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北京医保新药9月起增加513种 处方不合理停止报销

2017-08-31 03:36:28   北京晨报

(原标题:医保新药明起增加513种纳入36种国家谈判药品门诊特殊病种扩至11种处方不合理将停止报销)

昨天,市人力社保局发布惠民新政,明确从明天起,将国家药品目录新增的477种药品和国家组织谈判的36种药品共513种,全部纳入本市医保报销范围,并同步调整增加门诊特殊病病种至11种,其中,将现有门诊特殊病“恶性肿瘤放射治疗和化学治疗”调整为“恶性肿瘤门诊治疗”,同时将“多发性硬化”和“黄斑变性眼内注射治疗”增加纳入门诊特殊病病种范围。

此举将进一步方便群众就医用药,减轻患者医疗费用负担,据统计,精准调整门诊特殊病政策将为患者减负3.5亿元。

增加国家目录新增药品全部纳入

今年上半年,人力社保部发布了2017年版基本医疗保险、工伤保险和生育保险药品目录,7月份公布了36种国家谈判药品,包括了治疗肺癌、胃癌、乳腺癌、结直肠癌、淋巴瘤、骨髓瘤等15种抗癌靶向药,以及糖尿病、肾病、心血管病等慢性病药物。通过国家统一组织谈判,大幅度降低了药品价格,平均降幅达到40%,最高的达到70%。

北京晨报记者了解到,人力社保部发布的2017年版药品目录扩大了基本医疗保险用药保障范围,关注儿童用药和重大疾病用药,增加了职业病特殊用药等,比如新增了治疗尘肺病的汉防己甲素等药品;新增了91个儿童药品品种。药品目录中明确适用于儿童的药品或剂型达到540个,加大了儿童用药保障力度。同时加大了对创新药的支持力度。目录调整中将2009年后上市的新药作为重点评审对象,并对其中的创新药进一步倾斜。重点考虑重大疾病治疗药物。治疗癌症、重性精神病、血友病、糖尿病、心脑血管疾病等重大疾病的常用药品基本被纳入了药品目录或谈判药品范围。

为了让本市参保人员及时享受国家药品目录调整和药品谈判的利好新政,从9月1日起,将国家药品目录新增的477种药品和36种国家谈判药品共513种,全部纳入本市医保报销范围。

市人力社保局表示,具体新增药品名称可登录北京人力社保局官网(http://www.bjrbj.gov.cn/)查询。

门诊特殊病范围扩充到11种

将477种新增药品和36种国家谈判药品全部纳入本市医保报销范围的同时,精准调整门诊特殊病政策。自9月1日起,同步调整现有门诊特殊病病种范围,增加新的病种,进一步减轻大病患者的医疗费用负担。

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