 Home > Medical News > Latest Medical News > New regulations for long prescriptions!

New regulations for long prescriptions!

 Last Update: 2021-08-28
 Source: Internet
 Author: User

Tags

primary insomnia

long strep throat treatment

Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

813　812，《（）》（《》）
。《》、，，4；，，12
。

，《》，；，
。

《》，、
。

，

，、
。，
。

4《（）》（《》），《》：

Clearly stipulate medical use of toxic drugs, radiopharmaceuticals, precursor drugs, narcotic drugs, Class I and Class II psychotropic drugs, antimicrobial drugs (except drugs for the treatment of chronic bacterial and fungal infectious diseases such as tuberculosis), and the storage conditions Drugs with special requirements shall not be used for long-term prescriptions
.
Biological agents are classified in the 8 categories of drugs that cannot be used for long prescriptions in the "Draft of Opinions", but the "Specifications" has deleted them, and the psychotropic drugs are changed to the first and second categories of psychotropic drugs, which means the use of drugs The scope has been relaxed
.

In addition, the "norms" clearly, the local health administrative departments and medical institutions not to cost control, accounting for medicine and performance appraisal issued by the effects of long-term prescriptions
.
At the same time, it is emphasized that local health administrative departments should strengthen long-term prescription review, comment, and rational drug use assessment.
Drug costs incurred by long-term prescriptions are not included in the assessment of the average outpatient cost and the average cost of outpatient drugs.
Other assessments should also be based on the situation.
Manage long-term prescriptions individually
.

At the same time, the primary medical and health institutions are encouraged to issue long-term prescriptions.
If the primary medical and health institutions do not have the corresponding conditions, they can use remote consultations, Internet follow-up consultations, and hospital consultations to prescribe them under the guidance of qualified higher-level medical institutions in the medical consortium
.
Among them, "Internet follow-up" is a new content
.

In the original drug receiving method, “encourage the use of distribution logistics extension and other methods to solve the problem of patients’ difficulty in obtaining drugs”
.
Encourage areas with conditions to open WeChat official accounts, patient clients and other Internet interaction methods or channels to facilitate patients' inquiries about long-term prescription information, drug usage and dosage, and precautions
.
Among them, "Internet interactive methods or channels" are new content
.

　　The "Specifications" also added new clauses in the appendix: "Internet hospitals providing long-term prescription services should combine the conditions of the physical medical institutions they rely on, and comply with the relevant regulations on medical institution pharmacy management, Internet diagnosis and treatment management and this specification, and strengthen the quality of medical care.
And safety supervision
.
"

　　In general, the "Draft of Opinions" has 6 chapters and 35 articles, and the "Code" has 7 chapters and 43 articles
.
It is worth noting that Chapter VI of the "Specifications" "Long-term prescription medical insurance payment" is a new part of the whole, including 3 articles, respectively clarifying that medical insurance departments in various regions do not limit the number and amount of single long-term prescriptions in the payment link.
All localities should fully consider long-term prescription factors when formulating regional total budget management, and require local medical insurance departments to improve their handling and service capabilities
.

　　Internet + medicine + medicine press the "accelerator key"

　　The above-mentioned new content points out the specific direction for the development of long-term prescriptions, and will also help accelerate the development of the large-scale healthy ecology of chronic disease management, Internet hospitals, and medical technology development
.

　　Catalyzed by the 2020 epidemic, the number of online consultations has increased greatly, the health code has been "connected" across the country, and the "Internet + medical + medicine" has developed rapidly, but it has also shown new development trends
.
The National Health Commission and the National Medical Security Administration successively issued multiple documents, and even pressed the "accelerator" for the Internet + medical + medicine
.
According to the latest statistics released by the Internet Society of China, the number of Internet users in China has exceeded 989 million.
The total size of the Internet medical and health market will reach 283.
1 billion yuan in 2021, a year-on-year increase of 45%
.

　　Despite the rapid development of the Internet medical industry, at present, besides the good profit model of medical informatization and medical e-commerce, profit models in other fields still need to be explored.
Even the leading companies are still in the predicament of losing money
.
In 2020, Ping An Good Doctor achieved a net loss of 948 million yuan, an increase of 27% year-on-year; JD Health's net loss in 2020 was as high as 17.
234 billion yuan, and a loss of 1 billion yuan in 2019; WeDoctor's net loss from 2018 to 2020 was 40.
52 The three-year losses totaled nearly 8 billion yuan, 1.
937 billion yuan and 1.
914 billion yuan
.

　　Although Internet healthcare is also facing development difficulties and transformation, policy encouragement has released many benefits
.
In June of this year, the General Office of the State Council issued the "Opinions on Promoting the High-quality Development of Public Hospitals ", which clearly explored the interconnection of prescription information and drug retail consumption information in public hospitals.
The "Measures for the Supervision and Administration of Online Drug Sales", which has attracted the attention of the industry, will also be issued.

.

　　A few days ago, the National Medical Insurance Administration issued the "Opinions on Optimizing the Convenience of the Medical Insurance Field" which emphasized the promotion of Internet + medical services, the realization of prescription drug circulation, online payment and settlement, and home-to-door integrated services to promote the development of Internet medical services
.
This time, the National Medical Insurance Bureau officially proposed to open up an integrated chain of “online order-in-store delivery” medical insurance payment for prescribing, payment, and delivery of medicines.
O2O medical insurance payment is truly supported by top-level payment policies, and it is expected to be promoted quickly across the country in the future
.

　　From the perspective of industry insiders, as an important part of the "fourth terminal" of the pharmaceutical market, O2O is becoming the general trend of new pharmaceutical retail
.
With the integration of the three medicines to promote the upgrade of smart medical care, the opening of the circulation of electronic prescriptions, the gradual liberalization of online medical insurance payments in the 5G era, and the upgrading of consumption patterns triggered by the Internet, it will empower the deep restructuring of the online and offline layout of pharmaceutical retail
.

　　Long-term prescription management practices

　　(Trial)

　　Chapter I General Provisions

　　Article 1 In order to standardize long-term prescription management, promote hierarchical diagnosis and treatment, promote rational drug use, and ensure medical quality and safety, in accordance with the "Practicing Physician Law", "Drug Administration Law", "Medical Institution Management Regulations", "Narcotic Drugs and Psychotropic Drugs Management Regulations" "Prescription Management Measures", "Regulations on Pharmaceutical Affairs of Medical Institutions" and other relevant regulations, formulate this specification
.

　　Article 2 The term “long-term prescriptions” as used in this specification refers to the prescriptions prescribed by qualified physicians in accordance with regulations to appropriately increase the amount of prescriptions prescribed by qualified patients with chronic diseases
.

　　Article 3 Long-term prescriptions are suitable for patients with chronic diseases who have clear clinical diagnosis, stable medication regimens, good compliance, stable disease control, and long-term drug treatment
.

　　Article 4 Commonly used drugs for the treatment of chronic diseases can be used for long-term prescriptions
.

　　Article 5 Toxic drugs for medical use, radiopharmaceuticals, precursor drugs, narcotic drugs, Class I and Class II psychotropic drugs, antimicrobial drugs (except drugs for the treatment of chronic bacterial and fungal infectious diseases such as tuberculosis), and the storage of Medicines with special requirements shall not be used for long-term prescriptions
.

　　Article 6 The local health administrative department shall, based on actual conditions, formulate long-term prescriptions for the types of diseases and long-term prescription drugs
.

　　Article 7 This specification is applicable to the long-term prescription management work of various medical institutions at all levels and types across the country
.

　　Long-term prescriptions for chronic diseases that are not suitable for primary treatment should be issued by medical institutions above the second level
.

　　Article 8 The National Health Commission is responsible for the supervision and management of long-term prescriptions nationwide
.

　　Local health administrative departments at or above the county level are responsible for the supervision and management of long-term prescriptions within their administrative areas
.

　　Chapter II Organization Management

　　Article 9 A medical institution shall perform its main responsibility for long-term prescription management, establish and improve its long-term prescription management work system, ensure medical quality and medical safety, and meet the needs of patients for medication
.

　　Article 10 Medical institutions that issue long-term prescriptions shall be equipped with physicians who have the ability to evaluate patients' conditions, pharmacists (including other pharmaceutical technicians, the same below) who can review and adjust long-term prescriptions, and corresponding equipment and facilities
.

　　If the primary medical and health institution does not have the corresponding conditions, it can be issued under the guidance of qualified higher-level medical institutions in the medical consortium through remote consultations, Internet follow-up consultations, and hospital consultations
.

　　Article 11 According to the needs of patients for diagnosis and treatment, the amount of prescriptions for long-term prescriptions is generally within 4 weeks; according to the characteristics of chronic diseases, patients with stable conditions should be extended appropriately, and the longest will not exceed 12 weeks
.

　　For long-term prescriptions exceeding 4 weeks, physicians should strictly evaluate, strengthen patient education, and record in medical records, and patients should confirm by signing
.

　　Article 12 Medical institutions shall provide long-term prescription services to eligible patients in accordance with the types of diseases and the scope of long-term prescription drugs formulated by the administrative department of health and health
.

　　Article 13 Medical institutions may provide "one-stop" long-term prescription services for elderly patients with multiple diseases in general internal medicine, geriatrics, general medicine and other departments, and solve the problem of elderly patients seeking medical treatment and medicine in multiple departments
.

　　Article 14: Medical institutions shall issue long-term prescriptions and encourage priority selection of national essential drugs, national organizations to centrally purchase selected drugs, and national medical insurance catalog drugs
.

　　Article 15 Primary medical and health institutions shall strengthen the provision of long-term prescription medications to ensure that patients' long-term medications are accessible and stable
.

　　Article XVI local health administrative departments and medical institutions not to cost control, accounting for medicine and performance appraisal issued by the effects of long-term prescriptions
.

　　Local health administrative departments should strengthen long-term prescription review, reviews, and rational drug use assessment.
The cost of drugs generated by long-term prescriptions is not included in the assessment of average outpatient cost and average outpatient drug cost.
Other assessments should also include long-term prescriptions as appropriate.
Individual management
.

　　Chapter III long-term prescriptions issued and Termination

　　Article 17 For patients who apply for long-term prescriptions, doctors must check in person and judge whether they meet the conditions for long-term prescriptions
.

　　During the diagnosis and treatment activities, doctors can proactively propose long-term prescription recommendations to eligible patients
.

　　Article 18 Physicians should explain to patients the precautions for using long-term prescriptions, and they should voluntarily choose whether to use them; for patients who do not meet the conditions, they should explain the reasons to the patients
.

　　Article 19 Before issuing a long-term prescription for the first time, the physician shall conduct a comprehensive assessment of the patient’s past history, current medical history, medication regimen, compliance, disease control, etc.
, and formulate a prescription when the current medication regimen is determined to be safe, effective, and stable.
Long-term prescriptions can be prescribed for patients
.
When a long-term prescription is issued for the first time, relevant information should be recorded in detail in the patient's medical record
.

　　Article 20: In principle, the first long-term prescription should be issued by a doctor with a qualification for a disease-related professional and technical position or above in a medical institution above the second level, or a doctor with a qualification for a professional and technical position above the intermediate level in a primary medical and health institution.
Issued
.
When a long-term prescription is issued again, it should be issued by a doctor from a disease-related professional in a medical institution above the second level, or a doctor from a primary medical and health institution
.
Encourage patients to sign long-term prescriptions with family doctors through primary medical and health institutions
.

　　For remote areas or areas where conditions are not available, the requirements may be appropriately relaxed, and the specific requirements shall be separately formulated by the provincial health administrative department based on the actual situation
.

　　 Article 21 Physicians shall evaluate patients based on the long-term prescription information and health files issued for the first time in the patient's medical record information
.
After evaluation, if the patient's condition is stable and the long-term medication management goal is reached, a long-term prescription can be issued again and recorded in the patient's medical record; if the conditions are not met, the long-term prescription can be terminated
.
If the long-term prescription is used again after stopping, it shall be managed according to the long-term prescription issued for the first time
.

　　Article 22 In the following situations, it is necessary to reassess the patient's condition and determine whether to terminate the long-term prescription:

　　(1) The patient's long-term medication management has not reached the expected goal;

　　(2) Suffering from other diseases requires other medication;

　　(3) The patient is hospitalized for any reason;

　　(4) Other situations where the long-term prescription needs to be terminated
.

　　Article 23 The primary medical and health institutions that issue long-term prescriptions and the higher-level hospitals must do a good job of linking up, and establish a patient prescription information sharing and circulation mechanism through informatization methods
.

　　Article 24 The form and content of long-term prescriptions shall comply with the requirements of general prescription management in the "Prescription Management Measures"
.

　　Chapter IV long-term prescription swap

　　Article 25.
After a doctor has issued a long-term prescription, the patient can choose to dispense and take medicine at a medical institution or social retail pharmacy
.

　　Article 26 Pharmacists review long-term prescriptions, provide medication guidance and medication education to patients, and distribute medication education materials
.
If the primary medical and health institutions do not have the conditions, the pharmacists of the higher-level hospitals in the medical association shall remotely conduct prescription review or provide medication guidance services through the Internet
.

　　Article 27 When pharmacists review long-term prescriptions, provide consulting services, or dispense drugs, if they discover drug treatment-related problems or patients have potential drug safety risks, and need to carry out long-term prescription adjustments, drug reorganizations and other interventions, they should immediately contact the physicians Communicate for processing
.

　　Article 28 In principle, long-term prescription drugs shall be collected by the patient himself
.
Under special circumstances, due to inconvenience and other reasons, personnel who are familiar with the basic situation of the patient can pick it up on their behalf with valid identity documents of the patient and the patient, and cooperate with the corresponding registration record of taking medicine
.
Encourage the use of distribution and logistics extensions to solve the problem of patients' difficulty in getting medicines
.

　　Chapter V long-term prescription medication management

　　Article 29 Medical institutions shall regularly carry out rationality evaluation of long-term prescriptions, and continuously improve the level of rational use of long-term prescriptions
.

　　Article 30 Primary medical and health institutions shall include the long-term prescription information issued by the institution into the patient's health file, and record the patient's diagnosis and treatment and medication records in detail
.
The family doctor team shall conduct regular follow-up management of patients, evaluate changes in the patient's condition, medication compliance, and adverse drug reactions, adjust or terminate long-term prescriptions in time if necessary, and indicate in the patient's health files and medical records
.

　　Article 31 Medical institutions shall establish a monitoring and reporting system for safe drug use
.
After a serious adverse drug event occurs, the patient should be actively treated, immediately reported to the medical and pharmaceutical departments, and observed and recorded
.
Report adverse drug reactions and other information to relevant departments in accordance with relevant regulations
.

　　Article 32 Medical institutions should strengthen medication education for patients who use long-term prescriptions, increase their knowledge of rational medication, improve self-administration of medications and medication compliance, and inform patients that they should see a doctor if they experience any discomfort during medication
.

　　Article 33 Medical institutions shall instruct patients who use long-term prescriptions to conduct self-monitoring of drug treatment effect indicators and keep good records
.
Encourage the use of medical device wearable equipment to improve the information level of drug treatment effect indicator monitoring
.
On the premise of ensuring the security of data and privacy, it is possible to explore the use of remote monitoring equipment connected to the Internet to carry out monitoring
.

　　Article 34 Medical institutions shall instruct patients who use long-term prescriptions, preserve medicines as required, and ensure the quality of medicines
.

　　Article 35 Medical institutions shall incorporate the diagnosis and treatment of patients with long-term prescriptions into the overall arrangement of medical management, strictly implement the requirements of relevant disease diagnosis and treatment standards, strengthen quality control and management, and ensure medical quality and medical safety
.

　　Article 36 Regions where conditions permit are encouraged to open WeChat official accounts, patient clients and other Internet interactive methods or channels to facilitate patients' inquiries about long-term prescription information, drug usage and dosage, and precautions
.
Explore the development of medication reminder, follow-up, medication consultation and other services for patients with long-term prescriptions
.

　　Chapter VI Long-term Prescription Medical Insurance Payment

　　Article 37 The medical insurance departments of various regions shall pay for long-term prescriptions for drugs that meet the regulations.
There is no restriction on the number and amount of a single prescription, and the insured shall enjoy the treatment according to the regulations
.

　　Article 38 When formulating regional total budget management, all localities shall fully consider the factors of long-term prescriptions
.

　　Article 39 The medical insurance departments of various localities shall improve their service capabilities, facilitate the settlement of medical institutions and retail pharmacies by credit card payment, and provide long-term prescription medical insurance reimbursement consulting services for insured persons
.
Strengthen intelligent monitoring and intelligent review to ensure the rational use of drugs
.

　　Chapter VII Supplementary Provisions

　　Article 40 The local health administrative department shall, in conjunction with the medical security department, formulate the implementation rules for long-term prescription management within its jurisdiction and implement it
.

　　Article 41 The provision of long-term prescription services by Internet hospitals shall combine the conditions of the physical medical institutions on which they rely, and comply with relevant regulations on pharmaceutical management of medical institutions, Internet diagnosis and treatment management and these norms, and strengthen medical quality and safety supervision
.

　　Article 42: Primary medical and health institutions refer to township health centers, community health service centers (stations), village clinics, medical offices, outpatient departments, and clinics
.

　　Article 43 This specification shall come into force on the date of issuance
.

　　Medical Network, August 13 News On August 12, the Medical Administration and Hospital Administration of the National Health Commission issued the "Notice on Printing and Distributing Long-term Prescription Management Standards (Trial)" (hereinafter referred to as "standards")
.
The "Specifications" clarify the applicable subjects of long-term prescriptions, medical institutions that issue long-term prescriptions, and the main procedures for issuing long-term prescriptions.
According to the needs of patients for diagnosis and treatment, the amount of prescriptions for long-term prescriptions is generally within 4 weeks; according to the characteristics of chronic diseases, patients with stable conditions The patient should be extended appropriately for no more than 12 weeks
.

　　It is worth noting that the "Regulations" specifically require that primary medical and health institutions should be well connected with higher-level hospitals, and establish a patient prescription information sharing and circulation mechanism through informatization methods; if they do not meet the qualifications for reviewing parties, the higher-level medical association Pharmacists in the hospital remotely conduct prescription review or provide medication guidance services through the Internet
.

　　While the "Specifications" pointed out specific directions for the development of long-term prescriptions, it also provided opportunities for the development of Internet medical remote consultation and medical information
.

　　Biological agents are not ruled out, online follow-up consultations can also be prescribed

　　Medical institutions issue long-term prescriptions, and still encourage priority selection of national essential drugs, centralized procurement and use of drugs by national organizations, and drugs in the national medical insurance catalogue
.
Medical institutions shall provide long-term prescription services to eligible patients in accordance with the long-term prescriptions formulated by the administrative department of health and the applicable diseases and the scope of long-term prescription drugs
.

　　Compared with the "Long Term Prescription Management Regulations (Trial Draft for Soliciting Comments)" (hereinafter referred to as the "Opinion Draft") released in April this year, the "Specifications" have the following changes worthy of attention: