The National Health and Health Commission's Medical Administration and Hospital Administration issued prescription management regulations: clarify the target of long-term prescriptions

On August 12, in order to standardize long-term prescription management, promote hierarchical diagnosis and treatment, ensure medical quality and medical safety, and meet the long-term medication needs of patients with chronic diseases, the Medical Administration and Hospital Administration of the National Health Commission issued the "Regulations on Printing and Distributing Long-term Prescription Management Standards (Trial Implementation) )” (hereinafter referred to as the “Specifications”) and related interpretations
.

Screenshot of the official website of the National Health Commission's Medical Administration and Hospital Administration

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
.

The original text is attached below:

Long-term prescription management practices (trial implementation )

Chapter One 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
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Article 4 Commonly used drugs for the treatment of chronic diseases can be used for long-term prescriptions
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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
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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
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Long-term prescriptions for chronic diseases that are not suitable for primary treatment should be issued by medical institutions above the second level
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Article 8 The National Health Commission is responsible for the supervision and management of long-term prescriptions nationwide
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Chapter III Issuance and Termination of Long-term Prescriptions

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

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
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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
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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

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
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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
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Article 24 The form and content of long-term prescriptions shall comply with the requirements of general prescription management in the "Prescription Management Measures"
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Chapter 4 Long-term prescription adjustments

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
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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
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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

Chapter 5 Long-term prescription drug 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
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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

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
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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

Article 34 Medical institutions shall instruct patients who use long-term prescriptions, preserve medicines as required, and ensure the quality of medicines
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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
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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
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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
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Article 38 When formulating regional total budget management, all localities shall fully consider the factors of long-term prescriptions
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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
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Strengthen intelligent monitoring and intelligent review to ensure the rational use of drugs
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Chapter 7 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
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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
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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
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Article 43 This specification shall come into force on the date of issuance
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