Research On Implementation And Optimization Of Drug "Two Channel" Policy In Wuhu City

In order to strengthen the construction of the drug supply guarantee system,better meet the reasonable drug use needs of insured patients,and further enhance the "accessibility" of drugs,on May 10,2021,the National Medical Security Administration and the National Health Commission jointly issued the "Guiding Opinions on Establishing and Improving the" Two Channel "Management Mechanism for National Medical Insurance Negotiated Drugs",requiring all regions to actively explore the "Two channel" management mechanism and improve the accessibility of negotiated drugs,And clearly include designated retail pharmacies in the scope of negotiated drug supply guarantee,together with designated medical institutions,to form a "Two channel" for negotiated drug reimbursement.In July 2021,the Wuhu Medical Security Bureau and the Wuhu Health Commission jointly released the "Wuhu National Medical Insurance Negotiation Drug" Double Channel"Management Implementation Plan,clarifying the implementation rules and specific measures of the" Double Channel "policy,in order to achieve better medical security results.The "two channel" policy for drugs refers to the national negotiation of implementing a unified payment policy for drugs in both designated medical institutions and designated retail pharmacies,aimed at ensuring the "accessibility" of patient medication.This article utilizes the Horn Mitt policy execution model,draws on relevant theories and research foundations,combines literature analysis and stakeholder interviews,and constructs an analytical framework from six aspects: policy execution goals and standards,policy execution resource allocation,system environment,policy execution methods,characteristics of executing agencies,and executor preferences,Sort out the current situation of the implementation of the "two channel" policy for drugs in Wuhu City and the problems that have arisen in the policy implementation.Combining stakeholder theory,analyze the reasons for the problems that have arisen in the policy implementation from the perspectives of medical security departments,"two channel" designated medical institutions,"two channel" designated retail pharmacies,and patients.Then,propose optimization suggestions for the "two channel"policy,and improve the "two channel" management mechanism in Wuhu City,Provide suggestions for promoting the optimization of the "two channel" policy for drugs in Wuhu City.The analysis found that Wuhu City has basically established a "two channel" management mechanism,but there are still the following problems in the implementation process of this policy: low efficiency of two channel operation and limited role of retail pharmacies;The patient’s trust is not high;The operating threshold of "two channel" pharmacies is high,and the distribution of designated pharmacies is uneven;There are few injection channels for injectable drugs,making it difficult to ensure the quality of drug delivery outside the hospital;Lack of information resources and difficulty in prescription circulation;Prescriptions from medical institutions are not "outsourced";The regulatory pressure from the medical insurance department is high,and the standards for designated pharmacies are high;Designated retail pharmacies have difficulty preparing drugs and are unwilling to put them into operation.In response to the problems identified in the analysis of policy implementation status,optimization suggestions are proposed: expand the coverage of "two channel" pharmacies,and strengthen the role of pharmacies as channels;Increase policy promotion efforts;Strengthen the supervision of "two channel" designated pharmacies;Improve information technology construction;Improve the value orientation of policy executors;Strengthen interdepartmental collaboration;Enhance the awareness of prescription circulation in medical institutions.