Page 13 - 《中国药房》2025年20期

我国医保药品目录中药饮片管理现状分析
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张春梅 ，唐丽燕 ，王晓宇 ，王兴榆 ，刘晶晶 ，李青苗 （1.四川省中医药科学院中药新药创制川渝共建重点实
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验室，成都 610041；2.四川省医疗保障局，成都 610017）
中图分类号 R95；R288；R282 文献标志码 A 文章编号 1001-0408（2025）20-2495-07
DOI 10.6039/j.issn.1001-0408.2025.20.02
摘 要 目的 为进一步提高纳入医保基金支付范围的中药饮片（简称“医保中药饮片”）的管理水平提供参考。方法 收集国家医
保局及各省（自治区、直辖市）医保局官方网站中有关医保中药饮片的政策文件，采用文本分析法，从医保中药饮片管理办法和目
录形式两个维度，对我国各省医保中药饮片管理现状进行分析。结果 在医保中药饮片管理办法维度，对于饮片的执行标准，部分
省份执行国家标准和省级标准，少部分限定为国家标准和本省标准；对于支付类别，大部分省份以甲类为主，部分省份按乙类进行
管理，还有部分省份同时存在甲、乙类管理或按丙类管理的情况；对于申报主体，存在仅医疗机构、仅饮片生产企业、医疗机构和饮
片企业均可申报3种情况；对于申报程序，有的省份需要地方医保部门初评并上报推荐名单，有的不需要初评而由省级医保部门
统一评审；对于目录制定及调整办法，各省份区别不大。在医保中药饮片目录形式维度，部分省份在国家医保目录的基础上对目
录字段有所补充，有的省份目录则比较简单；有的省级增补目录按饮片名称的中文笔画进行排序，但大部分目录未见明确的排序
规则。结论 各省份在医保中药饮片管理办法和饮片目录制定方面已取得一定的成效，部分地区仍需结合实际和中药饮片特点，
拟定针对性及适应性强的管理条款，完善医保中药饮片目录内容及格式，持续追踪最新管理政策，提高目录制定的准确性和可操
作性。
关键词 中药饮片；医保；药品目录；管理现状

Current management status of Chinese herbal pieces in China’s national healthcare security drug catalog
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ZHANG Chunmei ，TANG Liyan ，WANG Xiaoyu ，WANG Xingyu ，LIU Jingjing ，LI Qingmiao（1. Sichuan-
Chongqing Joint Key Laboratory of Innovation of New Drugs of Traditional Chinese Medicine， Sichuan
Academy of Chinese Medicine Sciences， Chengdu 610041， China；2. Sichuan Provincial Healthcare Security
Administration， Chengdu 610017， China）
ABSTRACT OBJECTIVE To provide references for further improving the management level of Chinese herbal pieces covered
by the healthcare security drug catalog （hereinafter referred to as “healthcare security covered Chinese herbal pieces”）. METHODS
Policy documents related to healthcare security covered Chinese herbal pieces were retrieved from official websites of National
Healthcare Security Administration and medical insurance bureaus of various provinces （autonomous regions， municipalities directly
under the central government）. Using text analysis， the current management status of healthcare security covered Chinese herbal
pieces in various provinces was analyzed from two dimensions： management regulations and catalog formats. RESULTS In terms
of the management regulations for healthcare security covered Chinese herbal pieces， some provinces implemented both national
and provincial standards for Chinese herbal pieces， while a small number of provinces adopted national standards alongside their
own provincial standards. Regarding the payment categories of healthcare security covered Chinese herbal pieces， most were
classified as category A， though some provinces managed them as category B， and others included both categories A and B or
category C. In terms of applicants， there were three kinds： only medical institutions， only herbal piece enterprises， or both medical
institutions and herbal piece enterprises being allowed to apply. During the application process， some provinces required preliminary
evaluations by local healthcare security departments with recommended lists submitted， while some provinces omitted preliminary
evaluations and relied solely on unified evaluation by provincial healthcare security departments. Regarding the methods for catalog
formulation and adjustment， there was little variation among the provinces. In terms of the catalog format for healthcare security
covered Chinese herbal pieces， some provinces had supplemented the catalog fields based on the national medical insurance catalog.
In contrast， some provinces had relatively simple catalogs.
Δ 基金项目 四川省医疗保障局采购项目（No.SCSYLBZJFZC- Regarding the sorting of the herbal pieces catalog， some
2024-010） catalogs were arranged by the number of Chinese character
＊第一作者 副研究员，硕士。研究方向：中医药政策与信息。
strokes in the names of the herbal pieces， but most catalogs
E-mail：ilinda@126.com
# 通信作者 研究员，博士。研究方向：中药材优质高效生产理论 lacked clear sorting rules. CONCLUSIONS Significant results
与技术。E-mail：qingmiaoli@sina.com have been achieved in formulating management measures and

中国药房 2025年第36卷第20期 China Pharmacy 2025 Vol. 36 No. 20 · 2495 ·