为破解群众看病难、看病贵难题,近几年国家先后出台药品零加成、集中采购、国谈药品等一系列新政,持续提高医疗保障质量,不断减轻群众医药费用负担。各地在国谈药落地过程中面临着如何加强“医”“保”协同,打通“最后一公里”的困境。南京医保部门立足自身职能,以患者为中心,以保障医保待遇享受为主线,基于“以人为本,保障维度、完善制度、控制流程”的原则,建立保障参保人全要素协同的闭环服务管理体系,破解“进院难”,为国谈药“双通道”全面落地提供实践经验。

In order to improve availability and affordability of drugs, China has successively issued a series of new policies including the drug price zero-addition policy, the national volume-based procurement and national medical insurance negotiation drugs, continuously guaranteeing drug qualities and reducing medical burden. However, negotiation drugs fail to cross “the last kilometer” to enter the hospitals because local administration has difficulty in strengthening the coordination of the hospital and the medical insurance institution. Nanjing Healthcare Security Bureau is patient-centered and committed to ensuring the medical insurance benefit according to its own functions. Based on the people-oriented principle, dimensions of assurance, system improvement, process control, a closed-loop service management system with the coordination of all elements of the insured is established to solve the admission problem of negotiation drugs, providing Nanjing scheme for the full implementation of "double channel" of negotiation drugs.