为推动国家医保谈判药品政策落地,2021年10月,南京市医保局和卫健委联合发布《关于建立完善国家医保谈判药品“双通道”管理机制的实施方案》 （宁医发 〔2021〕 70号）,旨在通过定点医疗机构和定点零售药店两个渠道满足临床和患者用药需求。政策实施以来,医保局作为政策的制定者和执行者,医疗机构作为国谈药配备使用的首要责任主体,定点零售药店作为国谈药供应补充保障的重要主体,共同保障国谈药“双通道”落地。但也存在一些亟待解决的问题,如“双通道”管理药品范围界定模糊、配套政策贯彻落实不到位、定点零售药店尚未建立动态管理机制、异地就医直接结算不畅通、罕见病用药供应保障不足等。对此,建议相关主体多方协同以推进国谈药“双通道”顺利落地,如明确界定“双通道”管理药品范围、提升医院配备“双通道”药品动力、建立“双通道”定点零售药店动态管理机制、畅通异地就医直接结算、提升罕见病用药供应保障水平等。

In order to promote the implementation of national negotiated drug policies, the Nanjing Healthcare Security Administration and Health Commission jointly released The Implementation Plan for Establishing and Improving the “Dual Channel” Management Mechanism for National Medical Insurance Negotiated Drugs (Ningyifa〔2021〕No.70), which meets clinical and patients' medication needs through two channels of designated medical institutions and designated retail pharmacies. Since the implementation of the policy, the Healthcare Security Administration has been the decision-maker and executor of the policy, medical institutions have been the primary responsible body for the allocation and use of national negotiated drugs, and designated retail pharmacies have been an important body for the supplementary guarantee of national negotiated drug supply, jointly ensuring the implementation of the "dual channel" of national negotiated drugs. However, there are also some urgent problems to be solved, such as the vague definition of the scope of drugs included in the "dual channel" management, the inadequate implementation of supporting policies, the failure to establish a dynamic management mechanism for designated retail pharmacies, the blocked direct settlement for medical treatment in different places, and the insufficient supply of drugs for rare diseases. Therefore, the relevant authorities should coordinate with each other to promote the smooth implementation of the "dual channel" of the national negotiated drug, such as clearly defining the scope of drugs included in the "dual channel" management, improving the motivation of hospitals to supply "dual channel" drugs, establishing a "dual channel" dynamic management mechanism for designated retail pharmacies, facilitating the direct settlement of off-site medical treatment, and improving the supply guarantee level of rare disease drugs.