中国药业2025，Vol.34Issue(8)：11-16,6.DOI:10.3969/j.issn.1006-4931.2025.08.003
中药配方颗粒纳入医保报销政策发展脉络与内容优化建议
Textual Analysis and Optimization Suggestions of Chinese Medicine Granules Inclusion in Health Insurance Reimbursement Policies
摘要
Abstract
Objective To provide a reference for the improvement of the policy of incorporating traditional Chinese medicine(TCM)formula granules into the basic medical insurance(hereinafter referred to as medical insurance)and balanced development of the industry.Methods The relevant policy texts on the inclusion of TCM formula granules in medical insurance reimbursement at the national and local levels were sorted out.Existing problems in the policies were analyzed,and optimization suggestions were put forward.Results The construction of the two-tier standards for TCM formula granules still needs to be improved.The filing progress of some provincial standards is slow,affecting the overall standard-setting process.There are significant differences in the intensity of medical insurance support among various provinces(autonomous regions and municipalities directly under the central government).The new policies in some provinces have poor effects in benefiting the people.The policies to resist local protectionism are not yet specific and clear enough,leaving potential risks for the implementation of the centralized procurement policy.Conclusion The standard-setting process should be accelerated to maximize the advantages of medical insurance policies.In-depth basic research on drugs should be carried out to provide strong support for the filing work of provincial standards.Comprehensive measures should be taken to work in concert to enhance the policy effects.A whole-process supervision mechanism should be constructed to prevent and control potential risks that may arise during the centralized procurement process.关键词
中药配方颗粒/医保报销/政策文本分析/发展脉络/优化建议Key words
Chinese medicine formula granule/medical insurance reimbursement/policy text analysis/development content/optimization recommendations分类
医药卫生引用本文复制引用
张宇,郭斯伦..中药配方颗粒纳入医保报销政策发展脉络与内容优化建议[J].中国药业,2025,34(8):11-16,6.基金项目
北京市社会科学基金决策咨询项目[21JCB112]. （）
