✦ Tóm lược thông minh
Circular No. 02/2010/TT-BYT issues the Supplementary List of Medicines for children under six years old within the scope of health insurance fund reimbursement, applicable at public and private healthcare facilities that have signed health insurance contracts. This circular stipulates the use, cost reimbursement for medicine expenses, and responsibilities of healthcare facilities.
Đối tượng áp dụng
Public and private healthcare facilities that have signed health insurance contracts and provide medical services to children under six years old.
Các điểm cốt lõi
- Healthcare facilities use the Medicine List issued with Decision No. 05/2008/QĐ-BYT and this Circular to reimburse medicine costs for children under six years old.
- Medicines classified in other treatment groups shall be reimbursed by the Health Insurance Fund if they are prescribed or have pharmacological effects registered in the drug registration dossier approved.
- Healthcare facilities establish a specific Medicine List for children under six years old based on the principle of prioritizing generic, single-component drugs produced domestically and meeting GMP standards.
- Medicines marked with (*) are reserve medicines to be used only when other medicines are ineffective and must be discussed before prescribing their use.
- Healthcare facilities are not allowed to purchase medicines, including cancer treatments and anti-rejection drugs, outside the list covered by health insurance.
🌐 Tác động xã hội từ văn bản này
- Positive impact: Facilitates easier access for children under six years old to necessary medicines through the Health Insurance Fund.
- Negative impact: May impose financial burdens on healthcare facilities if the use of medicines is not properly managed.
❓ Câu hỏi thường gặp
When was the Medicine List issued?
This Circular takes effect from February 1, 2010.
What regulations must healthcare facilities follow regarding the use of medicines?
Healthcare facilities must establish a specific Medicine List for children under six years old and prioritize generic, single-component drugs produced domestically and meeting GMP standards.
When can medicines marked with (*) be used?
Medicines marked with (*) are to be used only when other medicines are ineffective and must be discussed before prescribing their use.
Can healthcare facilities purchase medicines for children under six years old themselves?
No, healthcare facilities are not permitted to purchase medicines, including cancer treatments and anti-rejection drugs, outside the list covered by health insurance.
Which medicines are reimbursable by the Health Insurance Fund?
Medicines listed in the supplementary list issued with Decision No. 05/2008/QĐ-BYT and this Circular, which are prescribed or have pharmacological effects registered in the drug registration dossier approved.
Toàn văn
CIRCULAR
Issuing the Supplementary List of Medicines for Children under Six Years Old to be Covered by the Health Insurance Fund
within the scope of payment by the health insurance fund
_______________
Pursuant to the Health Insurance Law dated November 14, 2008 and Decree No. 62/2009/NĐ-CP dated July 27, 2009 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law;
Pursuant to the Law on Protection and Care for Children dated June 25, 2004;
Pursuant to the Drug Law No. 34/2005/QH11 dated June 14, 2005 and Decree No. 79/2006/NĐ-CP dated August 9, 2006 of the Government detailing the implementation of certain provisions of the Drug Law;
Pursuant to Decree No. 188/2007/NĐ-CP dated December 27, 2007 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;
Pursuant to Circular Joint No. 09/2009/TTLT-BYT-BTC dated August 14, 2009 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance;
Pursuant to Decision No. 05/2008/QĐ-BYT dated February 1, 2008 of the Ministry of Health issuing the list of essential medicines for use at medical examination and treatment facilities;
To meet the requirements of treatment and ensure the rights to medicine for children under six years old, the Ministry of Health issues the Supplementary List of Medicines for Children under Six Years Old to be Covered by the Health Insurance Fund and provides guidance on its implementation as follows:
Article 1. Attached to this Circular is the "Supplementary List of Medicines for Children under Six Years Old to be Covered by the Health Insurance Fund."
Article 2. Scope and Applicability
1. The list issued with this Circular supplements the list of medicines issued with Decision No. 05/2008/QĐ-BYT dated February 1, 2008 of the Ministry of Health on the list of essential medicines for use at medical examination and treatment facilities, and is only used for reimbursement under the health insurance scheme for children under six years old.
2. The list of medicines issued with this Circular applies to public and non-public medical examination and treatment facilities that have signed contracts for health insurance examination and treatment services and provide examination and treatment services for children under six years old.
Article 3. Guidance on Using the List and Reimbursing Medicine Costs for Children under Six Years Old
1. The list of medicines issued with this Circular includes 54 active pharmaceutical ingredients and 4 traditional medicines, arranged according to the principles and groups specified in Decision No. 05/2008/QĐ-BYT dated February 1, 2008 of the Ministry of Health. Medicines in the list issued with Decision No. 05/2008/QĐ-BYT dated February 1, 2008 of the Ministry of Health and in the list issued with this Circular can only be used for children under six years old if they have indications and dosages for children under six years old registered in the drug registration dossier approved.
2. Medicines must be used according to hospital classification regulations regarding the level of use, appropriate to specialty and分级处理输入的长段落，确保每个部分都准确无误地翻译，并保持输出格式与输入完全一致。
3. Medicines in this group used to treat diseases outside their designated categories will be reimbursed by the health insurance fund if they have indications or pharmacological effects as registered in the drug registration dossier approved.
4. Finished products containing multiple active ingredients will be reimbursed by the health insurance fund if all active ingredients are included in the form of single-component drugs in the list issued with Decision No. 05/2008/QĐ-BYT dated February 1, 2008 or in the list issued with this Circular.
5. In cases where medicines are included in both the list issued with Decision No. 05/2008/QĐ-BYT dated February 1, 2008 of the Ministry of Health and the list issued with this Circular; finished products will be reimbursed by the health insurance fund as stipulated in Clause 4 of this Article but with different routes or forms of administration as listed: the health insurance fund will reimburse if the route or form of administration is convenient and suitable for children, such as syrup, aromatic powder, granules, emulsion, spray.
6. Medicines in the cancer treatment and immunomodulation group:
6.1. For medicines solely for cancer treatment, including those not specified in the Ministry of Health's list, they can only be used at Cancer Centers, Institutes, or Hospitals, or Departments of Oncology and must be prescribed by oncologists trained in the specialty.
6.2. For medicines used to treat cancer but also indicated for other non-cancer diseases, they can be used at hospitals or clinical departments other than the Department of Oncology according to the hospital's treatment protocol, but must be reviewed by an oncologist to ensure safety and efficacy of treatment.
7. Medicines marked with (*) are reserve medicines, to be used only when other medicines in the group are ineffective and must be reviewed before prescribing. In emergencies, the treating physician may prescribe immediately, followed by a review.
8. To avoid duplicate payments, medicines included in the list but already counted in the cost of technical services for reimbursement will not be additionally reimbursed by the health insurance fund.
Establishing a specific list of medicines for each medical examination and treatment facility and the responsibilities of these facilities
Article 4. Establish a specific list of medicines for each healthcare facility and the responsibilities of the healthcare facility
1. BASED on the Drug List attached to Decision No. 05/2008/QĐ-BYT dated February 1, 2008, of the Ministry of Health and the Drug List attached to this Circular; based on the professional technical line and disease model, healthcare facilities shall establish a drug list for their unit to be used for children under six years old. The selection of specific finished drugs for use at healthcare facilities shall follow the principle of prioritizing generic drugs, single-component drugs, domestically produced drugs, and drugs from pharmaceutical enterprises meeting Good Manufacturing Practice (GMP) standards, to ensure uniformity in supply, use, and reimbursement with the Health Insurance Fund according to the health insurance examination and treatment regime for children under six years old.
2. Healthcare facilities are responsible for ensuring adequate and timely drug supply, without allowing patients to purchase drugs themselves, including cancer treatment drugs and anti-rejection drugs outside the health insurance reimbursement list as prescribed; they must comply with prescription, indication, and rational, safe, and effective drug usage regulations.
3. Healthcare facilities that have not established an Oncology Department need to develop plans to train specialized staff and establish an Oncology Department according to the planning of the Ministry of Health, meeting patient treatment requirements as well as the professional operation regulations of the Oncology Department as stipulated by the Ministry of Health.
Article 5. Effectiveness
This Circular takes effect from February 1, 2010.
During the implementation process, if there are difficulties or obstacles, units are requested to report them to the Ministry of Health for consideration and resolution./.
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Căn cứ 7
62/2009/NĐ-CP
Nghị định số 62/2009/NĐ-CP Quy định chi tiết và hướng dẫn thi hành một số điều của Luật Bảo hiểm y tế
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Luật Bảo vệ, chăm sóc và giáo dục trẻ em số 25/2004/QH11
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Nghị định số 188/2007/NĐ-CP Quy định chức năng, nhiệm vụ, quyền hạn và cơ cấu tổ chức của Bộ Y tế
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Luật Bảo hiểm y tế số 25/2008/QH12
Còn hiệu lực
02/2010/TT-BYT
Circular No. 02/2010/TT-BYT Issuing the Supplementary List of Medicines for Children Under Six Years Old Within the Scope of Health Insurance Fund Reimbursement
Expired
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