Shanghai Health and Health Commission: doctors cannot induce or force patients to use drugs at their own expense

On January 28, Shanghai Municipal Health Committee issued the notice on Further Strengthening the management of clinical pharmacy in medical institutions and regulating the purchase and use of drugs at their own expense (hereinafter referred to as the notice) The details are as follows: health and Family Planning Commission of each district, development center of Shenkang hospital, relevant universities, China Fortune society, municipal medical institutions, Supervision Institute of health and Family Planning Commission, and quality control center of clinical pharmacy management: In order to further strengthen the clinical pharmacy management of medical institutions in this city, standardize the prescription behavior, promote the implementation of the "1 + 7" supporting documents for the treatment of kickbacks of medical products, and effectively protect the health rights and interests of the people, according to the prescription management measures, the specification for the examination of prescriptions of medical institutions, the administrative provisions of Shanghai medical institution pharmacy management and pharmacotherapy Committee, and the Shanghai medical institution Office The spirit of such documents as the regulations on the administration of Fang's comments, the notice on Further Strengthening the administration of self paid drug purchase and use of medical institutions designated by medical insurance in this city and the actual situation of this city, are hereby put forward the following clear requirements on Further Strengthening the administration of clinical drug affairs of medical institutions in this city and standardizing the administration of self paid drug purchase and use: 1、 Give full play to the function of Pharmaceutical Association, ensure the demand of clinical drug use, the pharmaceutical management and pharmacotherapeutics Committee of each medical institution (hereinafter referred to as "Pharmaceutical Association") should play an active role in strengthening the management of the basic drug supply catalogue of this institution According to the needs of diagnosis and treatment subjects and medical services, necessary drugs for treatment should be provided, and the normal allocation of drugs should not be affected by reasons or names such as the proportion of drugs In the selection of drugs, priority should be given to basic drugs, drugs within the scope of medical insurance catalog, drugs with high comprehensive cost performance, such as low-cost drugs commonly used by the state and the city, and drugs with high volume purchased in Shanghai, and the proportion of drugs used at their own expense should be reasonably controlled 2、 Implement the requirements of "1 + 7" supporting documents, strengthen the management of self paid drugs All medical institutions should seriously promote the implementation of the "1 + 7" supporting documents for the treatment of kickbacks of pharmaceutical products, and effectively strengthen the management of self paid drug procurement and use Drugs for clinical use in medical institutions (including drugs at their own expense) shall be purchased and supplied by pharmaceutical departments through the "Shanghai pharmaceutical procurement service and supervision information system" (i.e "sunshine platform") in accordance with regulations Medical institutions and doctors shall not induce or force patients to use drugs at their own expense If it is really necessary to use the drugs at one's own expense due to clinical needs, the written notification system shall be strictly implemented, and the drugs can only be used after being signed and approved by the patients or their clients Medical institutions shall include drugs at their own expense into the scope of drugs under their own key monitoring Establish and improve the regular monitoring and evaluation system and abnormal early warning system of self paid drugs The results of self paid drug prescription evaluation are included in the performance evaluation, annual evaluation index and regular evaluation index system of departments and staff Publicize the departments and doctors who issue the drugs at their own expense and the amount in front; take measures such as training, education, criticism, restriction or cancellation of prescription right for doctors who issue unreasonable prescriptions according to the seriousness of the case, and link with personal performance, year-end assessment, professional title promotion, etc 3、 To standardize the behavior of medical service and strengthen the management of prescriptions, medical institutions and doctors should guarantee the patients' right to purchase drugs, not limit the patients' independent request to purchase drugs from retail pharmacies with prescriptions, nor force or induce patients to purchase drugs from designated pharmacies For the self paid drugs with few patients and little use, if the patients need to buy them out of hospital, the medical institutions shall establish and improve the informed notification system, approval or filing system, and strengthen the management of medical record according to the requirements of the notice on Further Strengthening the self paid drug purchase and use management of medical institutions designated by medical insurance in this city The doctors shall follow the basic norms of medical record writing 》Relevant requirements of the application and management specification for electronic medical records (Trial Implementation), and improve the use records of self paid drugs in outpatient, inpatient medical records and electronic medical records Medical institutions shall take the initiative to inform the unit of the management system and process of drugs at their own expense and prescriptions for external distribution by using the promo bar in the outpatient hall, waiting point or service desk for the convenience of the people, so as to effectively guarantee the patients' right to know when purchasing drugs and accept public supervision 4、 Strengthen the supervision and management, increase the punishment The administrative departments of public health in each district and the main bodies of municipal level hospitals should improve the awareness of reducing the burden of people's medical treatment, improving the people's sense of health, creating a clean and healthy environment in the health industry, strengthen the daily supervision and management, and increase the punishment to the illegal organizations and individuals Within 30 days after the issuance of this notice, the administrative departments of health in each district and the medical entities at the municipal level shall organize the medical institutions within their jurisdiction and subordinate medical institutions to carry out self inspection and self correction, carefully check and sort out the problems, and timely rectify the problems found This work is one of the important tasks of the special action of Shanghai health industry style improvement The Municipal Health Committee will carry out on-site supervision in combination with the special action, circulate a notice of criticism to the medical institutions whose implementation is not in place, and investigate the responsibilities of the relevant personnel; the institutions and individuals with irregular behaviors will be strictly punished according to the law Notice is hereby given Shanghai Municipal Commission of health, January 24, 2019