Akishi
Recently, some people have reported that some hospitals in Zhengzhou illegally opened non-public welfare pharmacies operated by enterprises, and after patients were treated in the hospital, doctors issued a drug order and asked patients to go to designated pharmacies outside the hospital to get medicines. If a patient uses an out-of-hospital drug or preparation under the guidance of a doctor in a regular hospital, who is responsible for any safety problem? According to local media investigations, there are indeed drug orders prescribed by doctors in public hospitals, and they must go to designated commercial pharmacies outside the hospital to pick up drugs, etc., and the relevant situation has been reported and is waiting to be processed.
If the above situation is completely true, the hospital involved is playing the trick of "there are countermeasures". In 2017, all public hospitals across the country cancelled the drug markup policy that had been in place for more than 60 years, which left hospitals with a large amount of less revenue. However, pharmacies sell drugs profitably, and hospitals can still earn considerable drug profits by designating patients to buy drugs at specific pharmacies and asking pharmacies to share them, or even opening for-profit pharmacies directly near hospitals.
Hospitals hold resources such as disease sources and prescriptions, and pharmacies are plagued by problems such as "where do prescriptions come from", and the two are easy to "hit it off" and jointly empty the "zero addition" policy of drugs. In February 2020, the National Health Commission issued the Opinions on Strengthening the Management of Pharmaceutical Affairs in Medical Institutions and Promoting Rational Drug Use, clarifying that public medical institutions are not allowed to contract or lease pharmacies, not to host pharmacies to for-profit enterprises, and not to open for-profit pharmacies in any form. The hospital's approach is likely to violate these regulations.
From another point of view, the public cannot oppose phenomena such as "hospital prescription and pharmacy prescription" and so on. This is because the establishment of the "dual-channel" guarantee mechanism for drugs is to break the single drug guarantee channel of the hospital, so that the pharmacy guarantee can form a strong supplement to the hospital security and ensure that patients can use drugs in time. If prescriptions can flow smoothly from hospitals to pharmacies, it will greatly improve access to medicines and make patients more affordable and convenient.
Currently, hospitals sometimes face a dilemma when dealing with pharmacies. Hospitals and pharmacies are too far apart, and cooperation such as prescription circulation and drug security coordination is difficult to implement; If the two get too close, they may be suspected by black box operations and profit sharing. In addition, it is common for pharmacies to lack a certain drug, and a shortage of drugs is only available in one or two pharmacies, and if the doctor who has the information chooses not to tell, the patient may not have the drug available; If the patient is informed, there is a suspicion of "designation".
In particular, it should be noted that the reform of employee medical insurance outpatient clinics has been fully implemented, and outpatient drugs can be reimbursed proportionally, which will bring more abundant medical insurance benefits to outpatient prescriptions and significantly increase the "gold content". In this context, if outpatient prescriptions cannot be smoothly flowed, the competitive disadvantages of pharmacies will be more obvious, and the relationship between hospitals and pharmacies, and the coordination of prescription circulation between the two sides will face a more complicated situation. Resolving this difficult problem is conducive to the smooth implementation of this reform.
How do hospitals deal with pharmacies? Not only do hospitals need to answer seriously, but the medical reform department and even the whole society have the responsibility to find the best answer. On the basis of full research, a detailed rule or guideline should be issued to help hospitals accurately grasp the proportions, not only to avoid hospitals detouring pharmacies to make money, but also to prevent hospitals from thinking that things outside the hospital have nothing to do with themselves, and then passively respond to medical reform policies such as prescription circulation and drug "dual-channel" guarantees. Only by clearly delineating the boundaries of action can hospitals take into account the overall positive actions of medical reform when dealing with drug-related matters and pharmacies, and will not act with selfish motives.
Source: Beijing Youth Daily