First, the principle of classification
1. Class I drugs: commonly used drugs which have been proved to be safe by long-term clinical application, with mild adverse reactions, simple medication methods and low prices, including general chemotherapy drugs and endocrine therapy drugs.
2. Class II drugs: Compared with Class I drugs, they have certain limitations in safety and price, certain adverse reactions, complicated use process or special requirements.
3. Three kinds of drugs: drugs with large safety limitations, obvious adverse reactions, complicated medication process and high price, and drugs that require special applications for clinical use, generally third-line drugs.
Second, the hierarchical management:
1. Clinicians choose antineoplastic drugs according to diagnosis, patient staging and previous treatment. According to the classification principle of anti-tumor drugs, one kind of drugs is used by residents and above, the second kind is used by attending doctors and above, and the third kind is used by deputy chief doctors and above. According to the above principles, each department specifically formulates the level of anti-tumor drugs that each clinician can use.
2, the formulation or replacement of anti-tumor treatment plan, must be decided by the attending physician and above, and reflected in the course record.
3. Unconventional, overdose and new ways of tumor chemotherapy drugs should be determined by clinicians (deputy chief physicians and above) and clinical pharmacists through case discussion.
4. Standardize the correct use of tumor chemotherapy drugs, start an emergency plan for possible adverse reactions, and the Pharmaceutical Department provides necessary information support.
Legal basis: Article 6 of the Measures for the Administration of Clinical Application of Antineoplastic Drugs implements hierarchical management. According to safety, accessibility, economy and other factors, anti-tumor drugs are divided into restricted use level and general use level. The specific division criteria are as follows:
(1) Anti-tumor drugs with restricted use refer to anti-tumor drugs with one of the following characteristics:
1. Antitumor drugs with large toxic and side effects, strict indications and many contraindications should be used by medical personnel with rich clinical experience, and improper use may cause serious damage to human body;
2. New anti-tumor drugs with short time to market and little experience in drug use;
3. Antitumor drugs with high price and heavy economic burden.
(2) General-purpose antineoplastic drugs refer to other antineoplastic drugs except restricted-use antineoplastic drugs.
The classified management catalogue of antineoplastic drugs is formulated and dynamically adjusted by medical institutions. The local health administrative department shall guide the formulation and adjustment of the classified management catalogue of antineoplastic drugs.
The classification principles are as follows: Class I drugs: commonly used drugs which have been proved to be safe by long-term clinical application, with mild adverse reactions, simple medication methods and low prices, including general chemotherapy drugs and endocrine therapy drugs. Class II drugs: Compared with Class I drugs, there are some limitations in safety and price, some adverse reactions, and the use process is more complicated or has special requirements. Three kinds of drugs: drugs with limited safety, obvious adverse reactions, complicated medication process, high price and special application in clinical medication, generally third-line drugs.