Falsify and falsify prescriptions to cheat insurance!

The official website of the Sichuan Provincial Medical Security Bureau recently released the "Sichuan Provincial Medical Security Bureau Exposure Station Phase 1 Exposure of Typical Cases (10 Cases)", which issued public warnings on major fraud cases and insurance fraud cases handled in the past year in various cities across the province, and Severe crackdowns on related violations of laws and regulations.

As AstraZeneca's blockbuster third-generation lung cancer targeted drug, Osimertinib (Teresa) just received its third indication in April this year.

Medical insurance price cuts are hard to stop

"Step on the Red Line" to fight hard

According to the exposed documents of the Sichuan Provincial Medical Insurance Bureau, the Yibin Medical Security Bureau investigated according to the real-name reporting clues and found that from October to November 2019, the medical representative Li Mou fraudulently used the patient Yang in the name of Yibin Kangbei by forging prescription notes.

At the same time, after investigation, it was found that in 2019, medical representative Li and Nie, an employee of the pharmacy, forged 66 prescriptions and tampered with 34 prescriptions, involving 67 people and 100 person-times, involving reimbursement of medical insurance fund of 280,166.

As AstraZeneca's star drug, Osimertinib has maintained rapid growth in recent years.

Although it is already the market leader of the third-generation EGFR-TKI, the competitive situation facing Osimertinib is also changing rapidly.

The sharp drop in product prices, market competition, and the pressure on sales volume growth did not make AstraZeneca feel at ease.

At the beginning of 2021, AstraZeneca will start the team adjustment of the nephropathy business, and the sales team of "Liberzol (Sodium Zirconium Cyclosilicate)" will be merged into one large area and merged into the sales of "Arrizo (rosarestat)" team.

Optimizing the team does not mean "only performance", let alone relax the internal control standards to step on the bottom line of compliance.

"Bring gold" high risk

AstraZeneca repeatedly named

In fact, according to the regulations of the medical representative registration system, medical representatives are not allowed to undertake sales tasks, and some pharmaceutical companies have begun to comply with regulations and cancelled the sales targets for medical representatives.

In addition, the "Guiding Opinions on Establishing a Pharmaceutical Price and Recruitment Credit Evaluation System" issued by the National Medical Insurance Bureau further clarifies that entrusted service companies and agency companies shall bear joint and several liability for commercial bribery of their own drugs.

Obviously, corporate compliance management pressure is being transmitted to the entire product life cycle.

It is precisely based on this background that AstraZeneca has been repeatedly "named" by medical institutions and regulatory authorities in recent times:

At the end of last year, a work contact letter signed by the Xiangya Hospital Supervision Office of Central South University was exposed on the Internet.

As the medical representative of AstraZeneca Pharmaceutical Co.

In January of this year, China Procuratorate officially released the "Indictment by the People’s Procuratorate of Qinyuan County, Shanxi Province.

According to the data, on July 25, 2019, Sinopharm Shanxi Co.
, Ltd.
released the "Summary of the 2019 Semi-annual Work Conference" on its official website.
It is mentioned in the article that the person in charge of Sinopharm Shanxi Jinzhong Co.
, Ltd.
made a "County and Township Integration Work Experience Sharing" at the meeting, and the person in charge of the marketing department also communicated with various subsidiaries about the "AstraZeneca Project".
It can be seen that since at least 2019, Sinopharm has begun to operate the AstraZeneca project.

Whether it is a multinational company or a local company, it is not uncommon for the pharmaceutical industry to be involved in bribery cases.
Cutting off the medical corruption chain, illuminating the medical price and recruiting credit evaluation system, promoting the integration of financial and accounting supervision and disciplinary inspection and supervision, improving the credit evaluation system, strengthening the deterrent effect, and promoting the fairness, reasonableness, and honesty of pharmaceutical companies are undoubtedly the "three The new ecology that the industry chain must face under the background of “medical linkage”.

Regarding the specific adjustment measures such as the sales targets and compliance risk control of certain products involving medical representatives forged prescriptions and fraudulent insurance related to the documents exposed by the Sichuan Provincial Medical Insurance Bureau, AstraZeneca did not comment on the "Pharmaceutical Economic News".
The interview made a specific response, and this newspaper will continue to pay attention.