The List of Medicines for Basic Medical Insurance, Industrial Injury Insurance and Maternity Insurance in Sichuan Province (hereinafter referred to as the List of Medicines) is the standard for payment of medicines by the basic medical insurance, industrial injury insurance and maternity insurance funds. Clinicians prescribe drugs according to the condition, and the insured person is not restricted by the drug list.
"Examples of generic names" are descriptions and explanations of the classification and number, names and dosage forms, and limited payment scope of drugs in the drug list, which is an integral part of the drug list and its contents are binding in policy.
First, the composition of the directory
(a) the drug list is divided into three parts: western medicine, Chinese patent medicine and Chinese herbal pieces.
The medicines listed in the western medicine section and the Chinese patent medicine section are allowed to be paid by the basic medical insurance, industrial injury insurance and maternity insurance funds, including western medicine 12 15, Chinese patent medicine 1 105 and ethnic medicine 53. Only the industrial injury insurance fund is allowed to pay for 25 varieties of western medicine and 2 varieties of Chinese medicine; The maternity insurance fund is only allowed to pay for four kinds of western medicines.
Chinese herbal pieces listed in the column of Chinese herbal pieces are Chinese herbal pieces that are not paid by the basic medical insurance, industrial injury insurance and maternity insurance funds, including 127 kinds of Chinese herbal pieces, 1 class. Among them, there are 99 kinds of non-unilateral payment; There are 28 kinds of 1 single and compound drugs that will not be paid.
(2) The basic medical insurance drugs of western medicine and Chinese patent medicine are divided into Class A and Class B. There are 349 varieties of western medicine Class A and 866 varieties of class B. There are 154 varieties of Class A drugs and 95/kloc-0 varieties of Class B drugs in some Chinese patent medicines.
Industrial injury insurance and maternity insurance do not distinguish between Class A and Class B when paying for medicines.
Second, the arrangement and classification
(3) Western medicine, Chinese patent medicine and ethnic medicine are numbered according to drug varieties, and only one number is made for the same variety. When it appears repeatedly, it should be marked with "★" and the variety number should be marked with brackets. The sequence of drug numbers has no special meaning.
(4) Western medicines are mainly classified according to clinical pharmacology and clinical department medication, while Chinese patent medicines are mainly classified according to clinical department medication and functional indications. Doctors in clinical departments use drugs according to their illness, and are not restricted by the classification in the drug list.
Three. Name and dosage form
(5) The names of western medicines, except those marked with ◇ in the remarks column, all adopt the Chinese common names and the chemical components in the English International Drug Names (INN), excluding the base, acid radical parts and "children", "children", "infants" or "children's use". The part of the generic name of western medicine indicating chemical components is consistent with the drug list (the drugs in the drug list must be in oral dosage form), and if it is clearly stated in the legal instructions that the dosage form is suitable for children, it can be limited to payment when children use it, such as oral dosage form, granule, oral powder, suppository, nasal drops, etc., which can improve children's compliance.
Chinese generic names are used for Chinese patent medicines, and dosage forms are not listed separately. For the sake of simple arrangement, under the same classification and route of administration, different dosage forms under the same generic name are juxtaposed, and their order has no special significance.
(6) The dosage forms of western medicine are classified according to the provisions of the General Principles of Preparations in the current edition of China Pharmacopoeia, and the unclassified dosage forms shall be subject to those marked in the Drug Catalogue. The specific dosage forms contained in the classified label dosage forms are shown in the following table:
The labeled dosage forms include dosage forms.
Ordinary tablets (tablets, enteric-coated tablets, coated tablets, film-coated tablets, sugar-coated tablets, extract tablets, dispersible tablets and scraper), hard capsules, soft capsules (soft capsules) and enteric-coated capsules can all be taken orally.
Sustained-release and controlled-release dosage forms: sustained-release tablets, sustained-release coated tablets and controlled-release tablets; Sustained-release capsules and controlled-release capsules
Oral liquid, oral suspension, dry suspension, oral emulsion, mucilage, oral liquid, emulsion, emulsion, colloidal solution, mixture, tincture, drops, suspension drops, syrup (including dry syrup).
Pills, pills, dripping pills
Enteric-coated granules
Oral powder, powder, powder
Powder for external use: powder, powder, duster, duster.
Ointment, cream, cream, paste, ointment
Patch, patch, film, transdermal patch
External liquids: external solutions, lotions, mouthwashes, mouthwashes, mucus, liniments, tinctures and oils.
Gypsum plaster, hydrophilic plaster
Gel emulsion
Coating agent, coating agent, coating agent
Suppository suppository, anal suppository, vaginal suppository
Eye drops
Ear drops
Nasal drops
Inhalation spray, aerosol, nasal spray, powder spray, spray, atomized inhalation, atomized suspension, atomized solution, atomized inhalation, inhaled powder, dry powder, dry powder inhalation, powder inhalation, inhaled solution, inhaled suspension.
Injection, injection, solution for injection, intravenous injection, suspension for injection, sterile powder for injection, intravenous injection, water injection, emulsion for injection, powder injection, injection, sterile powder injection and freeze-dried powder injection.
"Dry suspension" (excluding ★( 14 1), No.4 13 andNo. 120 1) and "dry syrup" contained in "oral liquid" in the table shall be paid only when children use it.
In Chinese patent medicine dosage forms, pills include watered pills, honeyed pills, watered pills, ointment pills, concentrated pills and pellets, but do not contain dripping pills; Capsules refer to hard capsules, excluding soft capsules; Other dosage forms are not combined.
(7) Description of name and dosage form:
1. Western medicines whose main chemical components are the same as those in the drug list, but whose trade names or specifications or manufacturers are different, belong to the drug list.
2. The main chemical components in the generic name are the same as those in the drug list, and the dosage forms are the same, but western medicines with different acid radicals or bases belong to the drug list.
3. Western medicines whose main chemical components in generic names are the same as those in the drug list and whose dosage forms are the same, such as "children", "children", "infants", "children's use" and "infants", belong to the drug list.
4. The part before the dosage form in the generic name is the same as the part before the dosage form in the drug list, and the dosage form is the same, while the proprietary Chinese medicines with different trade names or specifications or manufacturers belong to the drug list.
(8) Drugs marked with "▽▽" in the remarks column are classified because of their similar components and indications, and the marked names are the generic names of the first class drugs. Details are as follows:
1. western medicine part number 164 "anti-AIDS drugs" refers to drugs used by the state to treat AIDS free of charge.
2. Not in the Western Medicine District. 175 "artemisinin drugs" refers to prescription preparations, combination drugs and artemisinin drug injections based on artemisinin drugs listed in "Principles for the Use of Anti-malaria Drugs and Medication Scheme" of the Ministry of Health.
3. No.223 "Animal Bone Polypeptide Injection" of the Ministry of Western Medicine includes bone peptide injection, deer and melon polypeptide injection and melon extract injection.
4. Western Medicine No.225 "Compound OTC preparation for relieving cold symptoms" specifically includes the following non-prescription drugs:
No. The drug name is not. Drug NameNo. 1 Paracetamol Caffeine Flavanol Amine Tablets 46 Compound Licorice Fritillaria Thunbergii Ammonium Chloride Tablets 2 Paracetamol Pseudoephedrine Drops 47 Compound Paracetamol Sodium Houttuyfonate Tablets 3 Paracetamol Pseudoephedrine Tablets 48 Compound Loquat Ammonium Chloride Syrup 4 Paracetamol Pseudoephedrine Tablets 49 Compound Dextromethorphan Hydrobromide Capsules 5 Paracetamol Dextromethorphan Capsules 50 Compound Dextromethorphan Hydrobromide Syrup 6 Paracetamol Caffeine Capsules 5 1 Compound Honeysuckle. Pilling tablets 7 paracetamol and amantadine capsules 52 compound zinc cloth granules 8 paracetamol and pseudoephedrine capsules 53 compound pseudoephedrine hydrochloride sustained release capsules 9 paracetamol and pseudoephedrine chewable tablets 54 compound Yinqiao pseudoephedrine capsules 10 paracetamol and pseudoephedrine granules 55 compound potassium guaiacol sulfonate oral solution1paracetamol and pseudoephedrine tablets 56 compound paracetamol and pseudoephedrine syrup 12 paracetamol and pseudoephedrine capsules 57 caffeine. 8+03 paracetamol and pseudoephedrine capsules (for night use) 58 Codarin 14 paracetamol and pseudoephedrine chewable tablets 59 paracetamol and pseudoephedrine tablets 15 paracetamol and pseudoephedrine tablets 16 paracetamol and pseudoephedrine solution 6 1 paracetamol and pseudoephedrine tablets 62. Min Capsule 64 Meipu Pseudoephedrine Tablets 20 An Card 65 Maxi Pseudoephedrine Tablets 2 1 Anka Pseudoephedrine Capsules 66 Meiyu Pseudoephedrine Capsules 22 Anka Yumin Solution 67 Meiyu Pseudoephedrine Oral Liquid 23 Beimin Pseudoephedrine Tablets 68 Meiyu Pseudoephedrine Oral Liquid 24 Buluo Pseudoephedrine Dispersible Tablets 69 Pentorine Ammonium Chloride Tablets 25 Buluo Pseudoephedrine Capsules 70 Pentorine Ammonium Chloride Syrup 26 Buluo Pseudoephedrine Granules 7/ Kloc-0/ Ropp Pseudoephedrine Tablets 27 Buluo Pseudoephedrine Tablets 73 Bipartite Pseudoephedrine Tablets 29 Phenol Caffeine Tablets 74 Double Pump Oral Liquid 30 Phenol Caffeine Ma Min Capsules 75 Double Pump Dispersible Tablets 3 1 Phenol coffee Ma Min tablets 76 double-pump pseudoephedrine capsules 32 phenol coffee soft capsules 77 double-pump pseudoephedrine granules 33 phenol pump pseudoephedrine tablets 34 phenol pump pseudoephedrine tablets 79 pseudoephedrine capsules 35 compound paracetamol syrup 80 pseudoephedrine 8+0 zinc cloth tablets 37 compound paracetamol zinc tablets 82 dextromethorphan guaifenesin paracetamol capsules 84 paracetamol spray topiramate granules 40 compound paracetamol granules 85 guaifenesin tablets 4 1 compound paracetamol tablets.
5. The western medicine part number 3 10 "compound amino acid (18AA)" includes: 18AA,18aa-Ⅰ,18aa-Ⅱ,18aa-Ⅲ (.
6. Four kinds of drugs, including amino acid-based enteral nutrition, short peptide-based enteral nutrition, disease-specific enteral nutrition and total protein-based enteral nutrition, under category 7.2 of western medicine, including various varieties that meet the requirements.
7. "Animal-derived insulin" in No.376 of Western Medicine Department includes short-acting insulin (such as ordinary insulin), medium-acting insulin (such as low-refined protein zinc insulin), long-acting insulin (such as refined protein zinc insulin) and premixed insulin.
8. The "recombinant human insulin" in No.377 of the Ministry of Western Medicine includes short-acting insulin, medium-acting insulin (such as low-refined protein zinc recombinant human insulin) and premixed human insulin in different proportions (such as mixed recombinant human insulin).
9. The "ultra-short-acting human insulin analogues" in No.378 of the Ministry of Western Medicine include insulin aspart and insulin lispro.
10. The "long-acting human insulin analogues" of Western Medicine Part No.379 include insulin glargine, recombinant insulin glargine and insulin detemir.
1 1. Western Medicine Part No.428 "Interferon α" includes all interferon α and its subtypes approved by the US Food and Drug Administration before June 30, 2009.
12. No.723 "Animal-derived pulmonary surfactant" of western medicine includes pulmonary surfactant extracted from animals such as bovine pulmonary surfactant and porcine pulmonary phospholipid.
The western medicine part 13. 8 18 "compound OTC preparation for relieving symptoms of digestive tract discomfort" specifically includes the following non-prescription drugs:
No. The drug name is not. Drug name number 1 compound proglumide cimetidine tablets 19 compound pancreatin powder 2 compound belladonna bismuth magnesium tablets 20 compound lactic acid bacteria capsules 3 compound belladonna aluminum hydroxide tablets 2 1 gaiweiping tablets 4 compound belladonna aluminum hydroxide powder 22 aluminum magnesium alginate granules 5 compound amylase oral liquid 23 sucralfate berberine tablets 6 compound ranitidine capsules 24 Gentiana macrophylla sodium bicarbonate tablets (4). 7 compound gentian sodium bicarbonate tablets 25 gentian sodium bicarbonate powder 8 compound aloe vitamin U tablets 26 aluminum magnesium belladonna tablets 9 compound woody aluminum magnesium tablets 27 aluminum magnesium suspension 10 compound woody berberine tablets 28 aluminum magnesium plus suspension1KLOC-0/compound allantoin tablets 29 Huang Shen sodium aluminum capsules 12 compound Lactobacillus acidophilus tablets 30 rhamnose magnesium. Glycine Capsules 14 Compound Vitamin U Capsules 32-dimensional U Belladonna Aluminum Capsules 15 Compound Pepsin Granules 33-dimensional U Belladonna Aluminum Capsules II 16 Compound Digestive Enzyme Capsules 34-dimensional U Belladonna Aluminum Magnesium Capsules 17 Compound Bromopropane Aluminum Magnesium Tablets 35-dimensional U Belladonna Aluminum Magnesium Tablets 18 Compound Aluminum Hydroxide.
14.No. "Anti-snake venom serum injection" of the Ministry of Western Medicine. 1227 includes: anti-Agkistrodon halys venom serum injection, anti-Cobra venom serum injection, anti-Bungarus bungarus venom serum injection, anti-Agkistrodon acutus venom serum injection, anti-venom serum injection, etc.
15. The serial number ★(434) of "Dioscin Oral Preparation" in the part of Chinese patent medicine includes: Di 'ao Xinxuekang Granules (Tablets) and Dioscin Tablets.
16. No.484 of "Ginkgo biloba oral preparation" in the part of Chinese patent medicine includes: Ling Xing granules (capsules and tablets), Ginkgo biloba dripping pills (granules, capsules, tablets, dripping pills and oral liquid), Ginkgo biloba extract tablets (drops), Ginkgo biloba honey ring oral liquid and Ginkgo biloba ester dripping pills.
The number ★(484) "Ginkgo biloba injection" includes Ginkgo biloba extract injection, Ginkgo biloba extract for injection, Shuxuening injection (Ginkgo biloba injection) and Yinxingdamo injection.
17. The "Safflower Yellow Injection" of Part 489 of Chinese Patent Medicine includes Safflower Yellow Injection and Safflower Yellow Sodium Chloride Injection.
18. erigeron breviscapus injection for injection. Part ★(490) of Chinese patent medicine includes: erigeron breviscapus injection, breviscapine injection and breviscapine for injection.
19. No.491"Panax Notoginseng Saponins Injection" in Chinese patent medicine part includes Xuesaitong injection, Xuesaitong injection, Xuesaitong injection (freeze-dried) and Xuesaitong injection (freeze-dried).
No ★(49 1) "Panax notoginseng saponins oral preparation" includes Xuesaitong granules (capsules and tablets), Xueshuantong capsules and Sanqitongshu capsules.
20. The "tripterygium wilfordii oral preparation" in Chinese patent medicine section No.665 includes tripterygium wilfordii tablets and tripterygium wilfordii polyglycoside tablets.
The No.21.★(744) of "Compound Monascus Oral Preparation" of Chinese patent medicine includes: Zhibitai Capsule, Xuezhikang Tablet and Zhibituo Tablet.
22. "Cordyceps fermentation preparation" in part 852 of Chinese patent medicine includes Bailing capsule (tablet), Jinshuibao capsule (tablet), Lexus capsule and Ningxinbao capsule.
Fourth, limit the scope of payment
(9) The limited payment scope of some drugs in the remarks column of the Drug Catalogue refers to the drug expenses incurred by the insured under the conditions of limited payment, which can be paid by the basic medical, industrial injury and maternity insurance funds according to regulations. The agency shall check the relevant evidence before paying the fee.
1. Drugs marked with △ in the column of "Remarks" refer to drugs paid by the basic medical insurance pooling fund when the insured is in hospital and paid by personal account when he is out-patient. Industrial injury insurance and maternity insurance are not subject to this restriction.
2 "Remarks" column marked as "Special for Work-related Injury Insurance" refers to the drugs paid by the work-related injury insurance fund, which are not covered by the basic medical insurance and maternity insurance fund.
3 "Remarks" column marked as "limited maternity insurance" refers to drugs paid only by maternity insurance funds, which are not covered by basic medical insurance and industrial injury insurance funds.
4. "Remarks" column indicates "limited to * * * and work-related injury insurance" refers to the medical expenses incurred under * * *, which can be paid by the basic medical insurance fund according to regulations, and the work-related injury insurance fund is not subject to this restriction.
5. "Remarks" column indicates drugs with indications, indicating that the insured has limited indications, and has corresponding clinical signs, laboratory and auxiliary examination evidence and corresponding clinical diagnosis basis, and the expenses incurred by using the drug can be paid according to regulations. This restriction is not a revision of the drug legal instructions. Clinicians should use drugs according to the needs of diseases and the legal instructions of drugs.
6. For drugs marked as "second-line drugs only" in the column of "Remarks", payment should be made on the basis that the first-line drugs in the drug list are invalid or intolerable.
(10) When the insured persons who are not covered by the national free AIDS treatment use anti-AIDS drugs provided by western medicine 1.5 countries free of charge, the basic medical insurance fund can pay the fees according to the regulations.
No. 1.3. 1 andNo. 2. 1 When the anti-tuberculosis and anti-schistosomiasis drugs involved in the * * health project provided by China A are used by the insured beyond the scope of national public medical payment, the basic medical insurance fund can pay the fees according to the regulations.
Verb (short for verb) others
(eleven) drugs such as insulin and insulin analogues included in this catalogue do not include syringes and other auxiliary devices.
(12) The "musk" contained in some Chinese patent medicines refers to artificial musk, and "bezoar" refers to artificial bezoar, bezoar cultivated in vivo and bezoar cultivated in vitro.