中新网4月16日电，近日，国家医保局针对社会广泛关注的“减肥神药”司美格鲁肽注射液是否纳入医保的问题，发布了官方声明。据公告，司美格鲁肽确已列入国家医保目录，但其医保支付范围严格限定在与成人2型糖尿病相关的治疗场景。
国家医保局指出，尽管司美格鲁肽在临床中也显示出一定的减肥效果，但其主要适应症是用于控制2型糖尿病患者的血糖水平。因此，该药品在医保报销范畴内，仅限于治疗糖尿病的两种特定情况，不包括用于减肥目的的使用。这意味着，患者若因减肥需求使用司美格鲁肽，相关费用将不能通过医保进行报销。
这一政策的出台，旨在确保医保资源的合理利用，优先保障基本医疗需求。国家医保局强调，将始终坚持药品医保准入的科学性和公正性，既要考虑药品的临床价值，也要兼顾医保基金的可持续性。
此次司美格鲁肽的医保政策调整，对于糖尿病患者来说，无疑是一大福音，但对于希望通过该药减肥的民众，则需自行承担相关费用。国家医保局的这一明确表态，也为公众理解医保报销政策提供了清晰的指引。
英语如下：
News Title: “China’s Medical Insurance Bureau Clarifies: Semaglutide Not Covered for Weight Loss, Only for Diabetes Treatment”
Keywords: Semaglutide, Medical Insurance Restrictions, Weight Loss Excluded from Reimbursement
News Content:
BEIJING, April 16 (Xinhua) – The National Medical Insurance Bureau (NMIB) has recently issued an official statement addressing the widely discussed topic of whether the weight loss drug, Semaglutide injection, would be covered by medical insurance. According to the announcement, Semaglutide has been included in the national medical insurance catalog, but its coverage is strictly limited to the treatment of adult Type 2 diabetes, excluding its use for weight loss purposes.
The NMIB emphasized that while Semaglutide has demonstrated some effectiveness in weight reduction, its primary indication is for controlling blood sugar levels in patients with Type 2 diabetes. Consequently, the drug’s reimbursement under medical insurance is confined to two specific diabetes treatment scenarios and does not extend to its use for weight loss. This means that individuals using Semaglutide for weight management will not have their expenses covered by medical insurance.
The implementation of this policy aims to ensure the rational utilization of medical insurance resources, prioritizing basic medical needs. The NMIB underscores its commitment to the scientific and impartial evaluation of drugs for medical insurance coverage, taking into account both their clinical value and the sustainability of the medical insurance fund.
The adjustment of Semaglutide’s medical insurance policy is undoubtedly a benefit for diabetes patients. However, for those seeking weight loss through the drug, they will need to bear the associated costs themselves. The NMIB’s clarification provides a clear guideline for the public to understand the reimbursement policy.
【来源】http://www.chinanews.com/life/2024/04-16/10199687.shtml
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