BOYTE CONG HOA xX HOI CHU NGHiA VIET NAM. . .DQc I~p - Tl}'do - H~nh phuc

Ha N(Ji, ngayz4 thang 10 ndm 2019s6:6269IBYT-BH

VIv di~n giai chi ti~t cac phu luc thuocQuyet dinh s6 4905/QU-BYT

Kinh giri:- Sa Y t€ cac tinh, thanh ph6 true thuoc Trung irong;- Cac benh vien, vien co giirong benh tnrc thuoc BQY t€;- Ban Thirc hien chinh sach bao hiem y t€, thuoc Bao hiemxa hoi Viet Nam;- Y t€ cac BQ, nganh.(Sau day goi chung fa cac dan vi)

Ngay 21110/2019, B(l twang B9 Y t~ da ban hanh Quyet dinh s6 490SIQU­BYT v~ viec Sua d6i, b6 sung Phu luc s6 OS (danh muc rna thuoc tan duoc) ban hanhkern thea Quyet dinh s6 7603/QU-BYT ngay 2SI12/2018 cua B(l tnrong B9 Y t~ v~ban hanh b9 rna danh muc dung chung ap dung trong quan 1y kham benh, chua benhva thanh toan bao hi~m y t~ (Sau day goi t~t la Quyet dinh s6 490SIQU-BYT). U~thu~n ti~n cho cac dO"nvi trong vi~c thvc hi~n c~p nh~t, b6 sung danh m\lc thu6c kipthai, chinh xac, B9 Y t~ cung d.p diSn giai chi ti~t cac ph\l 1\lctrong file "Cac ph\l 1\lcdinh chinh, sua d6i" ban hanh kern thea quy~t dinh s6 490SIQU-BYT nhu sau:

1. Sheet "T6ng hgp" (Cung d.p danh sach, s6 1ugng thu6c, s6 lugng hOi;ltchatthu9C cac danh m\lC trong Quy~t dinh s6 7603 va Quy~t dinh s6 490S).

2. Sheet "Danh m\lC hOi;ltchat d6i rna", vai t6ng s6 19 ho~t chAt, bao g6m cacthong tin:

• Ten hOi;ltchat;• Ma hOi;ltchat thea Quy~t dinh 7603;• Ma hoc;ttchat dinh chinh thea quy~t dinh s6 490S va,• S6 lugng thu6c tuang ung vai m6i hoc;ttchat.

3. Sheet "Danh m\lC thu6c d6i rna (Can cu vao hoc;ttchat d6i rna)", li~t ke danh sachchi ti~t 328 thu8c cua 19 ho~t chAt d8i rna.

4. Sheet "Danh m\lC thu6c b6 sung vao ph\l l\lc OS.1 (dugc cO"quan BHXH thanhtoan)", li~t ke danh sach 06 rna hOi;ltchat vai s61ugng thu6c tuang Ungnhu sau:

8TT Ma hoat ch~t 86 IU'O'D~thuoc1 40.1019 12 40.14 23 40.482 34 40.553 1205 40.759 16 40.774 1

Tong con~ 128

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5. Sheet "Danh muc thuoc loai khoi phu luc 05.1 (khong diroc co quan BHXHthanh toan), li~t ke danh sach 04 rna hoat ch~t voi s6 hrong thuoc nrong ling nhu sau:

STT Ma hoat chat S6luO'Dgthu6c Ghi chu1 40.180 182 40.324 13 40.328 24 40.30.303 1 Loai bo thuoc hoat chat Voriconazole

dirong Tiem do Thong tu 30/2018/TT-BYT chi quy dinh thanh toan d6i voiduong U6ng

TAng cong 22

6. Sheet "Danh muc thuoc b6 sung vao phu luc 05.4 (b6 sung vao danh mucthuoc loai)", li~t ke danh sach 04 rna hoat ch~t voi so hrong thuoc urong ling nhu sau:

STT Ma hoat chat S6luO'Dgthuoc Ghi chu1 40.180 182 40.324 13 40.328 24 40.30.303 1 Loai bo thuoc hoat chat Voriconazole

dirong Tiem, do Thong nr 30/2018/TT-BYT chi quy dinh thanh toan d6i voidirongU6ng

Tong conI! 22

7. Sheet "Danh muc thuoc loai khoi phu luc 05.4 (b6 sung tro lai phu luc 05.1,thuoc duoc co quan BHXH thanh toan)", liet ke danh sach 06 rna hoat ch~t voi s6hrong thuoc tuong irng nhu sau:

STT Ma hoat chit S6luO'Dgthu6c1 40.1019 12 40.14 23 40.482 34 40.553 1205 40.759 16 40.774 1

Tang cong 128

8. Sheet "Danh rnuc ho~t ch~t b6 sung phV Ivc 05.7 (lo~i ho~t ch~t)", li~t kedanh sach 03 ho~t ch~t cv th~ nhu sau:

STT Ma ho~t chit Ten ho~t chit DuOng dung Ma dUOngdung

1 40.328 Mefloquin U6ng 1.01

2 40.180 Ceftezol Tiem 2.10

3 40.324 Amodiaquin U6ng 1.01

9. Sheet "Danh fiVC ho?t ch~t lo?i kh6i ph\l l\lc 05.7 (b6 sung ho?t ch~t, b6sung thu6c duQ'c co quan BHXH thanh tmin)", li~t ke danh sach 07 ho~t ch~t cv th~nhu sau:

2

STT Ma hoat Ten host chit DU'Ong dung Ma dU'Ongchit dung

1 40.103 D6ng sul fat U6ng 1.01

2 40.480 Nicorandil Tiem 2.10

3 40.482 Adenosin triphosphat Uong 1.01

4 40.553 FenofibratU6ng (vien tac 1.01dung cham)

5 40.874 Nandrolon monosodium Nh6 mat 6.01

6 40.937 Rotundin Tiem 2.10

7 40.1019 Magnesi aspartat + kali aspartat Tiem 2.10

10. Sheet "Danh muc hoat chfrt b6 sung phu luc 05.8 (hoat chat loai dirongdung)", li~t ke danh sach 04 ho~t chit C\l th~ nhu sau: I

Ma duong dung IDU'OngdungSTT

1 40.103 Dong sulfat U6ng 1.01

2 40.480 Nicorandil Tiem 2.10

3 40.874 Nandrolon Nh6 mat 6.01monosodium

4 40.937 Rotundin Tiem 2.10

11. Sheet "Danh muc thuoc bo dfru sao", li~t ke danh sach 18 rna hoat chit vois6 hrong thuoc urong irng nhu sau:

STT Ma hoat chit SolU'O'ngthuoc1 40.168 952 40.174 333 40.183 1884 40.192 425 40.197 266 40.205 257 40.218 98 40.228 409 40.229 110 40.230 411 40.231 812 40.250 213 40.258 4314 40.272 815 40.271 1116 40.399 417 40.171 5918 40.172 146

Tong cong 744

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STT Ma hoat chAt S61U'ongthu6c1 Acid amin* 112 Doripenem* 53 Ertapenem* 34 Imipenem + cilastatin* 55 Meropenem* 136 Fosfomycin* 157 Linezolid* 58 Teicoplanin* 19 Amphotericin B* 210 Voriconazole* 5

Tong cong 65

12. Sheet "Danh muc thuoc bo d~u sao", liet ke danh sach 10 ma hoat eh§t vois5 hrong thuoc tuong irng nhir sau: .

13. Sheet "Danh muc ma duong dung", li~t ke 65 ma dU"irngdung thudc, trongdo b6 sung 02 ma duong dung moi nhir sau: I

STT Ma dU'O'ngdung DU'iYngdun~dangdung I1 5.11 Duong nQikill quan2 9.19 Tai ch6(ngam vao khoang mang bung) I

B9 Y t~ d~ nghi thu tnrong cac dan vi nghien elm, chi dao cac don vi thuocquyen quan ly, ca~ khoa, phong co lien quan trong dan vi thuc hien ra soat, die~ chin~lai danh muc thuoc dang sir dung tai dan vi va anh xa danh muc tren Cong tiep nhandfr lieu H~ thong Thong tin giam dinh BHYT cua co quan bao hiem xa h9i thea dungquy dinh tai quyet dinh nay, nham bao dam thuc hien trich chuy€n dfr li~u dung, dulkip thai thea qui dinh. I

Trong qua trinh t6 chuc th\Ic hi~n, ,n~u c6 ~6 khan, vU?ng m~c p,hat sinh, dtnghi cac cO'sa KBCB phan anh kip thai ve B9 Y te (Vv Bao hiem y te) de duQ'ctonghqp xem xet, giai quy~t.I.

Nu; nh~n:

- Nhu tren;- TT. Nguy~n TruOng Son (d€ b/c);- Vv tru6ng V\l BHYT (d€ b/c);- Luu: VT, BH.

TL. BO TRUONGKT. VU TRUONG VU BAo HIEM Y TE

. , TRUONG

Di}ng HAng Nam

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