Medical network - on January 9, 2017 urban public hospital drug addition all cancelled!
6, the closing session of the national family planning work of health, said li bin, director of the national health and family planning commission, the reform of public hospitals will be pushed all cities this year, all cancel drug addition, propulsion mechanism smooth transition between the old and the new.
Information from the meeting show, at present, more than 1560 cities across the country had been cancelled public hospital drug addition, break with medicine cure mechanism. Public hospital income structure optimization continuously, medical expenses growth under control. This year, China will adjust the extrusion price space, the medical service price, reforming health insurance payment and the government to carry out the compensation policy linkage.
Li stressed that 2017 will continue to deepen reform, promoting the construction of the grading system, actively promote the medical association, the medical community, college league construction, development of telemedicine network, improve the signing the family doctor service coverage.
And, she notes, years to realize long distance to the referral regulations for medical treatment in hospital expense settlement directly, advance the public medical institutions and drug procurement "two votes", strengthen the supervision of the industry, speed up the formation of the basic medical and health system framework; Further active optimal control medical resources distribution, in-depth implementation of health poverty alleviation project, we will continue to implement the improved medical services, enhance people's health get feeling.
This means that, before the drugs in local part of the ground zero addition, with the release of the "two votes", since the overall speed, entered the countdown of the sprint to the runway, bring a series of challenges and with drug addition, drug companies, hospitals and circulation channels, really ready?
▍ challenge 1: hospital gap have how old?
According to the spirit of the documents of the state council, carry out, after the "drug zero rate" of public hospital income gap will "fill" by three parts, namely, to improve the medical service price, government subsidies and hospital to digest, this three parts according to the proportion of "811" to spread: subsidies by 10%, the hospital digestion by 10%, 80% by improving medical service price compensation.
But according to the "21st century business herald reported, with the praise of" central union "xiangya hospital, central south university has been revealed, after the cancellation of drug addition, its annual revenue of 200 million yuan, the year shall not be kept back 50 million of equipment procurement budget; Previously, peng-cheng jiang, vice President of the first people's hospital of zhenjiang city once said in an interview, drug zero rate after the reform, the hospital on the drug sales loss of about 15 million each year.
Otherwise, according to data in 2013, shandong zhangqiu five pilot hospital the forecast loss for 76 million, but only 40 million fiscal subsidies; In 2013 during the two sessions, xianju county, zhejiang province, wang jf, vice President of the people's hospital said the hospital after zero bonus income gap has 120 million, and the government basically didn't get 10% of compensation.
In 2015, qionghai people's hospital of hainan province through the adjustment of medical service prices increase income accounts for only 39.5% of cancel the drug addition, 8-9 months only two months will loss 1.757 million yuan; Beijing has eight public hospital medical project cost accounting, all show serious losses of state, and nearly half of the belongs to practies - break the operation mode of "medicine for the medical" demolition of private hospital "fuse", in the face of sudden revenues, many hospitals somewhat unprepared.
Outlook weekly news magazine, the survey found that compared with the comprehensive hospital, medicine of higher hospital is hard to through the way of improving the service charge of pharmaceutical affairs to adjust the gap.
Guangdong city hospital is a level 2 grade a hospital, medicine accounted for nearly 50%. "Traditional Chinese medicine, surgery, hospitalization quantity is little, it is difficult to to compensate by increasing medical services price. For us, the more MenZhenLiang, the greater the loss." Increase urban Liu Weidong said, vice President of the hospital, the hospital medical revenue decline year by year, since the pilot reducing income of about 10 million yuan a year, and the government subsidy of more than 260 ten thousand yuan, annual losses of more than 700 700 yuan.
"Lower hospital medical service price and self-sustaining mechanism does not form a complete set, the hospital only through open checklist to make up for the inadequacy of medical service income, this kind of situation is real. Just cancel the drug addition can't solve the fundamental problems of public hospitals for profit." Guangzhou city health development planning commission, deputy director of the bing-jie hu said.
▍ challenge 2: drug firms become "flange"?
In this background, in a strong position of hospital drug firms default cost and for rebates to donate even become drug firms unspeakable pain.
According to public reporting, early in 2016 to date, only hunan xiangya hospital, hunan people's hospital, children's hospital of hunan province and other 20 public hospital is defaulted on changsha more than 40 drug drug payment of more than 10 billion yuan. In order to maintain the normal supply of drugs, and even some manufacturers have to high interest rates to the private lending, that's a loss of up to 200000 dollars per month.
At a news conference on December 20, price bureau of jiangsu province, reported the province QingFei authors -- as well as the enterprises charge check on that. Among them, the nanjing who planning commission for the drug centralized bid procurement process, without approval, without authorization, in the name of the donor to pharmaceutical enterprises "capital takes up preferential benefits compensation and scale".
Then reported, according to the "donation" cost is basically in accordance with the purchase amount 1% - 1% charge, the number is large, for the purpose of the money, nanjing health development planning commission said "for medical career"
▍ challenge 3: pharmacy custody can not meet?
Had been the analysis thinks, public hospitals cancelled after drug addition, hospital pharmacy is no longer profitable sector, coupled with the full implementation of the "two votes", public hospital or pharmacy for hosting, it also brought the opportunity of pharmacy trusteeship to circulation enterprises.
Domestic pharmaceutical, sinopharm, China resources has included sig pharmaceutical, keep on group of pharmaceutical companies to undertake the pharmacy trusteeship.
But then the guangdong health development planning commission inspectors manifold new wave has said publicly that pharmacy trusteeship is wolves love sheep, not squeeze the unreasonable price of water in the field of circulation, makes the interests of the chain is longer, the more water. In addition, the hospital pharmacy custody charge, custody fee to pay for hosting, hosting Fang Huijin step down drug purchase price, when the price is lower than the product cost, clinical need drugs may also be out of stock.
Public data shows that the Chinese hospital association had been authorized by state health development planning commission system reform, the advantages and disadvantages of the pharmacy trusteeship and potential risks, conducting research, and in May 2015 in the journal of the Chinese hospital titled "Chinese pharmacy trusteeship status analysis" of the paper.
This article by the Chinese hospital association and the national health development planning commission officials signed a paper, said: "the pharmacy is managed as well as some people think that have the function of preventing commercial bribery? 54.13% of the researchers think that will do nothing to prevent commercial bribery refs. As much as 97.02% of parameter tuning staff thinks that there are potential risks. Pharmacy trusteeship in questionnaire advice column, many people expressed opposition to the pharmacy trusteeship directly." |
