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云南网讯 记者昨日从省人社厅获悉,自9月1日起,全省基本医疗保险、工伤保险、生育保险统一执行《国家基本医疗保险、工伤保险和生育保险药品目录(2017年版)》(以下简称《国家药品目录》),将36种国家谈判药品纳入医疗保险乙类药品范围,目录所列药品按规定纳入医保支付范围。
36种高价刚需国家谈判药品,纳入新版国家药品目录,意味着参保人员可以享受两层次的“福利”,一是经国家谈判这些药品价格降下来了,最高降幅达70%,同时,还可享受报销,按医保目录的乙类药品报销,报销比例因各地的医保政策有所不同,但最终患者自费部分大大减少。这36种药品多是重大疾病治疗用药、儿童用药、急抢救用药、职业病特殊用药及临床价值高的新药、地方乙类调整增加较多的药品等。也多为高价刚需药,大多都是患者热盼的肿瘤专用药品,以及治疗心血管病、血友病等重大疾病的药品。与2016年平均零售价相比,国家谈判后比原价平均降幅达到44%,最高的达到70%,大部分进口药品谈判后的支付标准低于周边国际市场价格,大大减轻了患者的医疗费用负担,也兼顾了医保基金的负担能力。
我省在执行国家药品目录调整的文件中明确,自9月1日起,全省城镇职工医疗保险、城镇居民医疗保险、工伤保险和生育保险统一执行2017年版国家药品目录。我省新版药品目录发布前,现行药品目录及数据库仍按原规定执行。人社部36种谈判药品按照附表中的比例先行自付后,纳入报销,不再承担乙类药品自付比例。先行自付比例全省统一试行,执行中视情况进行动态调整。
同时,省人社厅官网还公布了《人社部36种谈判药品个人先行自付比例情况表》,要求各级人社部门要认真落实好统筹地区国家药品目录实施工作。记者 期俊军
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