Drug prices dropped sharply

Since the second half of this year, pilots in some counties and cities across the country have cancelled 15% of the drug price increase. This pilot reform has aroused widespread concern from all walks of life.

Industry sources pointed out that in addition to the hospital's publicly available drug additions, there are still some undisclosed drug price increases, such as hospital fees, tally fees, and unit costs, as well as the vital interests of the majority of patients, which need to be further improved through medical reform. solve.

"Ming and price increase" is easy to change, and "dark increase" is difficult to prevent On September 19, the National Development and Reform Commission, the Ministry of Health, and the Ministry of Human Resources and Social Sciences issued the "Circular on Promoting the Price Reform of Public Hospitals at County Level", requiring 311 counties (cities). The public hospital piloted the "medicine-supplemented" mechanism and cancelled the 15% "drug addition" policy.

Prior to this, some hospitals in Beijing, Shenzhen and other places took the lead in implementing a “zero markup”, with more than 2,000 medicines listed, and drug prices dropped to 85% or even lower. In Beijing Friendship Hospital alone, the half-a-month medical cost of medical insurance patients fell by 100.44 yuan over the first half of the year, and the decline was close to 30%.

Han Xiaofang, director of the Beijing Municipal Medical Reform Office, said that after the elimination of drug additions, if there is any link between the doctor and the medical representative, it is easy to expose it and facilitate supervision and inspection by the hospital.

However, investigations conducted by relevant state agencies have found that, in addition to the price increase for medicines in the zero-lot link, some undisclosed drug price increases also need to be cleared up. For example, if a certain medicine enters some hospitals, it will need to pay “admission fees.” Just as some commodities enter supermarkets, they need to pay “entrance fees,” and only by paying this fee can they enter some hospitals for sale.

The Baotou City Prosecutor's Office in Inner Mongolia recently arrested a party involved in a medical rebate case and found that the medical representative of the case gave a rebate ranging from RMB 5 to RMB 25 to the prescriber according to the total amount of drug sales when selling drugs to a hospital. According to preliminary findings, the maximum amount of money received was more than 700,000 yuan.

At the same time, after the medical insurance department identified the list of successful bidders, some hospitals did not accept the bills, but they had to make another choice. The hospital leadership and the pharmacy director “checked” the winning bids. In order to ensure that their own drugs can be selected, pharmaceutical companies also have to pay a fee, called the "crop fee."

In Baotou’s case, some hospital pharmacy staff also had to count the sales list for each drug. According to this statistics, medical representatives pay a fee of three to five cents per box to the pharmacy, and they must also return a fee to the doctor. The insiders call it the "unit fee" and the "prescription fee."

The price of clindamycin phosphate injection that was exposed by the media in 2011 also confirmed the “dark price increase” phenomenon. The ex-factory price of a single injection of 0.6 yuan, the bidding price is 11 yuan, much more than the ex-factory price. Insiders pointed out that this middle spread was eroded by medical representatives, hospitals and doctors.

Zhu Zhuoyi, former Director of the Department of Social Development of the State Council Research Office, who has long devoted himself to medical reform research, believes that "dark price increases" for drugs will not only harm the interests of patients, but also easily corrupt medical personnel, and are not conducive to relieving the "difficult" and "expensive" problems.

One side of the clinic is the pharmacy at the First Hospital of Peking University. The reporter saw drug outfalls on several outpatient floors. Mr. Fu, who was visiting the doctor here, told reporters that every time he came here, he had to open five or six hundred dollars for medicine. A doctor would have to buy a medicine once. "Some medicines dare not finish eating, and they throw them aside."

Another Ms. Chen told reporters that the child diarrhea to a children's hospital in Beijing to see a doctor, the doctor did not see five minutes, they opened five drugs. "I said to the pharmacy whether we can take two less. The other said that we must take it all away." She went home without any medicine at all. The next day, the child was naturally good.

Drug sales are an important source of hospital revenue. According to Yu Mingde, president of the China Pharmaceutical Enterprise Management Association, the current hospital drug add-on rate is 42%, and drug revenue accounts for more than 50% of total revenue.

In order to increase the sales of medicines, pharmaceutical companies often use kickbacks to knock on the doors of hospitals and encourage doctors to prescribe more medicines. Wang Xuehai, chairman of Wuhan Renfu Pharmaceutical Group, introduced that this phenomenon is more common in foreign pharmaceutical companies. Not long ago, Pfizer was found to have conducted commercial bribery to a number of Chinese hospitals and the rebate rate was around 30%.