肿瘤病人买靶向药，医院总没药让病人去外面药店买。为么医院没药？药店和医院买对病人来讲报销有区别吗？
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">自费购药时，朝思暮想等着药进<span style="color: black;">医疗保险</span>，进了<span style="color: black;">医疗保险</span>却<span style="color: black;">发掘</span>只是<span style="color: black;">懊恼</span>的<span style="color: black;">起始</span>。<span style="color: black;">非常多</span>抗癌药纳入<span style="color: black;">医疗保险</span>报销范围后，反而在医院开不到了。<span style="color: black;">这般</span>的案例近年来屡见不鲜：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">江苏有一位<span style="color: black;">病人</span>用了<span style="color: black;">医疗保险</span>目录内的药，结果还要自费50万。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pica.zhimg.com/80/v2-7bca0d2b77fbb9fba2056a0c18c9552f_720w.jpg?source=2c26e567" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">网友在网上发帖询问乳腺癌救命药赫赛汀，<span style="color: black;">然则</span>找了<span style="color: black;">非常多</span><span style="color: black;">地区</span>都被<span style="color: black;">通知</span>缺货。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">为何</span>会存在<span style="color: black;">这般</span>的<span style="color: black;">状况</span>？<span style="color: black;">由于</span><span style="color: black;">医疗保险</span>控费、药占比考核和<span style="color: black;">药物</span>集采。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">医疗保险</span>控费：国家的<span style="color: black;">医疗保险</span>投入总额有限，高价药即使进了<span style="color: black;">医疗保险</span>，<span style="color: black;">亦</span>会受到<span style="color: black;">医疗保险</span>总额控费的压力，会在处方上受到限制。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">药占比考核：<span style="color: black;">病人</span><span style="color: black;">看病</span>过程中，购买<span style="color: black;">药物</span>的花费<span style="color: black;">不可</span>超过总<span style="color: black;">看病</span><span style="color: black;">花费</span>的<span style="color: black;">必定</span>比例，在大<span style="color: black;">都数</span>城市公立医院，这一比例的上限为 30%。一针 70 万元的<span style="color: black;">药品</span>，对医院、科室乃至<span style="color: black;">大夫</span>的考核影响将是<span style="color: black;">非常</span>巨大的。即使进入<span style="color: black;">医疗保险</span>，恐怕<span style="color: black;">亦</span>鲜有<span style="color: black;">大夫</span>敢开。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">药物</span>集采：<span style="color: black;">医疗保险</span>支出每年增长的速度越来越快，其中药费支出占比很大。从2019年起，国家组织<span style="color: black;">药物</span>、耗材集中带量采购，集采政策给<span style="color: black;">每一个</span>医院都分配了考核指标，当<span style="color: black;">病人</span><span style="color: black;">运用</span>社保身份<span style="color: black;">看病</span>的时候，开药时医院<span style="color: black;">必须</span>优先<span style="color: black;">选取</span>集采目录内的<span style="color: black;">药物</span>和器械。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">原研变仿制、进口变</p>
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“板凳”（第三个回帖的人）
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