All provinces in the country have started the deployment of medical insurance electronic prescription centers, and nearly 20 provinces have officially launched the application
01. The medical insurance electronic prescription center covers the whole country
In order to promote the application and circulation of electronic prescriptions for medical insurance, the National Health Insurance Administration has taken a series of measures. Recently, in response to the proposal of the committee members, the National Health Insurance Administration said that in order to ensure the smooth flow of electronic prescriptions, the National Health Insurance Administration issued the "Technical Specifications for the Electronic Prescription Center of the Medical Security Information Platform" (No. 6 of 2022 of the Medical Insurance Information Office) to guide all localities to rely on the national unified medical security information platform to apply the medical insurance electronic prescription center. At present, all provinces in the country have started the deployment of medical insurance electronic prescription centers, and nearly 20 provinces have officially launched the application, realizing the smooth flow of electronic prescriptions in designated medical institutionsIt meets the needs of the insured people to use medical insurance electronic prescriptions to purchase drugs.
At the same time, timely inclusion in eligible designated retail pharmacies. Local medical insurance departments should adhere to the principle of "openness, fairness and justice", determine the selection criteria and procedures, and include designated retail pharmacies with qualifications, standardized management, good reputation, reasonable layout, and meet the conditions of electronic traceability of the drugs sold into the "dual channel" management, and take the initiative to disclose to the public in a timely manner. Establish and improve the exit mechanism of "dual-channel" designated retail pharmacies, moderate competition, entry and exit, and dynamic adjustment, and gradually increase the coverage rate of "dual-channel" pharmacies in rural areas, remote areas and economically underdeveloped areas. By the end of 2022, all provinces have basically achieved the task goal of "each prefecture-level city (prefecture, league) has at least one qualified 'dual-channel' retail pharmacy, and can provide corresponding drug guarantee services".
For drugs included in the "dual channel" management, a unified payment policy will be implemented in designated medical institutions and designated retail pharmacies to ensure the reasonable treatment of patients. For negotiated drugs with a long use cycle and high course of treatment costs, all localities are encouraged to explore the establishment of a separate drug guarantee mechanism, and determine the appropriate level of protection according to the affordability and hospitalization compensation level. On the other hand, the National Health Insurance Administration will include the "dual channel" guarantee of negotiated drugs into the scope of agreement management of designated medical institutions, clarify the main body and responsibility of drugs, and urge designated medical institutions to be equipped in a timely manner according to functional positioning and clinical needs, and designated retail pharmacies to be equipped according to the best capabilities and agreement requirements, so as to continuously improve the level of protection of negotiated drugs.
02. Electronic prescriptions are booming, and obstacles on the way to circulation still need to be tackled
Since the beginning of this year, the National Health Insurance Administration issued the "Notice on Further Improving the Inclusion of Designated Retail Pharmacies in the Overall Management of Outpatient Clinics", the pace of the implementation of the electronic prescription circulation policy has been significantly accelerated, and the first electronic circulation prescription in the province has been issued across the country, or relevant policies have been issued to actively promote the landing.
In November this year, Yunnan Provincial Cancer Hospital launched the "dual-channel" drug service of Internet hospitals, relying on the National Medical Insurance Electronic Prescription Center, issued the country's first Internet hospital electronic prescription, and through circulation, patients purchased drugs in designated "dual-channel" pharmacies and realized real-time reimbursement.
According to public reports, Fujian has been connected to 201 "dual-channel" medical institutions, including 73 designated medical institutions and 128 designated retail pharmacies, covering 11 overall planning areas in the province. Since the launch of the Fujian "dual-channel" electronic prescription center, it has served about 6 insured patients70,000 people, 220,000 prescriptions were issued, and drug sales were 55.4 billion yuan, and the settlement amount of medical insurance exceeded 37.6 billion yuan.
Recently, the Chongqing Municipal Medical Security Bureau also issued the "Notice on Doing a Good Job in the Circulation of Electronic Prescriptions for Medical Insurance", which will establish and improve the city's system.
1. The operation of an efficient, standard and standardized medical insurance electronic prescription circulation mechanism realizes the functions of online circulation and online settlement of prescriptions, enhances the accessibility of medical services, and improves the service level of medical insurance for the convenience of the people.
The notice makes it clear that the insured can choose to settle offline at the designated retail pharmacy that has been connected to the medical insurance electronic prescription circulation platform, and the designated retail pharmacy can also carry out the distribution.
The flow of electronic prescriptions means that patients can purchase drugs through the electronic prescription issued by the doctor after visiting the hospital, and there is no need to queue up at the hospital to pick up the medicine, and the reimbursement of medical treatment is more convenient.
According to statistics, the size of China's prescription drug market is expected to reach 266.8 billion yuan in 2022, and it is expected to exceed one trillion yuan by 2030, reaching 1,130.9 billion yuan. This means that retail pharmacies will face huge market demand and potential. The electronic prescription circulation policy will enable patients to purchase the drugs they need in designated "dual-channel" pharmacies after being treated in the hospital, and realize real-time reimbursement. The electronic prescription circulation policy will also promote information sharing and coordination between retail pharmacies, hospitals, medical insurance and other parties, and improve the management level and service quality of retail pharmacies.
However, the current circulation of electronic prescriptions still faces some problems. The progress of informatization related to electronic prescriptions in some hospitals has been slow, resulting in the "difficulty in outflowing" prescriptionsIn some places, doctors and pharmacists are not trained enough, and they are not familiar with the process of electronic prescription circulation and settlement, which makes it difficult to meet the ...... of patients' drug needsThe existence of these problems hinders the circulation of electronic prescriptions for medical insurance.
Despite the huge potential of the prescription market, it is not easy to achieve true "peace of mind". The requirements for the inclusion of pharmacies in outpatient co-ordination are very strict, and higher requirements are put forward for the informatization and digitization of pharmacies.
At the same time, the national medical insurance policy is becoming more and more stringent, and outpatient co-ordination pharmacies will face higher intensity and all-round supervision, which will greatly test the management and operation capabilities of pharmacies. In such an environment, it is not easy to share the cake of the prescription market, and pharmacies need to usher in qualitative improvements in informatization, digitalization and management.
Original title: Major Breakthrough!The circulation of medical insurance electronic prescriptions ushered in a key node!
* |National Health Insurance Administration, drug search.
Edit |Fu Meiru Liu Xinyu.
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