Under the high pressure and deterrence, the problem of wind and corruption in the pharmaceutical industry continues to mutate and escalate

Strictly investigate the transfer of hidden interests in the medical field

  Our reporter Han Yadong

  General Secretary Xi Jinping emphasized at the Second Plenary Session of the 20th Central Commission for Discipline Inspection that the situation in the fight against corruption is still severe and complicated, and the task of curbing the increase and eliminating the stock is still arduous.

It is necessary to deepen the treatment of both the symptoms and the root causes, and systematic governance, and promote an integrated promotion of not daring to be corrupt, not being able to be corrupt, and not wanting to be corrupt.

The Communiqué of the Second Plenary Session of the 20th Central Commission for Discipline Inspection stated: "Resolutely investigate and deal with new types of corruption and hidden corruption."

  Recently, the State Administration for Market Regulation notified 5 typical cases of special anti-unfair competition law enforcement actions, 2 of which were commercial bribery incidents in the medical and health industry in the form of scientific research sponsorship and kickback payment.

According to the report, as the investigation and punishment of commercial bribery cases continues to increase, some pharmaceutical companies have adopted more covert and complex means to put a "legal cloak" on their bribery behavior.

For example, some companies transfer illegal benefits in the name of sponsoring scientific research funds, academic conference fees, etc.; some pay kickbacks to hospital staff in the purchase and sale of medicines; Take money for bribery.

  What are the new trends in the invisible variation of wind and rot in the medical industry?

How to find clues to problems and dig deep into the transmission of hidden interests?

The reporter conducted an interview.

Meet with drug dealers in a camera-free location, use a different number for each contact, and leave without talking or getting out of the car to collect money... The hospital director who wears ordinary clothes and drives a second-hand car on weekdays accepts drug kickbacks privately

  If it hadn't been for a briber who lifted the cover, the cadres and staff of the People's Hospital of Huzhong District, Daxing'anling District, Heilongjiang Province would hardly have imagined that the director He Xianwei, who usually wears ordinary clothes, drives a second-hand car, and lives frugally, would have taken office shortly after taking office. They wantonly accept drug kickbacks.

  In June 2014, He Xianwei, who had served as the dean for more than half a year, took the initiative to contact He Moumou, the chairman of a pharmaceutical company in Heilongjiang Province, and the two parties agreed to meet in a secluded alley.

He Xianwei threatened "no kickbacks and no medicines", and finally agreed that He Moumou would give He Xianwei a kickback of 15% of the total amount of medicines purchased by the company from August of that year.

  He Moumou later recalled: "At that time, I thought that if I didn't agree with him, I might not buy from us. I was so cruel that I agreed that if all the goods were purchased from us, 15 points would be fine. Later, He Xianwei added two conditions. , first, it must be in cash; second, it must be kept secret, otherwise we will no longer cooperate."

  Since then, He Xianwei followed suit and extended his hand to accept buybacks to the other two pharmaceutical companies.

  According to the task force, in order to reduce the risk of exposure, He Xianwei met with drug dealers to discuss kickbacks, and they all chose places without cameras; when receiving kickbacks, they were required to meet alone, and each contact used a different number. The transaction location was on the highway at the junction of the two districts. On; the transaction is quick, completed within dozens of seconds, no verbal communication, no need to get off the car, just collect the money and leave; the rebates are all cash, deposited in foreign banks through relatives.

  In 2019, with the improvement of the country's drug procurement management system, the profit margins of drug suppliers have become smaller after "centralized procurement". After giving He Xianwei a 15% rebate, drug manufacturers have little profit at all.

He Moumou always wanted to discuss with He Xianwei to reduce the rebate rate, but every time he met He Xianwei, he would not speak, and left immediately after receiving the money, within less than ten seconds.

  One day in December 2020, He Moumou arrived at the agreed place ahead of schedule, thinking that He Xianwei must reduce the rebate ratio this time.

He Xianwei's car finally appeared. After the car stopped, He Moumou drove closer and skillfully put the black plastic bag with rebates on the passenger seat of He Xianwei's car through the passenger window: "Dean He, let's talk Tan—" Before he finished speaking, he was interrupted by a "shh", He Xianwei made a "mute" gesture with his index finger, then waved his hand, and drove away.

  According to the special case team, the He Xianwei medical corruption case involved a large amount of money and a long duration, covering two major areas of drugs and medical devices, involving more than 10 pharmaceutical and medical device companies across the country.

Since both the accepting and offering of bribes have a strong awareness of prevention, the criminal behavior is highly concealed, which increases the difficulty of investigation and punishment.

However, in July 2021, when the local Commission for Discipline Inspection and Supervision was investigating another case, a briber took the initiative to explain the clues to the bribery to He Xianwei, and his carefully woven bribery network was exposed.

  He Xianwei's suspected job crime case is the largest corruption case in the medical field investigated and dealt with since the establishment of the Daxing'anling area.

After investigation, when He Xianwei was the director of the hospital, he decided on private drug dealers and received drug rebates of more than 3.08 million yuan; illegally intervened in hospital reconstruction and expansion projects and other projects, and received more than 670,000 yuan in favors, with a total of more than 3.75 million yuan in money received.

He Xianwei was "double-opened", and his suspected crimes were transferred to the procuratorate for review and prosecution according to law.

"Customized" bidding, "evasive" entrusted procurement, "rights share" share dividends, "welfare" seminars and training... The problem of wind and corruption in the medical field is constantly changing and iteratively upgrading

  With the continuous increase of investigation and punishment, the problem of wind and corruption in the medical field continues to mutate and upgrade iteratively.

  ——Being "clean and simple" in front of the public, acting as a "trader" in the rear, and concealing the crime of the bribe-taker.

  Sun Zhilong, former member of the party committee and vice president of the Second People's Hospital of Fuyang District, Hangzhou City, Zhejiang Province, relied on concealing his identity to manipulate the profit chain of pharmaceutical kickbacks.

When contacting pharmaceutical companies and pharmaceutical representatives, he appeared in the name of his cousin Fei Mou; when distributing drug rebates to doctors, his relatives came forward and intermediaries made the transition; when the stolen money was transferred, the accounts were opened in the name of relatives and friends... Through Carefully disguised, Sun Zhilong illegally accepted drug kickbacks 196 times, totaling more than 16 million yuan. He was sentenced to 12 years in prison and a fine of 2 million yuan for the crime of accepting bribes. His bribery proceeds were confiscated and turned over to the state treasury.

  ——Hidden identity, behind-the-scenes operations, increased vigilance of bribers.

  According to He Xianwei's confession, he once received kickbacks from a medical representative "Xiao Zhang", and asked who he was, only to know that she was a woman in her 40s, with no real name or contact information.

According to the approximate time of the last time the money was sent and related information, the investigators retrieved more than 300 photos, but "Xiao Zhang" was not among them as identified by He Xianwei.

The investigators expanded the scope, and among the more than 3,000 photos, He Xianwei recognized "Xiao Zhang" at a glance.

"Xiao Zhang", whose real name is Wu Moumou, is a special related person of Zhang Moumou, the medical representative of a certain company.

It turned out that Zhang Moumou was worried that his appearance would make people suspicious, so he asked Wu Moumou to come forward.

In order to deceive others, Wu Moumou appeared as "Xiao Zhang" again.

  ——"Customized" bidding, "evasive" entrusted procurement, "rights share" dividends, "welfare" seminars and training, the invisible variation of benefit delivery methods, and put on a "legal cloak" for bribery.

  According to Huang Xianfeng, Member of the Standing Committee of the Yuhuan Municipal Committee of Zhejiang Province, Secretary of the Municipal Commission for Discipline Inspection, and Director of the Supervisory Committee, "customized" bidding refers to the use of medical professional barriers to ingeniously set up "technical bidding" in bidding for medical supplies and medical equipment. Specific conditions such as "parameters" and "medicine efficacy parameters" are under the guise of "technology" and "medicine efficacy", and "customized" bidding screening rules are added to achieve the purpose of long-term cooperation with "designated" pharmaceutical companies and mutual benefit; "Entrusted procurement refers to turning the "public power" of procurement into the private operation of a third-party procurement agency company through private "aggregation" and behind-the-scenes manipulation. Item price difference, capital turnover rate, etc.; "Rights shares" dividends, refers to the pharmaceutical companies through invisible "supply" shares, seminars and training disguised subsidies, gifts and medicines for free or at low prices, etc., prompting both parties to negotiate and reach a medical promotion "High-price agreements" form a pharmaceutical rebate benefit chain; "welfare-style" seminars and trainings refer to the "inclusive" and "recuperation-style" in which pharmaceutical companies give back in disguise to "please" the managers and medical staff of medical institutions in order to maintain the alliance of interests. ""Emotional connection" benefits.

Thoroughly investigate the transmission of hidden benefits, and continue to rectify corruption and work style problems in the medical field

  The medical field is highly professional, and the related violations of discipline and law are concealed to a certain extent, and the problems are not easy to be detected.

But no matter how hidden the means of corruption are, they will always leave traces.

With the implementation of "small incision" breakthroughs and "targeted" investigations, there are still traces of relevant problems.

  "Human, financial, and material management is an important risk point for integrity. There are many subordinate units in the medical field, a large number of personnel, and daily business supervision and inspection. However, the discipline supervision is relatively weak, and the depth of inspection and supervision is insufficient, which leads to the luck of its supervisors. "Fang Yang, director of the Second Supervision and Inspection Office of the Taizhou Municipal Commission for Discipline Inspection and Supervision, analyzed that it is necessary to be good at grasping key "acupuncture points" and strengthen the "key minority" such as the "top leaders" and team members of medical institutions, key positions, and medical equipment. When supervising procurement and other aspects, it is necessary to adopt effective on-site supervision, cross-extending inspections and other means to effectively break the inertial thinking.

  In order to thoroughly investigate problems such as power-money transactions in the medical field, medical equipment rebates, and opaque bidding and procurement, the Taizhou Municipal Commission for Discipline Inspection and Supervision has established a "discipline inspection and supervision office leading, agency supervision, auditing professional cooperation, The main body of health and health implements the "work communication and consultation system", and conducts regular investigations and judgments on the performance of duties, integrity risks, problem clues, and complaints and reports of medical institutions and their subordinate institutions, forming a work of multi-dimensional supervision, simultaneous efforts, and overall governance pattern.

Up to now, 12 special supervisions have been carried out on key links such as pharmacy trusteeship, bidding and procurement management, key job rotation, multi-site practice, scientific research and academic activities, large-scale medical equipment procurement, loan arrears, and business operations, and 17 clues to problems have been found. Article, party discipline and government affairs sanctioned 2 people.

  "Although the medical industry is hidden, if you pay attention to the abnormal behavior of key people in daily supervision, you will still find clues." The relevant person in charge of the First Discipline Inspection and Supervision Office of the Discipline Inspection and Supervision Committee of Fuyang District, Hangzhou City introduced, in February 2018, Hangzhou Public Security Bureau The Fuyang District Bureau transferred the clues to the committee that Sun Zhilong had repeatedly participated in large-sum gambling and was administratively punished.

After research and judgment, Sun Zhilong gambled for a relatively large amount, and there were medical representatives involved in the gambling together. The District Commission for Discipline Inspection and Supervision established an investigation team to start a preliminary inspection, and found that he was suspected of serious violations of discipline and law, and launched a review and investigation on him.

  Huang Xianfeng analyzed that "long-term stability" is often an important breakthrough when handling related cases. Disciplinary inspection and supervision agencies can start with details such as long-term cooperative pharmaceutical companies, key positions that have not been rotated for a long time, and long-term frequent out-of-school training. Abnormal data such as job rotation, scientific research and academic activities, and employee loan arrears are stripped layer by layer, focusing on the role of the "two bills" of good bills and bills, and transfer of funds through pharmaceutical companies or third-party agency companies Amount, check and sort out the relationship between the benefit transfer personnel, judge the phenomenon of one-way transfer (deposit) of funds, high-interest loans, project dividends, etc., and accurately discover invisible corruption problems.

  In order to evade supervision and inspection, Huang Senchao, the former deputy secretary of the Party General Branch and director of the Second People's Hospital of Yuhuan City, ordered a pharmaceutical company to pay for him to purchase gift cards, tobacco, alcohol, tonics, etc., totaling RMB 347,500.

Investigators found that Yuhuan Second Medical had previously signed a pharmacy trusteeship contract with the pharmaceutical company. During the three-year cooperation period, they had prepaid the pharmaceutical company's medical funds in advance, and the advance payment was not discussed by the team, and Huang Senchao agreed privately.

The Municipal Commission for Discipline Inspection thus broke through the problem of Huang Senchao's invisible power-money transaction.

  The person in charge of the Disciplinary Commission of Wuxi City, Jiangsu Province said that such problems are highly concealed, but they can be investigated by obtaining the list of major hospital suppliers, sorting out supplier account books, bank records, etc., and can also investigate the main long-term suppliers of hospitals. The person in charge conducts social network surveys and establishes correlation analysis with hospital staff to accurately identify problems.

Xu Hongliang, the former director of the Orthopedics Department of Xishan People's Hospital in Wuxi City, received clues to the problem of kickbacks, which were discovered by the local market supervision department from the company's account books when the local market supervision department investigated and dealt with the supplier Dai.

Incorporate integrity education into the compulsory subjects of new employee induction training, and realize the effective traceability and traceability of the power operation of the core business of the hospital...Continue to do a good job in case investigation and handling "the second half of the article"

  Carry out special rectification for the shortcomings exposed by the case.

After the case of He Xianwei, the Discipline Inspection and Supervision Committee of the Greater Khingan Mountains focused on key areas and key links such as pharmaceutical purchases and sales, medical services, infrastructure projects, health supervision and law enforcement, and comprehensively used methods such as letters and reports, clue handling, open and unannounced visits, special inspections, and special inspections to investigate and deal with it. Liu Zhanling, the former president of Xinlin District People's Hospital, and Dong Quan, the former deputy director of the hospital office of Songling District People's Hospital, and other cases of kickbacks and violations of discipline and law in the medical field have created a deterrent in the local area.

Since the launch of the special rectification, relevant units in the region have been promoted to improve 11 relevant systems, and 2 recommendations for discipline inspection and supervision have been issued.

  Strengthen supervision in the medical field based on functional responsibilities.

In response to the lack of internal supervision in public hospitals, the Wuxi Municipal Commission for Discipline Inspection and Supervision has carried out the reform of the discipline inspection and supervision system of public hospitals.

After the reform, the Office of the Ombudsman became the resident institution of the higher-level supervisory committee in the public hospital, rather than its internal institution, and performed the supervision duties of its public officials.

The Yuhuan Municipal Commission for Discipline Inspection and Supervision implements an internal inspection mechanism in the medical field. The inspection office of the Municipal Party Committee and the disciplinary inspection and supervision team dispatched by the Municipal Party Committee are responsible for supervision and guidance. According to the inspection work responsibility system, regular internal inspections are carried out on medical institutions and their dispatched institutions. At present, a comprehensive inspection of 2 public hospitals, 3 health institutions and 11 township health centers in the jurisdiction has been completed, and a total of 190 problems have been found. , put forward 53 rectification opinions, investigated 15 people responsible, cleared more than 75,000 yuan in refunds, and recovered more than 114,700 yuan in economic losses.

  Supervise and urge competent authorities to improve systems and mechanisms.

The Yuhuan Municipal Commission for Discipline Inspection and Supervision has urged medical institutions at all levels in Yuhuan City to improve their internal control mechanisms and include integrity education as a compulsory subject in the induction training for new employees.

The Discipline Inspection and Supervision Committee of Pizhou City, Jiangsu Province urges public hospitals to improve the rotation supervision and control mechanism for key positions such as pharmacy, finance, and procurement management. Indiscriminate purchase and abuse of high-priced drugs.

Fuyang District, Hangzhou uses digital means to integrate the three application scenarios of smart security hospital, smart ward, and smart medical care in the hospital, as well as 10 core data pools such as clean government files, personnel files, drug catalogs, medical representative management, and procurement projects. The effective traceability and traceability of the operation of core business power cut off the connection between medical representatives and doctors, and firmly manage the "nomination rights" and "prescription rights" in the hands of doctors.

The Liyang Municipal Commission for Discipline Inspection and Supervision of Jiangsu Province promoted the establishment of a hospital information disclosure system to release bidding information in a timely manner to effectively ensure transparency and reduce the space for rent-seeking power.

On the basis of supervising and implementing the national and provincial mass procurement plan, the Wuxi Municipal Commission for Discipline Inspection and Supervision promoted two rounds of alliance mass procurement at the municipal level, involving 82 4 varieties of medical polymer splints, ultrasonic cutter heads, etc. For standard products, the average price drops by about 60%, and some varieties even drop by more than 80%.

  Carry out warning education in the field of medical and health care.

Disciplinary inspection and supervision agencies at all levels combined the typical cases in the medical field investigated and dealt with, timely and classified public exposure, and strengthened deterrence.

After investigating the case of Xu Hongliang, the Xishan District Commission for Discipline Inspection and Supervision of Wuxi City produced a special warning educational film "The Tricky Behind Medical Consumables", which was used in the health care system to warn and educate people around them.

The Discipline Inspection and Supervision Committee of Fuyang District, Hangzhou City organized the health system to carry out the warning education month activities, and organized the leading groups of hospitals, cadres above the middle level, and personnel in important positions to attend the trial of Sun Zhilong’s case, creating the effect of one trial, one warning, and one batch of education.

(China Discipline Inspection and Supervision News)