Status, problems and improvement measures of health insurance reimbursement of national negotiated drugs used in outpatients
10.11665/j.issn.1000-5048.20200516
- VernacularTitle:国家谈判药品门诊医保待遇现状、问题及完善措施
- Author:
Ye CHEN
1
;
Jinxi DING
;
Ting LIU
;
Di TANG
;
Fang WU
;
Liping WU
;
Wanting DUAN
;
Yangyan XU
Author Information
1. 中国药科大学国际医药商学院
- Publication Type:Journal Article
- Keywords:
negotiating drugs;
outpatient coordination;
single disease payment;
health insurance
- From:
Journal of China Pharmaceutical University
2020;51(5):628-634
- CountryChina
- Language:Chinese
-
Abstract:
The access negotiations of National Reimbursement Drug List (NRDL) in China from 2017 to 2019 effectively improved the availability and affordability of high-value innovative drugs. However,the actual outpatient reimbursement of most negotiated drugs is lower,which affects the patients" health insurance funds. In this paper,97 negotiated drugs in 337 overall planning cities were selected as samples to analyze the outpatient reimbursement for negotiated drugs. The results showed that the reimbursement level of 40 negotiated drugs was less than 50% in over 70% cities,which can be mainly interpreted as absence or imperfection of outpatient reimbursement policies for special diseases. Finally,this paper puts forward suggestions and protocols for improving the outpatient medical insurance through realizing outpatient overall planning,improving outpatient reimbursement policies for special diseases,and exploring innovative payment,ensuring the achievement of the access to NRDL.
