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国家医保局详解“四类药”不进医保

guojiayibaojuzhengmianhuiyingzhuanjiapingshentongguolvdi、zhongguoyaopintanpanyaoguojizuidijiabuhelidengwenti。

图源:视觉中国

界面新闻记者 | 唐卓雅

界面新闻编辑 | 谢欣

11yue28ri,xinbanguojiayibaoyaopinmuludiaozhengjieguoyijinggongbu,danshehuishangweiraomuludiaozhengchanshengdeyihuohetaolunqueweitingzhi。12yue9ri,guojiayibaojujuban2024nianguojiayibaoyaopinmulujieduhuodong,zhengmianhuiyingzhuanjiapingshentongguolvdi、zhongguoyaopintanpanyaoguojizuidijiabuhelidengwenti。

zaicicihuodongshang,guojiayibaojuyiyaoguanlisisizhanghuangxinyujieshaocheng,ciciyibaomuludiaozhenggongzuozaishenbaojieduangongjishoudaoqiyewangshangshenbaoziliao626fen,sheji574getongyongming,gong445getongyongmingyaopinyuyitongguo,129getongyongmingyaopinweiyutongguo;muluwaiyaopin249zhongjinruzhuanjiapingshenjieduan,zuizhong121zhongyaopintongguo,tongguolvwei48.6%;muluwai117zhongyaopincanyutanpan/jingjia,zuizhong89zhongtanpan/jingjiachenggong,chenggonglvwei76.1%。

huangxinyujieshishangshu129geyaopinweitongguoxingshishenchazhuyaoyousifangmiandeyuanyin。qizhong,banshuweitongguoxingshishenchadeyaopinmingxianbufuhe5nianneixinhuopitongyongminghuoxinhuopishiyingzhengdetiaojianqueyiranshenbaoyoudeshilianxuduonianshenbao,bingqiewufatigong5neishiyingzhengfashengzhongdabianhuadepizhunwenjian。biru,lingyangqingfeijiaonangyuanpizhunwenhaoz20053134,wei2005nianshangshideyaopin,bufuhe5nianneixinhuopitongyongming。

youyixieyaopinyijingzaimuluneiqueanmuluwaitiaojianshenbao。biru,muluneideniuhuangjiedupian、nvjinwan、wujibaifengwandeng,youqiyeanzhao“muluwai“tiaojian”shenbao。lingwai,you13zhongyaopinmingxianbushuyuguojiajibenyaowumuluneipinzhongqueanzhaogaitiaojianshenbao;bufenzhongchengyaoanzhaomuluwaihanjianbingyongyaoshenbao,danzhongchengyaodegongnengzhuzhibingmeiyoumingquedehanjianbingbingzhong。

huangxinyuzhezhongqiangdiao:“zaishenbaojieduan,jinduiyaopinzuoxingshishencha,buzuoshizhipanduan。”cengyourenzhiyi,zhiliaotuofa、tishengxinggongnengleiyaopinbunenggoujinruguojiayibaomulu。huangxinyujieshicheng,zaishenbaojieduan,buduiyaopinshifoushizhiliaotuofahuozhetishengxinggongnengleiyaopinzuopanduan,zhiyaofuhetiaojianjike,erhouzaiyouzhuanjiajinxingpanduan。

congyibaomuludiaozhenggejieduanchengguokan,zhuanjiapingshentongguolvxiangjiaoqianliangnianmingxianjiangdi。2022nianji2023niantongguoxingshishenchademuluwaipinzhongshuliangfenbiewei224ge、198ge,canyutanpanhejingjiadeyaopinshuliangfenbiewei143gehe147ge,zhuanjiapingshentongguolvjunzai60%he70%zuoyou。zai2024nianguojiayibaoyaopinmulujieguogongbuzhiqian,yeneibianliuchuanjinnianyibaotanpanquyan,zhuanjiapingshentongguolvbudao50%。

huangxinyuyezhuanmenduijinnianzhuanjiapingshenlvjiangdideyuanyinzuochuhuiying。shouxian,bufenyishangshiduoniandelaoyaotongguoxiugaiyaopinshuomingshu,shanchuyigeshiyingzhenghuoxiugaibiaoshumanzu5nianneishiyingzhengfashengbianhuadeshenbaotiaojiantongguoxingshishencha,danqiyeweitigongxindelinchuanghuoxunzhengzhengju,linchuangzhuanjiapubianrenweiyaopinlinchuangjiazhibuqueqie。“guojiayibaojuguliqiyetongguolinchuangshiyanfaxianlexindezhiliaolingyu,danshiyouqiyelingpixijing,shanchuyijingshangshiduoniandelaoyaodemougeshiyingzhenghuoduiwenzibiaoshugaibian,congermanzushenbaotiaojian。suiranzheizhongyaopinfuheshenbaotiaojian,danshizaizhuanjiapingshenjieduanhuiduizheizhongyaopin(delinchuangjiazhi)jinxingpanduan。”huangxinyucheng。

图片来源:国家医保局直播

qici,bufenyaopinjiageshifenanggui,youdeshenzhishangbaiwan,bufuhejibenyibaobaojibendedingwei,sheji26zhongyaopin。qizhongdabufenyaopinqunianyinweinianzhiliaofeiyongguogaomeiyoutongguopingshen,danguawangjiameiyoubianhua。biru,jinnian“tianjialiaofa”car-txibaozhiliaogongyousikuanchanpintongguoxingshishencha,danshijiagejunzaibaiwanjibie,weinengtongguozhuanjiapingshen。qunian,ajilunsaizhusheye(fuxingkaite)、ruijiaolunsaizhusheye(yaomingjunuo)jiuyijing“peipao”。

huangxinyucheng:“qunianyouyixieyaopinyinweijiagegaoangweinengjinruyibaomulu,jinnianzaizhuanjiapingshenzhiqianzhudongjiangjia,zuizhongtongguopingshen。”“ruguoqiyexiangyaojinruyibaomulu,jiubuyaozaijiageshangbaozhe‘gaogaozaishang’detaidu,ruguoyouzugoudechengyi,zhuanjiapingshenjieduanhuichongfenkaolv。”huangxinyubiaoshi。

zaizhe,bufenyaopinxiugaichengfenpeibihuojixing,danlinchuangzhuanjiarenweipeibibianhuahuojixinggaizaobiyaoxingbuqiang、yaopinjiazhimeiyouxianzhutisheng,“danshijiagetishenghenda”,gongsheji55zhongyaopin。huangxinyujuli,muluneiyiyoumouhuatanyaodekoufuchangshijixing、zhusheye、koufurongye,kemanzubutongquntideyongyaoxuqiu,bencishenbaolekelijidelinchuangbiyaoxingbuqiang,bingweitongguozhuanjiapingshen。

huangxinyubiaoshi,guojiayibaojuzhichihelidegailiangxinyao,danshiyou“4bugai”,bugaizhuchengfen、bugaishiyingzheng、bugaijiyaotujing、bugailinchuangjiazhi。

haiyoubufenyaopinshuyu《jibenyiliaobaoxianyongyaoguanlizanxingbanfa》guidingdebuyudiaorudeyaopin,suoyiweinengtongguozhuanjiapingshen。biruxxneifeipian,shuomingshushiyingzhengweinanxingboqigongnengzhangai。lingwai,haiyoubufenyaopinlinchuangjiazhiweinenghuodezhuanjiarenke,weinengtongguopingshen。

ciciyibaomuludiaozhengzuizhongtanpanjieduanjieguodechenggonglvwei76.1%,yuwangnianchenggonglvxiangdang。danyeyou28zhongtanpanshibaidepinzhong。

zaizhei28zhongtanpanshibaidepinzhongzhong,juedabufenshixiyao;juedabufenshijixinggaizaohuoyinjinguowaishangshiduoniandelaoyao,jinyou3zhongweixinyao;juedabufenzaiyibaomuluneidouyouxiangtongshiyingzhenghejizhideleisiyaowu,you5zhongshiyingzhenghuozhejizhiyouyidingtese,danmuluneiyeyouqitaketidaizhiliaofangan。

huangxinyuzhiyan,tanpanshibaideyaopinguigendaodishijiagemeitanlong。xizhilaikan,yifangmianyuanyinshibufenqiyejiageyuqiguogao,mingxianchaochuyibaozhifuyiyuan。biruyouqiyexiwangtongguoduilaoyaojinxingjixinggaizaohuodebuheligaojia,yongyuzhiliaoguomin(qianmazhen)demouyaopin,muluneiyiyoukoufujixingqierizhiliaofeiyongbuzu1yuan,gaizaoweizhusheyehoujiagechaoguo1000bei;youyixiejinnianshangshidexinyao,jiagemingxianchaoguomuluneitongleipinzhong,daozhitanpanshibai。

lingyifangmian,bufenjinkouyaopinshouguojijiageyingxiang,daozhitanpanshibai。shehuishangcengyouyulunchengzhongguoyaopintanpanyaoguojizuidijiabuheli,danhuangxinyuzhichu,suoweide“guojizuidijia”shicankaoguojiadezuidijia,birumeiyingderihandengguojia,yuzheixieguojiaxiangbi,zhongguodeshichangdadeduo,yaoqiuyigegengdidejiageyeshihelide。

cicixinzengjinruyibaomuludeyaopinyeyougongtongtezheng,huangxinyujieshaocheng,linchuangjiazhida、chuangxinchengdugao、jiagehelishixinzengyaopindegongtongtezheng,qizhongmouxieyaopinnenggoutianbumulukongbai。

未经正式授权严禁转载本文,侵权必究。

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国家医保局详解“四类药”不进医保

guojiayibaojuzhengmianhuiyingzhuanjiapingshentongguolvdi、zhongguoyaopintanpanyaoguojizuidijiabuhelidengwenti。

图源:视觉中国

界面新闻记者 | 唐卓雅

界面新闻编辑 | 谢欣

11yue28ri,xinbanguojiayibaoyaopinmuludiaozhengjieguoyijinggongbu,danshehuishangweiraomuludiaozhengchanshengdeyihuohetaolunqueweitingzhi。12yue9ri,guojiayibaojujuban2024nianguojiayibaoyaopinmulujieduhuodong,zhengmianhuiyingzhuanjiapingshentongguolvdi、zhongguoyaopintanpanyaoguojizuidijiabuhelidengwenti。

zaicicihuodongshang,guojiayibaojuyiyaoguanlisisizhanghuangxinyujieshaocheng,ciciyibaomuludiaozhenggongzuozaishenbaojieduangongjishoudaoqiyewangshangshenbaoziliao626fen,sheji574getongyongming,gong445getongyongmingyaopinyuyitongguo,129getongyongmingyaopinweiyutongguo;muluwaiyaopin249zhongjinruzhuanjiapingshenjieduan,zuizhong121zhongyaopintongguo,tongguolvwei48.6%;muluwai117zhongyaopincanyutanpan/jingjia,zuizhong89zhongtanpan/jingjiachenggong,chenggonglvwei76.1%。

huangxinyujieshishangshu129geyaopinweitongguoxingshishenchazhuyaoyousifangmiandeyuanyin。qizhong,banshuweitongguoxingshishenchadeyaopinmingxianbufuhe5nianneixinhuopitongyongminghuoxinhuopishiyingzhengdetiaojianqueyiranshenbaoyoudeshilianxuduonianshenbao,bingqiewufatigong5neishiyingzhengfashengzhongdabianhuadepizhunwenjian。biru,lingyangqingfeijiaonangyuanpizhunwenhaoz20053134,wei2005nianshangshideyaopin,bufuhe5nianneixinhuopitongyongming。

youyixieyaopinyijingzaimuluneiqueanmuluwaitiaojianshenbao。biru,muluneideniuhuangjiedupian、nvjinwan、wujibaifengwandeng,youqiyeanzhao“muluwai“tiaojian”shenbao。lingwai,you13zhongyaopinmingxianbushuyuguojiajibenyaowumuluneipinzhongqueanzhaogaitiaojianshenbao;bufenzhongchengyaoanzhaomuluwaihanjianbingyongyaoshenbao,danzhongchengyaodegongnengzhuzhibingmeiyoumingquedehanjianbingbingzhong。

huangxinyuzhezhongqiangdiao:“zaishenbaojieduan,jinduiyaopinzuoxingshishencha,buzuoshizhipanduan。”cengyourenzhiyi,zhiliaotuofa、tishengxinggongnengleiyaopinbunenggoujinruguojiayibaomulu。huangxinyujieshicheng,zaishenbaojieduan,buduiyaopinshifoushizhiliaotuofahuozhetishengxinggongnengleiyaopinzuopanduan,zhiyaofuhetiaojianjike,erhouzaiyouzhuanjiajinxingpanduan。

congyibaomuludiaozhenggejieduanchengguokan,zhuanjiapingshentongguolvxiangjiaoqianliangnianmingxianjiangdi。2022nianji2023niantongguoxingshishenchademuluwaipinzhongshuliangfenbiewei224ge、198ge,canyutanpanhejingjiadeyaopinshuliangfenbiewei143gehe147ge,zhuanjiapingshentongguolvjunzai60%he70%zuoyou。zai2024nianguojiayibaoyaopinmulujieguogongbuzhiqian,yeneibianliuchuanjinnianyibaotanpanquyan,zhuanjiapingshentongguolvbudao50%。

huangxinyuyezhuanmenduijinnianzhuanjiapingshenlvjiangdideyuanyinzuochuhuiying。shouxian,bufenyishangshiduoniandelaoyaotongguoxiugaiyaopinshuomingshu,shanchuyigeshiyingzhenghuoxiugaibiaoshumanzu5nianneishiyingzhengfashengbianhuadeshenbaotiaojiantongguoxingshishencha,danqiyeweitigongxindelinchuanghuoxunzhengzhengju,linchuangzhuanjiapubianrenweiyaopinlinchuangjiazhibuqueqie。“guojiayibaojuguliqiyetongguolinchuangshiyanfaxianlexindezhiliaolingyu,danshiyouqiyelingpixijing,shanchuyijingshangshiduoniandelaoyaodemougeshiyingzhenghuoduiwenzibiaoshugaibian,congermanzushenbaotiaojian。suiranzheizhongyaopinfuheshenbaotiaojian,danshizaizhuanjiapingshenjieduanhuiduizheizhongyaopin(delinchuangjiazhi)jinxingpanduan。”huangxinyucheng。

图片来源:国家医保局直播

qici,bufenyaopinjiageshifenanggui,youdeshenzhishangbaiwan,bufuhejibenyibaobaojibendedingwei,sheji26zhongyaopin。qizhongdabufenyaopinqunianyinweinianzhiliaofeiyongguogaomeiyoutongguopingshen,danguawangjiameiyoubianhua。biru,jinnian“tianjialiaofa”car-txibaozhiliaogongyousikuanchanpintongguoxingshishencha,danshijiagejunzaibaiwanjibie,weinengtongguozhuanjiapingshen。qunian,ajilunsaizhusheye(fuxingkaite)、ruijiaolunsaizhusheye(yaomingjunuo)jiuyijing“peipao”。

huangxinyucheng:“qunianyouyixieyaopinyinweijiagegaoangweinengjinruyibaomulu,jinnianzaizhuanjiapingshenzhiqianzhudongjiangjia,zuizhongtongguopingshen。”“ruguoqiyexiangyaojinruyibaomulu,jiubuyaozaijiageshangbaozhe‘gaogaozaishang’detaidu,ruguoyouzugoudechengyi,zhuanjiapingshenjieduanhuichongfenkaolv。”huangxinyubiaoshi。

zaizhe,bufenyaopinxiugaichengfenpeibihuojixing,danlinchuangzhuanjiarenweipeibibianhuahuojixinggaizaobiyaoxingbuqiang、yaopinjiazhimeiyouxianzhutisheng,“danshijiagetishenghenda”,gongsheji55zhongyaopin。huangxinyujuli,muluneiyiyoumouhuatanyaodekoufuchangshijixing、zhusheye、koufurongye,kemanzubutongquntideyongyaoxuqiu,bencishenbaolekelijidelinchuangbiyaoxingbuqiang,bingweitongguozhuanjiapingshen。

huangxinyubiaoshi,guojiayibaojuzhichihelidegailiangxinyao,danshiyou“4bugai”,bugaizhuchengfen、bugaishiyingzheng、bugaijiyaotujing、bugailinchuangjiazhi。

haiyoubufenyaopinshuyu《jibenyiliaobaoxianyongyaoguanlizanxingbanfa》guidingdebuyudiaorudeyaopin,suoyiweinengtongguozhuanjiapingshen。biruxxneifeipian,shuomingshushiyingzhengweinanxingboqigongnengzhangai。lingwai,haiyoubufenyaopinlinchuangjiazhiweinenghuodezhuanjiarenke,weinengtongguopingshen。

ciciyibaomuludiaozhengzuizhongtanpanjieduanjieguodechenggonglvwei76.1%,yuwangnianchenggonglvxiangdang。danyeyou28zhongtanpanshibaidepinzhong。

zaizhei28zhongtanpanshibaidepinzhongzhong,juedabufenshixiyao;juedabufenshijixinggaizaohuoyinjinguowaishangshiduoniandelaoyao,jinyou3zhongweixinyao;juedabufenzaiyibaomuluneidouyouxiangtongshiyingzhenghejizhideleisiyaowu,you5zhongshiyingzhenghuozhejizhiyouyidingtese,danmuluneiyeyouqitaketidaizhiliaofangan。

huangxinyuzhiyan,tanpanshibaideyaopinguigendaodishijiagemeitanlong。xizhilaikan,yifangmianyuanyinshibufenqiyejiageyuqiguogao,mingxianchaochuyibaozhifuyiyuan。biruyouqiyexiwangtongguoduilaoyaojinxingjixinggaizaohuodebuheligaojia,yongyuzhiliaoguomin(qianmazhen)demouyaopin,muluneiyiyoukoufujixingqierizhiliaofeiyongbuzu1yuan,gaizaoweizhusheyehoujiagechaoguo1000bei;youyixiejinnianshangshidexinyao,jiagemingxianchaoguomuluneitongleipinzhong,daozhitanpanshibai。

lingyifangmian,bufenjinkouyaopinshouguojijiageyingxiang,daozhitanpanshibai。shehuishangcengyouyulunchengzhongguoyaopintanpanyaoguojizuidijiabuheli,danhuangxinyuzhichu,suoweide“guojizuidijia”shicankaoguojiadezuidijia,birumeiyingderihandengguojia,yuzheixieguojiaxiangbi,zhongguodeshichangdadeduo,yaoqiuyigegengdidejiageyeshihelide。

cicixinzengjinruyibaomuludeyaopinyeyougongtongtezheng,huangxinyujieshaocheng,linchuangjiazhida、chuangxinchengdugao、jiagehelishixinzengyaopindegongtongtezheng,qizhongmouxieyaopinnenggoutianbumulukongbai。

未经正式授权严禁转载本文,侵权必究。