{"id":209662,"date":"2020-12-01T12:19:56","date_gmt":"2020-12-01T11:19:56","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=209662"},"modified":"2020-12-07T10:54:07","modified_gmt":"2020-12-07T09:54:07","slug":"vseobecna-zdravotni-pojistovna","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=209662","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: Hrad\u00ed poji\u0161\u0165ovna substitu\u010dn\u00ed terapii u drogov\u00e9 z\u00e1vislosti?"},"content":{"rendered":"

\"\"<\/p>\n

OT\u00c1ZKA T\u00ddDNE:<\/h6>\n
Hrad\u00ed poji\u0161\u0165ovna substitu\u010dn\u00ed terapii u drogov\u00e9 z\u00e1vislosti?<\/h6>\n
ODPOV\u011a\u010e:<\/h6>\n

Ano, VZP stejn\u011b jako ostatn\u00ed poji\u0161\u0165ovny hrad\u00ed l\u00e9\u010diva do v\u00fd\u0161e a v souladu s podm\u00ednkami, kter\u00e9 ur\u010duje St\u00e1tn\u00ed \u00fastav pro kontrolu l\u00e9\u010div (S\u00daKL). Ten je pov\u011b\u0159en rozhodov\u00e1n\u00edm o cen\u00e1ch a \u00fahrad\u00e1ch v procesu spr\u00e1vn\u00edho \u0159\u00edzen\u00ed. VZP hrad\u00ed l\u00e9\u010div\u00e9 p\u0159\u00edpravky pro substitu\u010dn\u00ed l\u00e9\u010dbu drogov\u00e9 z\u00e1vislosti v\u0161em pacient\u016fm, kte\u0159\u00ed spl\u0148uj\u00ed \u00fahradov\u00e1 krit\u00e9ria stanoven\u00e1 S\u00daKL.<\/strong><\/p>\n

Pro substitu\u010dn\u00ed terapii je v sou\u010dasn\u00e9 dob\u011b dostupn\u00fd Suboxone (buprenorfin + naloxon), kter\u00fd je z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed hrazen\u00fd na z\u00e1klad\u011b preskripce psychiatra nebo l\u00e9ka\u0159e s odbornost\u00ed \u201en\u00e1vykov\u00e9 nemoci\u201c v r\u00e1mci substitu\u010dn\u00ed l\u00e9\u010dby na opioidech. Jde o p\u0159\u00edpravek, jeho\u017e pou\u017eit\u00ed je podle podm\u00ednek S\u00daKL pro \u00fahradu koncentrov\u00e1no do specializovan\u00fdch pracovi\u0161\u0165. Pacient si ho tedy nevyzved\u00e1v\u00e1 na recept v l\u00e9k\u00e1rn\u011b, ale zdravotn\u00ed poji\u0161\u0165ovn\u011b ho m\u016f\u017ee \u00fa\u010dtovat pouze specializovan\u00e9 pracovi\u0161t\u011b, a to na z\u00e1klad\u011b smlouvy uzav\u0159en\u00e9 se zdravotn\u00ed poji\u0161\u0165ovnou. Stanoven\u00e1 \u00fahrada nepokr\u00fdv\u00e1 mo\u017enou maxim\u00e1ln\u00ed cenu l\u00e9ku, tak\u017ee pacient mus\u00ed p\u0159\u00edpadn\u011b zaplatit rozd\u00edl. Terapie Suboxonem je ur\u010dena pro u\u017eit\u00ed u dosp\u011bl\u00fdch a dosp\u00edvaj\u00edc\u00edch nad 15 let, kte\u0159\u00ed souhlasili s l\u00e9\u010dbou z\u00e1vislosti. L\u00e9\u010dba se nehrad\u00ed, jestli\u017ee pacient nespolupracuje (nap\u0159. nedodr\u017euje sch\u00e9ma p\u0159edepsan\u00fdch pl\u00e1novan\u00fdch n\u00e1v\u0161t\u011bv).<\/p>\n

Dal\u0161\u00ed mo\u017enost\u00ed je substituce l\u00e9\u010div\u00fdm p\u0159\u00edpravkem Subutex, co\u017e je samotn\u00fd buprenorfin, kter\u00fd ale v t\u00e9to indikaci nen\u00ed hrazen z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Buprenorfin (ve form\u011b transderm\u00e1ln\u00edch n\u00e1plast\u00ed) je indikov\u00e1n a hrazen p\u0159i st\u0159edn\u011b siln\u00e9 a\u017e siln\u00e9 bolesti p\u0159i n\u00e1dorov\u00e9m onemocn\u011bn\u00ed a siln\u00e9 bolesti, kter\u00e9 nereaguj\u00ed na neopioidn\u00ed analgetika. Subutex je buprenorfin ve form\u011b tablet pro substitu\u010dn\u00ed l\u00e9\u010dbu a pacient si ho mus\u00ed hradit s\u00e1m; p\u0159edepisuje se na tzv. opi\u00e1tov\u00fd recept s modr\u00fdm pruhem.<\/p>\n

Metadonov\u00e1 l\u00e9\u010dba, co\u017e je asi nejzn\u00e1m\u011bj\u0161\u00ed varianta substitu\u010dn\u00ed l\u00e9\u010dby, je hrazena Ministerstvem zdravotnictv\u00ed, tj. mimo syst\u00e9m \u00fahrad z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Prob\u00edh\u00e1 ve specializovan\u00fdch substitu\u010dn\u00edch centrech, p\u0159i\u010dem\u017e podm\u00ednkou pro vstup do metadonov\u00e9ho programu je v\u011bt\u0161inou plnoletost a tak\u00e9 n\u011bkolik prokazateln\u00fdch ne\u00fasp\u011b\u0161n\u00fdch pokus\u016f o l\u00e9\u010dbu vedouc\u00ed k abstinenci.<\/p>\n

Vedle substitu\u010dn\u00ed l\u00e9\u010dby (kter\u00e1 nahrazuje u\u017e\u00edv\u00e1n\u00ed p\u016fvodn\u00ed drogy l\u00e9ka\u0159sky p\u0159edepsan\u00fdm u\u017e\u00edv\u00e1n\u00edm jin\u00e9 l\u00e1tky s podobn\u00fdmi \u00fa\u010dinky, av\u0161ak s v\u00fdrazn\u011b men\u0161\u00edmi riziky) toti\u017e existuj\u00ed r\u016fzn\u00e9 l\u00e9\u010debn\u00e9 postupy a metody, jejich\u017e c\u00edlem je p\u0159\u00edmo drogov\u00e1 abstinence. Tato l\u00e9\u010dba m\u016f\u017ee b\u00fdt ambulantn\u00ed nebo pobytov\u00e1 a zahrnuje nap\u0159. farmakoterapii p\u0159i \u00favodn\u00ed detoxifikaci, psychoterapii, poradenstv\u00ed, soci\u00e1ln\u00ed pr\u00e1ci. I substitu\u010dn\u00ed l\u00e9\u010dba drogov\u00e9 z\u00e1vislosti by ov\u0161em m\u011bla b\u00fdt prov\u00e1zena psychoterapi\u00ed a tak\u00e9 soci\u00e1ln\u00edm poradenstv\u00edm.<\/p>\n

VZP spolupracuje na komplexn\u00edm \u0159e\u0161en\u00ed problematiky zdravotn\u00edch slu\u017eeb v adiktologii s Ministerstvem zdravotnictv\u00ed \u010cR a Radou vl\u00e1dy pro koordinaci protidrogov\u00e9 problematiky. C\u00edlem je nastavit spolupr\u00e1ci v problematice organizace p\u00e9\u010de, s\u00edt\u011b pracovi\u0161\u0165 pro zaji\u0161t\u011bn\u00ed dostupnosti slu\u017eeb v adiktologii, v\u010detn\u011b substitu\u010dn\u00ed terapie a nutnosti jasn\u00e9 definice zdravotn\u011b soci\u00e1ln\u00edho pomez\u00ed. Tato problematika je \u0159e\u0161ena v kontextu reformy psychiatrick\u00e9 p\u00e9\u010de a navrhovan\u00e1 p\u00e1te\u0159n\u00ed s\u00ed\u0165 referen\u010dn\u00edch adiktologick\u00fdch pracovi\u0161\u0165 odpov\u00edd\u00e1 profilu roz\u0161\u00ed\u0159en\u00e9 ambulance Center du\u0161evn\u00edho zdrav\u00ed.<\/p>\n

(tzvzp)<\/strong><\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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