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Catalogue of Agricultural Insurance Drugs in Hefei City
Catalogue of special drugs for serious illness insurance
Introduction to the catalogue of special drugs for serious illness insurance
The list of special medicines for critical illness insurance has always been a little knowledge. Let's take a look with Bian Xiao.
I. Catalogue of Special Drugs for Serious Illness Insurance
Special drugs for critical illness insurance 16 kinds, including:
1, imatinib mesylate (capsule, tablet), dasatinib, nilotinib in the treatment of chronic myeloid leukemia,
2. Recombinant human coagulation factor VII for injection for treating hemophilia B,
3. Bevacizumab in the treatment of colorectal cancer,
4. Ectinib hydrochloride (7 tablets and 2 1 tablet), gefitinib and pemetrexed disodium for injection in the treatment of non-small cell lung cancer.
5. Tratuzumab for injection for treating HER2-positive breast cancer and HER2-positive gastric cancer,
6. Rituximab is used to treat lymphoma,
7. Bortezomib for injection for the treatment of multiple myeloma and mantle cell lymphoma,
8, the treatment of myelodysplastic syndrome decitabine,
9. Lanruipeptide acetate for injection for the treatment of acromegaly and carcinoid,
10, lanthanum carbonate chewable tablets for the treatment of hyperphosphatemia.
Two, serious illness insurance special drugs and limited payment scope
Special drugs for serious illness insurance refer to drugs that are not listed in the list of basic medical insurance, industrial injury insurance and maternity insurance in * * province, but are clinically necessary, effective and expensive to treat major (rare) diseases, and are included in the payment scope of serious illness insurance by the provincial human resources and social security department through negotiation mechanism. The Provincial Department of Human Resources and Social Security has identified Gleevec 15 kinds of special drugs, which must be strictly implemented by all agencies and may not be expanded and adjusted without authorization.
Three, to protect special drugs and serious illness insurance benefits
(A) the protection of special drugs
The protection object of special drugs is the patients who meet the indications for the use of special drugs among the insured persons of serious illness insurance.
(two) special drugs for serious illness insurance treatment.
The treatment of serious illness insurance for special drugs includes the compensation treatment of serious illness insurance and the free drug supply treatment obtained from relevant pharmaceutical companies or charities according to provincial agreements.
1. Payment and treatment of serious illness insurance: When the insured patients have special drug expenses that meet the requirements, they will be included in the payment scope of serious illness insurance and incorporated into the compliance medical expenses borne by individuals. In a natural year, the part of the accumulated compliance medical expenses of individuals that exceeds the deductible line of compensation for serious illness insurance shall be paid by serious illness insurance according to the following proportions: 50% of the part from 30,000 yuan to 60,000 yuan; 60% of the part above 60,000 yuan.
2. Free drug supply treatment (free drug supply period): According to the provincial agreement, after some special drugs are used for a course of treatment, pharmaceutical companies or charities can provide free follow-up treatment. After the insured patients meet the conditions for free drug supply due to treatment, they apply to the designated drug distribution pharmacy for free drug supply, and the serious illness insurance fund and the individual patients no longer pay special drug fees.
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