Page 12 - 《中国药房》2024年7期

慢性病长期用药处方外配的落地障碍和实现途径
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徐 源 ，金春林 ，宋 捷，何阿妹，陈珉惺[上海市卫生和健康发展研究中心（上海市医学科学技术情报研究
＊
所），上海 200031]

中图分类号 R951；R197 文献标志码 A 文章编号 1001-0408（2024）07-0778-05
DOI 10.6039/j.issn.1001-0408.2024.07.02

摘 要 我国慢性病长期用药处方（以下简称“长处方”）政策逐步完善落实并开始鼓励长处方外配。长处方政策贯穿药品供应
端、配备端、使用端及政策端，涉及医疗保障、卫生健康等政府部门及患者、医疗机构、定点零售药店等利益相关方。目前，要实现
长处方外配存在以下问题：政策端药品目录不统一、监管各方需协同；配备端参与积极性和服务能力有待提高；使用端处方管理难
度增加、流转平台有待完善。长处方政策的推进需要“三医”联动、多方参与和政策协同，其中，国谈药品“双通道”政策、药品集采
及药店纳入门诊统筹管理均为慢性病长处方外配的落地起到了积极的推动作用。未来需在政策端完善配套政策、落实监管责任，
配备端推进药品分级分类、提升服务能力，使用端完善电子处方流转平台、规范处方管理，以推动长处方外配落地执行。
关键词 长处方；慢性病；处方外配；零售药店；政策落地

Obstacles and approaches for the implementation of external long-term prescription dispensing for chronic
diseases

XU Yuan，JIN Chunlin，SONG Jie，HE Amei，CHEN Minxing[Shanghai Health Development Research Center
（Shanghai Institute of Medical Science and Technology Information）， Shanghai 200031， China]

ABSTRACT The policy of long-term prescription for chronic diseases in China is gradually being improved and implemented，
and external long-term prescription dispensing is being encouraged. The long-term prescription policy runs through the links of drug
supply， equipment， use and policy， involving government departments such as medical security and health， as well as stakeholders
such as patients， medical institutions and designated detail pharmacies. There are still some problems in the external dispensing of
long-term prescriptions， such as the disunity of drug catalogue and the need for coordination among regulatory parties in the policy
link； the need to improve the participation enthusiasm and service ability in the equipment link； the increased difficulty of
prescription management， the need to improve the circulation platform in the use link. The promotion of external long-term
prescription policy requires health insurance， medical service， and the medicine industry co-development， multi-party participation，
and policy coordination. Among them， the “dual channel” policy， the policy of centralized medicine procurement， and the
pharmacy included in outpatient overall management policy have all played a positive role in promoting the implementation of
external long-term prescription dispensing for chronic diseases. It is necessary to improve supporting policies and implement
regulatory responsibilities in the policy link， promote drug classification and service capabilities in the equipment link， improve the
electronic prescription circulation platform， and strengthen prescription management in use link， so as to promote the
implementation of external long-term prescription dispensing.
KEYWORDS long-term prescription； chronic diseases； external prescription dispensing； retail pharmacies； policy implementation

慢性病长期用药处方（以下简称“长处方”），是指具 慢性病患者人数不断增加。由于慢性病患者不便于频
备条件的医师按照规定，对符合条件的慢性病患者开具 繁重复挂号、排队、看病、取药，导致长处方需求不断增
用量适当增加的处方。随着人口老龄化和疾病谱变化， 加。国家卫生健康委在 2020 年度公立医院绩效考核情
况通报中也明确提出减少患者就诊次数的要求。长处
Δ 基金项目 上海市2023年度“科技创新行动计划”软科学研究项
目（No.23692114600） 方能够减少往返开药次数和排队等待时间，提高患者的
＊第一作者 助理研究员。研究方向：药物政策、卫生规划。
就医获得感，减少医师重复劳动和医疗资源的浪费，减
E-mail：xuyuan@shdrc.org
少人群聚集，降低感染风险。
# 通信作者 研究员，博士。研究方向：卫生经济、卫生政策。
E-mail：jinchunlin@shdrc.org 处方外配是指参保人在定点医疗机构就医后，持医

· 778 · China Pharmacy 2024 Vol. 35 No. 7 中国药房 2024年第35卷第7期