The secret of "purchasing" rebates behind the hospital's "purchasing medicine" is as high as 30%. After being recommended by doctors, the doctor directly purchases medicines from the medical representative office. There is a huge risk hidden behind the transaction--the secret behind the "outsourcing medicine" profiteering.
The family members of the Haizhu District Court in Guangzhou recently sued Zhujiang Hospital for a series of cases, which attracted public attention. In these cases, the phenomenon of â€œoutsourcing drugsâ€ in some large hospitals in Guangzhou has gradually surfaced.
The doctor asked the patient to buy high-priced drugs from outside the hospital; the operation failed, the hospital became the defendant. From July 2004 to September 2005, 15 children with thalassemia had bone marrow transplants at Zhujiang Hospital. The hospital promised patients that the success rate of surgery can reach 93%. However, although most of the children's families spent between 200,000 and 700,000 expensive treatment costs, 9 out of 15 children died, and 3 cases failed.
Parents of the children reported that before and after their child's bone marrow transplant operation, Zhu Weiguo, deputy director of the hospital's pediatrics, asked them to buy some expensive special effects drugs from a person named Wang Hua. Among them, the price of a special anti-rejection drug called celecoxib is as high as 4,500 yuan / branch.
Zhu Weiguo claimed that the parents of the children did not have these drugs in China, or claimed that the effect of domestically produced drugs could not match the "purchasing" in Hong Kong. According to the after-the-fact investigation, the doctors asked the parents to purchase Andaosheng, amphotericin B, sinipiride, fludarabine, etc., which were sold in Guangzhou Cancer Pharmacy. In the Guangzhou market, 100 pieces sold only 260 pieces of Ma Lilan, Zhu Weiguo's "purchasing" price is 25 pieces of 500 dollars.
After receiving complaints from parents, the Guangdong Provincial Health Department and the Guangdong Provincial Food and Drug Administration dismissed Zhu Weiguo as the deputy director of the pediatrics and suspended the bone marrow transplant operation.
For the death of the child, Zhujiang Hospital insisted that â€œthe disease is not in the medicineâ€. The hospital believes that â€œoutsourcingâ€ drugs are Zhuâ€™s personal actions, and the hospital only has â€œmanagement responsibilitiesâ€. Explain that the parents of the child said that they could not accept it and brought the hospital to court.
Zhu Weiguo said that the drugs he provided to patients were purchased by Hong Kong Haohua Pharmacy. However, Haohua Pharmacy does not have a corresponding purchase order. The pharmacy clerk said that they have never had such a transaction amount of 100,000 yuan. The reporter learned that patients have great risks in entrusting outsourced drugs under the guidance and guidance of doctors. Due to the lack of necessary supervision links, some drug dealers are shoddy and expensive. In the end, patients lose money and hurt the body. .
Doctors and medical representatives join hands, and the â€œpurchaseâ€ can get up to 30% rebate
According to informed sources, â€œoutsourcing drugsâ€ is an open secret in some large hospitals in Guangzhou.
After many twists and turns, He Jian (pseudonym), a pharmaceutical representative of a company, sat opposite the reporter. He said that â€œoutsourcingâ€ is like the expensive imported drug of Sainipi, and their rebates for doctors are maintained at 15%-20. % level, some even as high as 30%. But if it is not "outsourcing," but the doctor prescribes to take the medicine in the pharmacy, most of the rebates they give to the doctor are between 5% and 10%.
In the process of medicines from the pharmaceutical factory - the pharmaceutical company - the hospital - the patient, the pharmaceutical company went to the hospital for a 6% increase, and the hospital to the patient had a 15% markup. This is the profit of the drug sales that the patient can see.
He Jian said that â€œoutsourcing drugsâ€ first avoided the 15% profit link of â€œhospitalsâ€. If the "purchased medicine" is not from the pharmaceutical company, but the drug is directly discharged from the factory in the local offices, it also saves 6% of the profit of the pharmaceutical company. At the same time, pharmaceutical companies can also evade 17% VAT. A few accumulations, accounting for 22% - 42% of the profit margin of "outsourced drug" drug prices, can be divided by doctors, medical representatives and agents (office directors).
He said that these profit margins do not include the â€œrebateâ€ and â€œbusiness commissionâ€ that were originally reserved for prescribers and medical representatives.
The benefits are so rich, and most of them involve expensive "special effects drugs". Some doctors can't resist the temptation and join hands with medical representatives to take risks.
After the pharmaceutical "sunshine procurement", the pharmaceutical company expanded the "outsourcing drug" business in the investigation, doctors of several hospitals revealed that because the health authorities and hospitals have significantly strengthened the supervision of doctors, doctors now generally dare not blatantly administer medicine. Representative contact. The phenomenon of â€œoutsourcing drugsâ€ has somewhat converged.
However, Zhou, a medical representative of a pharmaceutical company, told reporters that his company has recently established a â€œoutsourcing drug groupâ€ to concentrate the â€œoutsourcing drugâ€ business that was dispersed by medical representatives in the past, and to concentrate financial and material resources. It claims that it must "explore a new road" for the company in the "outsourcing drug" business.
Since the first half of this year, Guangdong Province's pharmaceutical management has achieved â€œsunshine procurementâ€. After the â€œelectronic biddingâ€ and â€œonline negotiationâ€ of pharmaceutical companies with the same product name and the same specifications, the winners can â€œhang the net for saleâ€, and the hospitals For the purchase of drugs for â€œhanging net salesâ€, â€œone product and two regulationsâ€ are implemented, that is, one product with only one product name can only choose two specifications. This move blocked a large number of "new drugs" with the same product name and different specifications.
It is against this background that companies that have not been selected for procurement have begun to adjust their thinking and set up â€œoutsourcing drug groupsâ€ to guide doctorsâ€™ pens to their medicines with high rebates and various temptations.
Restricting medical representatives is the key to breaking the chain of interest behind â€œoutsourced drugsâ€ The difficulty of cracking down on â€œoutsourcing drugsâ€ lies in the definition of â€œoutsourcingâ€ and the identification of related responsibilities.
In the investigation of the reporter, it was found that in the context of the current practice of â€œmedical not separatedâ€ in most hospitals, some patients do have the demand for purchased drugs. The medicine outside is better or cheaper than the hospital. Why do you want to buy it in the hospital?
Doctors recommend patients to buy medicine outside the hospital, often on the grounds of caring for the needs of patients. Usually, only doctors who are found to be profitable by introducing patients outside the hospital will be considered to be participating in â€œoutsourced drugsâ€.
Regarding the issue of â€œpurchased medicineâ€ in Zhujiang Hospital, the hospital believes that â€œexternal medicineâ€ is the personal behavior of doctors. If they are wrong, they should be responsible for management at most. The doctorâ€™s â€œoutsourcing medicineâ€ behavior also harms the hospital. economic benefit.
In an interview, most hospitals believe that it is difficult to find a better solution than to educate doctors and increase investigations.
In an interview, the reporter found that â€œoutsourcing drugsâ€ is actually a product of the current drug circulation system, and its production is closely related to â€œmedical representativesâ€. When the medicines of the medical representatives enter the hospital pharmacy, they will find ways to let the doctors open more; when their medicines fail to enter the hospital pharmacy, they will rack their brains and let the doctors persuade the patients to "outsource" them.
Experts suggest that if you can limit or even cancel the "medical representatives", there are many problems that need to be solved, such as drug rebates and "outsourcing drugs." Zhu Liyu, deputy of the Guangdong Provincial People's Congress, believes that the most direct way to cancel the "medical representatives" is to "separate medicines." Patients can buy medicines at various pharmacies by prescription, so there will be no space for "medical representatives".
He Jian believes that the most critical part of the medical representative is actually verifying the specific number of each drug prescribed by the doctor. Every month, medical representatives will have to pay the relevant information supervisors to print out the detailed computer list of each product, including who opened the medicine and how much. If the regulatory authorities can strictly supervise these computer information and prevent this information from going out, the medical representatives will be unable to do anything. In addition, if the health authorities can promote the circulation of prescriptions within a certain range, patients can choose to purchase medicines in this hospital, or they can choose to buy medicines in other hospitals or pharmacies. Medical representatives will also lose because they cannot fully compile medication information. The influence of the doctor on prescribing medicine. (People's Network)
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