Pharmacy service fee is coming!

Recently, the Fujian Provincial Medical Security Bureau issued the "Notice on the Trial Implementation of the Pharmacy Service Charging Policy in Provincial Public Hospitals", which will be implemented on a trial basis for one year from July 1, 2022
.
That is to say, the pharmacy service fee of Fujian provincial public hospitals will be officially launched in the second half of this year
.
Previously (October 13, 2021), the National Health and Medical Commission had issued five specifications including the "Pharmacy Outpatient Service Specification for Medical Institutions", which stipulated the basic requirements that medical institutions should meet to provide corresponding pharmaceutical services, as well as service targets, work content, Quality management and evaluation improvement,
etc.
This is the first time that the pharmacy service specification for medical institutions has been specially formulated at the national level
.
This also means that the pharmacy service fee is coming
.
As a reasonable compensation for pharmacy services, the pharmacy service fee is conducive to invoking the enthusiasm of pharmacists and promoting rational drug use
.
The relevant person in charge of the Medical Administration and Medical Administration Bureau of the National Health and Health Commission said that they will actively cooperate with relevant departments to promote the setting of charging items related to pharmaceutical services.
Service items also need to be refined and standardized to issue practical standards to undertake corresponding responsibilities and reflect reasonable labor services.
value
.
Since the nationwide cancellation of drug mark-up in September 2017, the entire hospital pharmacy has faced huge challenges
.
In fact, as early as 2020, the "Opinions on Strengthening the Management of Pharmaceutical Affairs in Medical Institutions to Promote Rational Use of Drugs" emphasized that the cost and value of pharmaceutical services should be considered in the price of medical services, and at the same time, the cost and value of pharmaceutical services should be considered reasonably for the medical insurance department.
Set up relevant charging items for pharmaceutical services, reflect the labor value of pharmaceutical personnel, and lay an important foundation
.
However, the actual implementation of the pharmaceutical service fee has to be explained from the medical reform star Sanming
.
As early as 2018, Sanming added a pharmacy service fee, which will be fully borne by the medical insurance fund.
The fee standard is clearly as follows: the outpatient pharmacy service fee is 10 yuan per person, and the traditional Chinese medicine decoction piece dispensing pharmacy service fee is 30 yuan per person.
The overall fund is fully borne; the inpatient pharmacy service fee is 30 yuan per person, which is included in the charging and paying standards for all diseases
.
Sanming then raised the bar in February 2021
.
In the "Notice on Further Improving Pharmacy Service Fees" issued by Sanming Municipal Medical Insurance Bureau and Sanming Municipal Health and Health Commission, it is clear that the city's second-level and above public hospitals will increase the western medicine pharmacy service fee (outpatient clinic), from 10 yuan Each person is adjusted to 15 yuan per person in tertiary hospitals and 13 yuan per person in secondary hospitals; the inpatient pharmacy service fee has been adjusted from 30 yuan per person to 50 yuan per person in tertiary hospitals and 45 yuan per person in secondary hospitals
.
This time, Fujian Province, once again a pioneer in medical reform, took the lead in clarifying that provincial hospitals will try to charge additional pharmacy service fees
.
Next, let's take a look at the key contents of this notice in Fujian Province
.
"Additional charges" for drug treatment outpatient clinics are limited to provincial public hospitals, and do not include charges for traditional Chinese medicine: Pharmacy service charges refer to the application of professional pharmacy knowledge and technology by clinical pharmacists who meet the prescribed qualifications in medical institutions to promote rationality and economy.
Fees charged for the provision of patient-oriented, content-independent, and directly-provided drug treatment services for the purpose of drug use
.
Scope of trial implementation: “Additional charges” for drug treatment outpatient clinics, multidisciplinary comprehensive outpatient clinics, and inpatient examination fees are limited to provincial public hospitals that provide patients with clinical drug treatment and other pharmaceutical services, but do not include traditional Chinese medicine
.
Public medical institutions provide pharmaceutical services such as serum drug concentration determination, screening of various drugs of abuse, drug sensitivity tests, intravenous drug dispensing fees, and genetic testing for medication guidance
.
Price Items New drug treatment outpatient item
.
Pharmacists who meet the prescribed qualifications, have intermediate or above professional and technical position qualifications and have been engaged in clinical pharmacy work for 3 years or more, provide medical treatment history records, conduct medication guidance, intervention or propose medication for patients who really need it in a fixed outpatient setting opinion
.
Standardize integration of current price items
.
Sort out and improve the charging items related to pharmaceutical services in the current price items, and standardize and integrate the price items of pharmaceutical medical services, including but not limited to serum drug concentration determination, screening of various drugs of abuse, drug sensitivity tests, genetic testing for medication guidance, intravenous Items such as drug configuration fees
.
Adjustment of inpatient consultation fees and multidisciplinary comprehensive outpatient price items
.
Qualified clinical pharmacists participate in inpatient inspection rounds and multidisciplinary comprehensive outpatient clinics, provide interpretation of drug test results, clinical medication recommendations, and put forward suggestions for drug reconstitution or drug intervention.
"Additional Charges" Policy
.
Please refer to Appendix 1 for the content and price of the above items
.
Among them: the price of multidisciplinary comprehensive outpatient clinics should be based on reasonable costs, reflecting the technical content of medical services and the degree of medical risks, taking into account market supply and demand, taking into account factors such as the population and the level of local economic and social development, and should be determined by medical institutions independently, and maintain the price Relatively stable within a certain period of time, the price adjustment period is not less than 6 months, and the rate of one increase shall not be higher than 20%, and there is no limit to the downward adjustment
.
The hospital's due matters such as traditional prescription review and adjustment, as well as the service matters that belong to the internal management of the hospital pharmacy, are considered as the comprehensive operation cost of the public hospital, and the medical service price item is not set up separately
.
Drug treatment outpatient programs are included in medical insurance payment, and various types of drug abuse screening and multidisciplinary comprehensive outpatient medical insurance are not covered.
Drug treatment outpatient programs are included in the scope of medical insurance payment, and paid by basic medical insurance according to regulations; intravenous drug configuration, serum drug concentration determination , drug sensitivity test, drug-guided genetic testing and other pharmaceutical medical service price items, as well as inpatient consultation fees after “additional charges” according to regulations, are included in the scope of medical insurance payment according to regulations; various drug abuse screening and multidisciplinary Comprehensive outpatient medical insurance does not pay
.
Effectiveness evaluation, promote rational drug use and safe drug use, establish a pharmaceutical service fee monitoring and evaluation mechanism, carry out follow-up monitoring of pharmaceutical service charges and payments in provincial public hospitals, and focus on monitoring drug safety, rationality, economy and influence.
, and choose an opportunity to analyze and evaluate drug treatment management, promote rational and safe drug use in medical institutions, and let patients feel the value of pharmaceutical services
.
For the monitoring and evaluation indicators of pharmaceutical service charges, please refer to the following attachments
.
Strengthen the management of medication and standardize the charging behavior.
In the process of implementing the charging of pharmaceutical services, each pilot hospital should effectively reflect and give full play to the role of professional and technical personnel in pharmacy, incorporate pharmaceutical services into the medical quality management and control system of the institution, control the irrational use of drugs, reduce the Medication risk
.
All pilot hospitals should improve the internal salary distribution system, rationalize the performance distribution mechanism of pharmacy service personnel, and focus on reflecting the value of pharmacy personnel's technical labor services
.
The medical security department should strengthen the management of agreements, include the medical insurance payment for pharmaceutical services into the content of the management of agreements, and strengthen the rationality of drug use and the review of expenses
.
Each trial hospital should combine its own pharmacy service capabilities, provide services in accordance with regulations and charge fees according to the facts, and must not make up services or exchange items
.
Each trial hospital should answer the patient's questions about the charges for pharmaceutical services, take the initiative to disclose the prices of pharmaceutical services, strictly implement the charging publicity system, and consciously accept social supervision
.
The new drug treatment outpatient program should fully respect the patient's right to know and the right to choose, and the patient should voluntarily choose the drug after obtaining the doctor's order
.
The medical security department will intensify the supervision and inspection of the charges for pharmacy services in the trial hospitals, seriously investigate and deal with violations of laws and regulations related to pharmacy service charges, and effectively protect the legitimate rights and interests of patients
.