▍ Source/Cyber blue
▍ Author/Ania
A batch of drugs, the use of which was restricted
<h1 class="pgc-h-arrow-right" > hospital release: Restrictions on the use of non-essential drugs</h1>
Recently, according to documents circulating in the industry, a people's hospital in Guangdong issued the Notice on the Limited Use of Non-basic Drugs.
According to the content of the notice, the hospital made it clear that in order to implement the "Notice on Further Strengthening the Management of the Allocation and Use of Essential Drugs in Public Medical Institutions" (Guowei Pharmaceutical Zhengfa (2019) No. 1), "Foshan Municipal Health Bureau and Other Four Departments Forward the Notice on Printing and Distributing the Implementation Plan for the Overall Promotion of the National Essential Drugs System" and other documents, and further control the unreasonable growth of medical costs, the Pharmaceutical Affairs Management and Pharmacotherapeutics Committee decided to implement limited use of non-basic drugs in the hospital's use list from October 2020.
The specific limits are as follows:
Auxiliary drugs, Foshan medical institutions key monitoring drug catalog (2018 edition), monthly limit of 10,000 yuan / specification; therapeutic drugs, antibacterial drugs monthly limit of 20,000 yuan / product specifications. The amount of the limited variety is calculated from the 1st of each month, and the use of the drug is suspended when the month is used up, and the use status of the drug is reactivated on the 1st of the following month.
In fact, limiting the use of non-basic drugs, the hospital is only a microcosm of many hospital phenomena. Not long ago, a hospital in Shenzhen also announced the "2020 Phase out non-national essential drug varieties catalog" of 148 varieties, and large varieties such as human blood albumin, vinpocetine injection, safflower yellow pigment for injection, and brain protein hydrolysate for injection are all in the list.
The same is a people's hospital in Guangdong Province, on April 20, because the use of basic drugs did not meet the standards, was interviewed by the Health and Health Bureau, in principle, the use of basic drugs did not meet the standards of the units will not be evaluated. Therefore, the hospital urgently solicited the replacement needs of national basic drugs from the clinical department and introduced national basic drugs.
< h1 class="pgc-h-arrow-right" > 986 policy has taken shape, is there still a base drug cold?
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Cyberblue has previously learned that the state is clear, the national-based varieties and the national talk varieties should be given priority procurement, and the pharmaceutical affairs of each hospital are clear, and the meeting only discusses the national base and the state talk varieties. Because entering the hospital means wide coverage, these two types of varieties are the first focus of agents.
In addition, because the basic drug list focuses more on the basic attributes of commonly used clinical drugs, the drug countries that enter the list encourage priority procurement and use, and promote the use through various policies, which has aroused widespread concern in the industry is the 1+X drug model - public medical institutions at all levels must be equipped with a certain number of basic drugs in order to consider the procurement and use of other non-basic drugs. The allocation of basic drugs depends on the different levels of medical institutions. It is required that the proportion of basic drugs in primary/secondary hospitals/tertiary hospitals shall not be less than 90%/80%/60%.
Although the state vigorously promotes the use of basic drugs, many data show that there are still local basic drugs that are "cold" - large hospitals are reluctant to use them, and small hospitals are not enough.
Huang Yong, marketing director of Yongjiang Pharmaceutical, analyzed to Cyberblue: Basic drugs may need to be analyzed from a variety of angles when they are cold, and basic drugs are roughly divided into three categories. The first is a very cheap general drug, such as penicillin and amoxicillin, basically pharmacies can buy and sell in various channel terminals, this drug does not have much commercial value. The second category is the other extreme, with new special drugs or quasi-new special drugs, or even exclusive Chinese medicines, entering the basic drug catalog, they must have greater commercial value; the third type is in the middle of the drug, the commercial value is general, the medical value is not particularly large.
He further explained: With the gradual deepening of the influence of the national 986 management method, and even affecting the assessment background of doctors, the first cheap general drug mentioned above may be "cold", because in some grade hospitals, the diseases diagnosed and treated by doctors are often difficult diseases or comprehensive diseases, and it is difficult to easily cure a drug from decades ago; especially under the supervision of performance policies, doctors should comprehensively consider the rehabilitation rate, patient compliance, comfort, safety, economy and other factors - These products, which have been on the market for decades, cannot adapt to today's disease spectrum, and it is reasonable that such products are cold.
"Doing basic drugs in grade hospitals is still solving the basic needs of chronic diseases." Some old drugs are indeed not suitable for use in grade hospitals, but hospitals should be equipped according to this number, and 986 is the proportion of the quantity, not the proportion of the amount of medication. ”
This can be clearly reflected in the data, according to the assessment notice issued by the National Health Commission: the proportion of review prescriptions in the total number of prescriptions, the evaluation rate of ward (district) medical orders (prescriptions), the number and proportion of basic drug procurement varieties have increased year by year, and the proportion of basic drug prescriptions for outpatients has reached 52.25% (this indicator refers to the proportion of prescriptions with essential drugs in the total prescriptions). The remarks are obvious: the proportion of basic drug prescriptions is only the prescription of "essential medicines", not the amount, so it can only indicate "basic drugs", but the proportion of more important amounts has not been expressed.
Huang Yong said frankly: In fact, there is no absolute cold and heat in the base drug, for example, in the community hospital, the base drug requires 90% of the number of catalogs, and his execution is relatively good. Because many of the grassroots are chronic disease drugs, as well as rehabilitation medicine level things, so it does not need to use too many new special drugs to solve critically ill patients, only need to undertake from large hospitals back to community hospitals for health care treatment of patients, the use and adaptation of basic drugs is relatively high.
Although the implementation of basic drugs still needs to wait for updated data support, as the country's attention to basic drugs is gradually put on the agenda, the quiet reshuffle of the future drug pattern is already foreseeable.