194.shtml
the official website of the Shandong Provincial Office of the people's society issued 6 days notice that from August 1st this year, Shandong will include 14 kinds of drugs such as Rege - Fei and other kinds of drugs into the coverage of major diseases insurance.
in accordance with the opinion of the office of the people's Government of the Shandong provincial government on the establishment of the insurance system for the major diseases of the staff and workers (No. 55 of Lu Zheng Fa [2016]), the notice of the 6 departments of the human resources and social security department of Shandong Province on the implementation of the plan for the implementation of the major diseases insurance for workers in Shandong province (2016 [2016] 50) and the human capital of Shandong Province The source and the Shandong Provincial Department of social security of the Department of finance of the Department of finance of the Shandong Province on improving the policy of the residents' insurance policy on major diseases of the residents "(Lu people's word [2016] 412) document spirit, the Provincial Department of human society is organized by the organization of experts to review and negotiate, to determine the 14 kinds of drugs into the coverage of major diseases insurance. The generic names of
14 drugs are: rig Fani tablets, oxatinib mesylate, anatinib maleate, Crizotinib Capsules, acitiinib, injection of Ina Heap, Nilotinib Capsules, phosphoric acid reticoni, PPO, ozopp microspheres, methotrexate hydrochloride tablets Hydrochloric acid, radaltamivir tablets, Paclitaxel For Injection (albumin bound), Doxorubicin Hydrochloride Liposome Injection. Among them, many drugs are targeted drugs (anticancer drugs).
notice that the 14 drugs in this negotiation have been included in the scope of payment since August 1, 2018. Taking into account the medical annual calculation problems, the payment line for the payment of drug costs in 2018 was adjusted to 10 thousand yuan. The capping line and the proportion of payment remained unchanged from 2019, according to the insurance policy of Shandong province. The original serious illness insurance medicine Cetuximab Solution for Infusion, sunitinib malate capsules and Bosentan Tablets are still implemented according to our province's serious illness insurance policy.
the generic name, dosage form (including the consolidated form) and the same specifications are the scope of the payment of the large disease insurance, which is carried out at the negotiated price, if the actual price is lower than the negotiated price, and is carried out at the actual price. The drugs with the same name and the same dosage form but with different specifications shall be promulgated and executed by consultation with the production or business enterprises according to the principle of difference in price.
Provincial Office of the provincial people's society requests that the cities should do a good job of policy link work, do a good job in management services and ensure the procurement and use of negotiated drugs in accordance with the requirements of drug management in negotiations (medical institutions, responsible physicians and retail pharmacies). The negotiated drugs should be included in the agreement management of the designated medical institutions, the cost analysis and monitoring should be done, the designated medical institutions should be urged to standardize the clinical diagnosis and treatment behavior, promote rational drug use and reduce unreasonable expense expenditure.