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2022 is coming to an end, and the pharmaceutical anti-corruption blows a dense clarion call!
Recently, the Shanghai Municipal Health Commission and other eight departments jointly issued the "Notice on Correcting Unhealthy Tendencies in the Field of Pharmaceutical Purchase and Sales and Medical Services in Shanghai in 2022", clarifying that medical institutions must not allow undocumented personnel to carry out academic promotion and other related activities against medical personnel or pharmaceutical affairs personnel of their medical institutions, promote bribery and bribery to investigate together, make full use of reporting clues, promptly transfer the clues found in the work to discipline inspection and supervision and judicial departments, and accelerate the implementation of the connection
between rules and discipline laws 。
Last month, the Liaoning Provincial Health Commission issued the Notice on the Implementation Plan of the Liaoning Provincial Medical Institutions and Their Staff Honest Practice Action, focusing on carrying out special actions to rectify "red envelopes" and kickbacks, increasing supervision and inspection, and enforcing discipline and law enforcement.
At the same time, the Shanxi Provincial Food and Drug Administration issued the Notice on Normalizing the Special Rectification Work to Treat the "Rebates" of Out-of-Hospital Purchased Drugs in Public Hospitals in the Province (hereinafter referred to as the "Notice"
).
Among them, the "hospital-side store" located outside the hospital and close to the hospital will become the focus of investigation
.
As the medical anti-corruption campaign continues to deepen and probe into the subtleties, the gray areas hidden in the dark parts of the medical field are constantly exposed to the sun
.
The special rectification of the bidding or profit transmission of drugs and consumables in the procurement process is continuing, and the rot/corruption space in the hospital such as doctors receiving "red envelopes", abandoning centralized drugs, and using high-value medical consumables in tandem is constantly being compressed
.
The industry generally believes that in recent years, medical anti-corruption related policy documents have become more and more intensive, from local health commissions to national health commissions, from single departments to multi-department joint issuance, from inside the hospital to outside the hospital.
.
.
The increasingly severe anti-corruption trend in pharmaceuticals demonstrates the determination
of the regulatory authorities.
01, the rebate punch in the hospital The supervision sword hangs high at all times
Looking back at the marketing model in the early years, "drug rebates" were popular, and pharmaceutical companies increased product sales by paying extra cash in exchange for more prescriptions from doctors
.
In this way, doctors with additional income naturally prescribe a large number of relevant drugs, sales with gold have naturally become the most common sales method in the pharmaceutical industry, and drug rebates have become a tacit transaction
between doctors and medical representatives.
For more than 20 years, this unhealthy trend that disrupts the pharmaceutical market and the medical environment has been repeatedly banned and intensified
.
Accompanied by the crooked wind, the "moth" of China's medical and health system is overgrown, and the medical field corruption/corruption involves all aspects such as drug consumables and medical insurance funds, which has brought about problems such as inflated prices of drugs and medical consumables and excessive growth of medical costs, which not only disrupts the development order of the industry, but also increases the burden of patients' medical treatment, and the public cannot afford to take medicine and see a disease more and more severely
。
Experts pointed out that the medical and health system is highly professional, especially the "key minority" of some hospitals have been deeply cultivated in their fields for many years, often gathering decision-making power and discourse power in one, easy to form personal forces, small circles, which leads to the medical institutions' drug and equipment procurement operation power and decision-making power is often in the hands of a small number of people, external supervision is weak, receiving kickbacks, "open tricks and covert determination" and other operations naturally occur
from time to time 。
In the face of the great harm of bribery/corruption, medical insurance fraud, and sales with money, the regulatory authorities are "fighting tigers", "flapping flies" and "fox hunting" in a multi-pronged manner, and are fighting corruption and punishing evil with a zero-tolerance attitude, insisting on investigating bribes and bribes together, cutting off the chain of interests of bribe-givers and bribe-takers, and severely punishing corruption/corruption
in the medical field 。
In September 2020, the official website of the Central Commission for Discipline Inspection of the Communist Party of China (CPC) published that Du Quanyi, director of the original equipment house supply department of the First People's Hospital of Longquanyi District of Chengdu, violated the spirit and integrity discipline of the eight central regulations, accepted red envelopes and gifts from management targets, and took advantage of official business to change lanes for travel; Violation of integrity discipline by accepting tourism activities that may affect the impartial performance of official duties; Violations of laws and regulations by taking advantage of one's position to seek benefits for relevant personnel in drug supply, equipment procurement, etc.
in violation of laws and regulations
.
In December 2021, the Intermediate People's Court of Zigong City, Sichuan Province, sentenced Li Yuanfeng, president of Sichuan Provincial People's Hospital, to be guilty of bribery and embezzlement.
The court found that the defendant Li Yuanfeng accepted nearly 21.
19 million yuan in bribes and embezzled 280,000 yuan, and sentenced him to 11 years and six months
in prison.
Li Yuanfeng pleaded guilty and accepted punishment, saying after the verdict was pronounced that he "would not appeal.
"
In June 2022, Tang Hui, former president of Yichun Maternal and Child Health Care Hospital in Jiangxi Province, was expelled from the party for serious violations of discipline and law; The Yichun Municipal Supervision Commission will cancel his retirement benefits; Confiscate their gains from violations of discipline and law; Transfer their suspected crimes to the procuratorial organs for examination and prosecution
in accordance with law.
In June this year, the National Health Commission, the State Administration for Market Regulation and other 9 departments jointly issued the "2022 Correction of Unhealthy Trends in the Field of Pharmaceutical Purchase and Sales and Medical Services", aiming to continue to consolidate the results of many years of special rectification in the pharmaceutical field, and continue to tackle doubts, difficulties and blocking points
.
The website recently published an article introducing the case-handling experience
of the Guilin Municipal Commission for Discipline Inspection and Supervision, an advanced collective of the national discipline inspection and supervision system.
Tang, secretary of the Party Committee of Guilin Hospital of Integrated Traditional Chinese and Western Medicine, lent 1.
5 million yuan to a boss for lending, which was verified to be given to Tang by Li, a medical device supplier, and then found that Tang and Qian, former president of the Municipal People's Hospital, Liu Mou, vice president and others jointly accepted bribes of more than 50 million yuan
.
The Guilin Municipal Commission for Discipline Inspection and Supervision held a special review meeting to deeply analyze Tang's bribery case and find out the corruption/defeat methods
of "relying on medicine and eating medicine" such as illegal bidding and "kickback" sales of drugs.
At the same time, through the "three checks and one look" method of checking the procurement list, checking the list of drugs, checking the list of engineering projects, and looking at profit margins, a comprehensive investigation was carried out on seven hospitals in the city, and it was found that the leading cadres of the hospitals abused their power for personal gain in project contracting, medical equipment procurement, drug procurement, and other problems, and retained 11 leading cadres
in five hospitals.
At the same time, the Municipal Commission for Discipline Inspection and Supervision also urged all public hospitals in the city to carry out warning education, and many party-member cadres took the initiative to surrender, including 156 people in Nanxishan Hospital alone
.
The pain point of people's livelihood is the focus
of anti-corruption and punishment.
Nowadays, the regulatory authorities have both established rules and plugged loopholes, grasped bribery and bribery, and worked together in an all-round and multi-angle manner to continuously compress the gray space of power operation, cut off the chain of corrupt/corrupt interests in the medical field, and promote the medical industry to dispel crooked trends and create new winds
.
02.
There is no "oil and water" in the hospital, and the kickback is aimed outside the hospital?
Not long ago, after the patient Xiao Wang was seen in the hospital, the doctor wrote two prescriptions, saying that one was to get the medicine in the hospital, and the other was going to the pharmacy outside to buy it
.
Xiao Wang was suspicious, and the doctor's reply was: The hospital did not have this medicine
.
After Xiao Wang finished taking the medicine in the hospital, when he bought the medicine at the pharmacy at the entrance of the hospital, he found that the medicine was not only expensive, but also could not be reimbursed
.
Obviously, the above-mentioned "notice" issued by Shanxi Province is pointing the supervision spear at the problem that such as patient Xiao Wang may encounter: buying drugs outside the hospital to take "kickbacks"!
With the combination of policies such as "zero price difference" of drugs, scientific approval, medical insurance fee control, volume procurement, and compliance supervision, the regulatory measures issued by relevant departments are intertwined, and the prices of drugs collected in hospitals have been greatly reduced, completely squeezing out the unreasonable moisture
of drug prices.
However, while the in-hospital market is accelerating its return to value-based medical care, the out-of-hospital layout of pharmaceutical companies has begun to suffer from the invasion of
gold-bearing sales.
"Those who come to the doctor with a prescription to prescribe medicine; Out-of-town patients take medicine for a long time, and the doctor's prescription cannot be prescribed; Low-cost recycling, cross-selling prescription drugs.
.
.
"Some "unscrupulous" hospital stores have targeted these consumers
.
At the same time, under the normalization and institutionalization of drug centralized procurement, drugs that fall under the standard cannot enter the hospital, but they can still be prescribed by doctors, allowing patients to pick up drugs at designated out-of-hospital pharmacies, and the pharmacy is responsible for the prescription, and doctors still receive drug rebates
based on prescriptions.
Of course, out-of-hospital pharmacies that sell these drugs prescribed by doctors are also much
higher than other drugs.
With the continuous regulatory high pressure of the in-hospital market, the space for drug rebates has gradually been squeezed, and the main battlefield has naturally shifted from hospitals to out-of-hospital pharmacies
.
From the "Notice" issued by the Shanxi Provincial Food and Drug Administration, it can be intuitively felt that compared with the previous medical kickback rectification, the pharmaceutical anti-corruption is no longer limited to the hospital, and it is also illegal outside the hospital!
The "Notice" makes it clear that the work objectives are to follow the "four strictest" requirements, implement the major decision of the provincial party committee to comprehensively build a clean and honest Shanxi, promote the construction of clean organs, clean hospitals, and clean enterprises, compact and tighten the responsibilities of all parties, urge pharmaceutical retail enterprises to operate in accordance with the law, and ensure that the normalization of the problem of "kickbacks" for out-of-hospital drug purchases has achieved solid results
.
The Notice also emphasizes that this inspection:
First, it is necessary to strengthen the verification of tickets, certificates, accounts, goods and payments around the hospital;
2.
Supervision and inspection of prescription drug sales, and eliminate white slips, notes and other behaviors;
The third is to pay close attention to key parts and key varieties, interview and remind pharmacies with a large number of drugs purchased outside the hospital, and promptly notify <B1 of illegal "unified prescriptions" found41>。
Enterprises with serious circumstances will be included in the "blacklist", focused on inspection, and key supervision
.
Some insiders said that the nationwide pharmaceutical anti-corruption storm has been underway, and the special rectification work in Shanxi against the problem of "kickbacks" for out-of-hospital drugs shows that the local government's continuous rectification and reform in the medical field has moved to a deep water area, and medical anti-corruption will not miss any loophole
.
For a long time, "hospital-side stores" have become the main choice channel
for patients to purchase drugs by virtue of their natural advantages.
In the eyes of the industry, after years of continuous promotion of drug procurement, the drug prices of medical institutions are almost "unprofitable", and "hospital-side stores" have become a battleground
for pharmaceutical companies.
Today, regulators will take this gray area with strictness, and this is not without trace
.
03.
Is it difficult to have both advantages and disadvantages of prescription outflow? Compliance is the "red line"!
Medical insurance negotiation is an important policy exploration
to improve the affordability of innovative drugs and improve the accessibility of drugs for patients in the process of promoting medical reform in China.
However, after the new drug entered the medical insurance catalogue through medical insurance negotiation, it was still blocked in the process of opening up the "last mile" of the hospital, and was affected by "hospital internal control fees" and "one product, two rules", and the amount of negotiated drugs entering the hospital was not optimistic
.
Regulators naturally note the problems
encountered in the implementation of the policy.
In April 2021, the National Health Insurance Administration and the National Health Commission jointly issued the Guiding Opinions on Establishing and Improving the "Dual-channel" Management Mechanism for Drugs Negotiated by National Medical Insurance, which requires that national varieties with high clinical value, urgent patient need, and low substitution should be promptly included in the management of designated hospitals and designated pharmacies, the so-called "dual channel"
。
With the introduction of the "dual-channel" implementation measures for drugs in various provinces and cities, this policy continues to advance, and major professional pharmacies continue to emerge, on the one hand, promoting the "separation of medicines" to control the unreasonable income of medical institutions, on the other hand, it also brings medication protection
to patients.
The prescription outflow has an officially issued pass, but it has also allowed some unscrupulous companies to exploit
loopholes.
Experts pointed out that the problem of out-of-hospital drug rebates is still a stubborn disease and has a growing trend
.
The core concern now is how to avoid the illegal transfer of benefits from medical institutions and retail pharmacies after the outflow of prescriptions.
At present, the outflow of prescriptions has become the general trend, and the relevant regulatory authorities have issued regulatory documents and rectified them, in addition, the provisions related to the outflow of prescriptions, such as the sorting out of drug circulation blockages, the acceptance of prescriptions inside and outside the hospital, the details of medical insurance payment, and the value of pharmacist services, will also be implemented
as soon as possible.
Health care reform policies have been benefiting more patients and making more medicines accessible and affordable; Since the beginning of this year, the regulatory authorities have repeatedly notified medical anti-corruption, drug kickbacks and other issues, and while medical representatives and illegal enterprises have been continuously discovered, many medical institution leaders and "number one" have also been found out one after another
.
What is certain is that as the medical improvement process continues to advance, the stubborn diseases accumulated in the medical system for many years will be completely eliminated, and the original source of the pharmaceutical field is just around the corner
.
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