| Micro-channel |
 |
|
|
|
|
|
| |
| How to deal with key drug monitoring enterprises? |
| |
| Author：中国铭铉 企划部 Release Time：2017-9-18 11:18:06 Number Browse：1011 |
| |
On September 18, the medical network did not rest on the clinical management and even key monitoring of auxiliary, nutritional drugs and high varieties. Recently, north guangdong people's hospital of monitored auxiliary medication management regulations, to strengthen the metabolism of tissue, vitamins, electrolytes, immune enhancer of 43 kinds of drugs are monitored, has begun to be implemented in September. In addition, there are new reports that zhejiang will introduce a catalogue of key surveillance drugs and be prepared by September 30. In fact, in Inner Mongolia, sichuan, yunnan, anhui and other places have issued auxiliary medicine catalogues or key drugs to monitor the provincial directory. Other provinces, municipal health and family planning commission also issued relevant policies and varieties list.
"Different regions have different levels of specific varieties, quantities and measures of control." Interview, fudan university, professor, school of public health, sanitation and health development research center of Shanghai chief adviser Hu Shan said, establish the core of the auxiliary drug or monitored directory is to control the medical expense, to guide rational drug use. After the above-mentioned provinces, other provinces and cities and regions to release key drug monitoring catalogue is a trend.
Is the selection process similar?
Reporter noticed that, according to the monitored north guangdong people's hospital auxiliary medicine catalogue, varieties are listed in the catalog according to the catalog of guangdong province key tracking monitoring varieties, combining the reality of hospital, according to the drug in clinical efficacy, indications are clear, the incidence of adverse reactions, combined with drug prices and other factors to determine. And drug once monitored directory listed in the hospital, according to the file spirit, will limit the purchase amount of each month, the use of excess and top auxiliary medication, many comments on unreasonable, restricted or suspended procurement measures.
Comb from the rest of the way to see, the reporter found that health care reform pioneer in anhui province in 2017 focused on three parts to the drug monitoring directory, grassroots medical institutions monitored directory 20 varieties, the hospital at or above the county level shall monitor and catalogues 30 (10 antibiotic drugs, the antibiotic 20), three directories include common TCM injections, also easy to abuse of proton pump inhibitors, clinical, and antibiotics. There are 50 categories of key management auxiliary medicines (first batch) in Inner Mongolia autonomous region, which are divided into two categories: clinical restriction (12 kinds) and key monitoring (38 kinds). Tianjin health development planning commission is a "use exceptions varieties regular evaluation system of medical institution" (trial), "rational drug use of quantitative classification management system of medical institution" (trial), the varieties of abnormal exit interview system (trial), use varieties based on abnormal monitoring mechanism. In zhejiang province and according to the recent notice requirements, will be monitored drugs directory includes: antibacterial drugs, tonic kind of proprietary Chinese medicine, Chinese medicine injection, the auxiliary treatment, high nutritional medicine, clinical incidence of adverse reactions, no special causes rapid growth of usage of drugs.
"In the selection of key monitoring varieties, there are similarities and differences between different regions. But overall, there are several factors, such as high drug prices and large clinical use, such as' purchase amount, use of the top 20 or 50 drugs'; Some of the effects are unclear, the mechanism of pharmacological action is unknown, and it is not a drug to be treated for or symptomatic treatment, such as some auxiliary varieties; Some drugs that are susceptible to adverse reactions, such as injections. "He told reporters.
It is worth mentioning that the key monitoring directory is the dynamic readjustment directory, which can be adjusted in principle every other time according to local customs. "For example, the selection of the previous year's purchase amount, the use of the previous variety, or this year's comparison with last year, the volume of the drug or the increase in costs is particularly high." The experts said.
In fact, the real purpose of the provinces and cities to publish catalogues is to control the unreasonable use of drugs. In view of the unreasonable use of clinical medicine, especially the irrational drug behavior of high price, high dosage and auxiliary treatment drugs, the management should be strengthened to control the irrational growth of medical expenses.
Market factor
The reporter combed and found that many key monitoring varieties are the high price, the clinical sales volume, the total sales amount of high varieties. In most of the provinces, the main targets are injection dosage forms, especially digestive tract and metabolic drugs, which are almost all injectable. For example, the most important surveillance drugs that the guangdong people's hospital focuses on to monitor the use of drugs are injectable.
Professor xuan jianwei, professor of medicine economics at the school of medicine at sun yat-sen university, used the drug economic model to provide evidence for drug decisions. According to introducing, guangxi zhuang autonomous region, the price relatively high oral novy this reimbursement directory, in the same directory, the price is relatively low intravenous novy this confirmed by FDA the curative effect. According to the analysis of pharmacoeconomics, the cost of the course of oral administration of novaviary is 365 yuan, while the cost of intravenous administration of norweben is more than 3,000 yuan.
"In addition to save the medical expenses, as far as possible on the delivery way, a medical institution shall strictly follow the world health organization advocating 'oral is not injected, can muscle injection intravenous drugs' principle, which is from the perspective of security." "Hu added.
Reporter noted that total bureau of national food and drug supervision and administration of released in April this year the national adverse drug reaction monitoring annual report (2016) showed that if the adverse reactions and drug dosage form of statistics, injection accounted for more than sixty percent.
In addition, there are a number of Chinese traditional Chinese medicine, especially in the treatment of tumors and cardiovascular diseases. For example, about 28 percent of the key drug control catalogue of the guangdong people's hospital was made up of drugs. "Because of the traditional Chinese medicine (TCM) contains composition is complicated, and a lot of traditional Chinese medicine effective components have not been clarified, or only partially to clarify, is common in the clinical use in the process of high prices, caused the phenomenon of rising medical costs in excess of medical institutions, and thus become the key monitoring objects." In the interview, an industry source told reporters.
Look from future trends, YouYan report pointed out that our country all levels of hospital accused of exertion, control cost of medical insurance will also continue to expand, due to the implementation of clinical pathway and press disease to realize the charge complement each other, care to pay money for the quota, beyond the part shall be borne by the hospital, the hospital natural need consideration from the clinical actual demand. The industry believes that the effective, clinical path and rigid treatment needs of the varieties can be found in the hospital undefeated, and more and more of the auxiliary medical treatment space will be squeezed.
"The enterprise needs to adjust the production structure from the perspective of the patient." Interview with industry, he says, with abundant evidence of evidence-based medicine, clinical pathway support will become the mainstream of drugs, drug companies can improve the clinical data, attaches great importance to the post-marketing clinical research, provide the titer and high security products for the market.
|
| |
Previous article：The new pharmacopoeia is expected to be able to complement the estimated 6,400 drug standard shortboards
Next article：In 2017, a total of 54 medical devices will be put into special examination and approval
|
| |
|
|
