四部门发文，这两种病患者门诊用药费用负担将减轻
<div class="wx_rich_media_content" id="jsWxContainer"><p><br></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; box-sizing: border-box !important;'><span style='max-width: 100%; color: rgb(123, 12, 0); box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>国家医保局 财政部 国家卫生健康委 国家药监局关于完善城乡居民高血压糖尿病门诊用药保障机制的指导意见</strong></span></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; box-sizing: border-box !important;'><span style='max-width: 100%; color: rgb(123, 12, 0); box-sizing: border-box !important;'>医保发〔2019〕54号</span><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='text-align: center; max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='text-align: center; max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'></p><p style='text-align: center; max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'>各省、自治区、直辖市及新疆生产建设兵团医保局、财政厅（局）、卫生健康委、药监局：</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'>为进一步减轻<span style='background-color: rgb(255, 251, 0);'>城乡居民高血压、糖尿病（以下简称“两病”）</span>患者医疗费用负担，现就完善“两病”患者门诊用药保障提出指导意见如下：</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='max-width: 100%; color: rgb(123, 12, 0); box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>一、指导思想</strong></span></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'>以习近平新时代中国特色社会主义思想为指导，全面贯彻落实党的十九大和十九届二中、三中全会精神，按照“保基本、可持续、惠民生、推改革”的总体要求，以城乡居民基本医疗保险“两病”患者门诊用药保障为切入点，坚持“既尽力而为、又量力而行”原则，探索完善门诊慢性病用药保障机制，增强基本医保门诊保障能力，减轻患者门诊用药费用负担，不断提升人民群众获得感、幸福感、安全感。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='max-width: 100%; color: rgb(123, 12, 0); box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>二、锁定范围，明确保障内容</strong></span></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（一）明确保障对象。</strong><span style='background-color: rgb(255, 251, 0);'>参加城乡居民基本医疗保险（以下简称“居民医保”）并采取药物治疗的“两病”患者</span>。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（二）明确用药范围。</strong>对“两病”患者门诊降血压或降血糖的药物，要按最新版国家基本医疗保险药品目录所列品种，优先选用目录甲类药品，优先选用国家基本药物，优先选用通过一致性评价的品种，优先选用集中招标采购中选药品。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（三）明确保障水平。</strong>以二级及以下定点基层医疗机构为依托，<span style='background-color: rgb(255, 251, 0);'>对“两病”参保患者门诊发生的降血压、降血糖药品费用由统筹基金支付，政策范围内支付比例要达到50％以上</span>。各省（区、市）要在摸清“两病”门诊用药人数、用药数量和金额等实际情况的基础上合理设定支付政策。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（四）做好政策衔接。</strong>要做好与现有门诊保障政策的衔接，确保群众待遇水平不降低，对降血压和降血糖以外的其他药品费用等，或已纳入门诊慢性病或特殊疾病保障范围“两病”患者的待遇，继续按现行政策执行。要避免重复报销、重复享受待遇。要做好与住院保障的衔接，进一步规范入院标准，推动合理诊疗和科学施治。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='max-width: 100%; color: rgb(123, 12, 0); box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>三、配套改革，确保患者受益</strong></span></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（一）完善支付标准，合理确定支付政策。</strong>对“两病”用药按通用名合理确定医保支付标准并动态调整。积极推进药品集中带量采购工作，以量换价、招采合一，对列入带量采购范围内的药品，根据集中采购中标价格确定同通用名药品的支付标准。根据“两病”参保患者就医和用药分布，鼓励开展按人头、按病种付费。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（二）保障药品供应和使用。</strong>各有关部门要确保药品质量和供应，医疗机构要优先使用集中采购中选药品，不得以费用控制、药占比、医疗机构用药品种规格数量要求、药事委员会审定等为由影响中选药品的供应保障与合理使用。有条件的地方可探索第三方配送机制。完善“两病”门诊用药长期处方制度，保障患者用药需求，但要避免重复开药。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（三）规范管理服务。</strong>完善医保定点服务协议，将“两病”门诊用药保障服务纳入协议管理。坚持预防为主、防治结合，落实基层医疗机构和全科医师责任，加强“两病”患者健康教育和健康管理，提高群众防治疾病健康意识。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='max-width: 100%; color: rgb(123, 12, 0); box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>四、加强领导，做好组织实施</strong></span></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（一）压实责任，确保待遇落实。</strong><span style='background-color: rgb(255, 251, 0);'>各省（区、市）要高度重视“两病”门诊用药保障工作，加强统筹协调，本文件印发后一个月内出台本省实施方案，指导督促统筹地区于2019年11月起开始实施，确保群众年内享受待遇。</span></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（二）细化分工，加强协同配合。</strong>医疗保障行政部门要积极会同相关部门做好“两病”患者门诊用药保障工作，加强指导，密切跟踪工作进展。财政部门要积极参与“两病”用药保障有关工作，按规定保障所需工作经费。卫生健康部门要做好“两病”患者的健康管理，加强医疗服务行为监管，进一步健全完善“两病”用药指南和规范，规范诊疗行为，确保集中带量采购药品合理使用。药品监督管理等部门负责做好“两病”用药一致性评价审评和生产、流通、配送等环节的监督管理。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='max-width: 100%; box-sizing: border-box !important;'>（三）加强监管，用好管好基金。</strong>要健全监督举报、智能监控、信用管理等机制，严厉打击欺诈骗保行为，加强对虚假住院、挂床住院等违规行为的监管，引导住院率回归合理水平。各部门要各尽其责，密切配合，通力协作，及时研究解决新情况新问题，总结推广经验做法，不断完善“两病”门诊用药保障机制建设。</p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><br style='max-width: 100%; box-sizing: border-box !important;'></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: right; box-sizing: border-box !important;'><b>国家医疗保障局</b></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: right; box-sizing: border-box !important;'><b>财政部</b></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: right; box-sizing: border-box !important;'><b>国家卫生健康委</b></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: right; box-sizing: border-box !important;'><b>国家药监局</b></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><b><br style='max-width: 100%; box-sizing: border-box !important;'></b></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: right; box-sizing: border-box !important;'><b>2019年9月16日</b></p><p style='max-width: 100%; min-height: 1em; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: right; box-sizing: border-box !important;'><br></p></div>
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