Comment: efficient rectification of medical corruption requires cure for the standard and cure

China Well -off Network Exclusive Specialty

Wen ｜ Liang Jialin

Recently, nine ministries and commissions such as the National Health and Health Commission and the Ministry of Public Security jointly issued the "Key Points of the Elementary School in the Field of Medical Purchasing and Sales and Medical Services in 2022". This annual medical/medicine anti -corruption heavy document proposed that the financial supervision of the production link was increased, and the setting of the "rebate" funds was transferred from the circulation link to the production link. Consumption equipment rebate, commercial bribery behavior. Throughout the time of the work of work, this is the first time that the State Council has extended anti -corruption objects from the traditional pharmaceutical purchase and sales field to the entire pharmaceutical industry chain. This will have a profound impact on my country's big health industry.

The atmosphere of the pharmaceutical industry and the medical service industry determines whether the physician can be diagnosed and treated reasonably, and determines whether the medical products can win the fittest, which will affect the health rights and interests of the people and the burden of medical treatment. The lessons of experience in some countries show that if most pharmaceutical companies have obtained hospital access and medical prescription advantages through illegal acts such as "gold sales", and then the so -called "marketing" cost is passed on to terminal drug prices or additional costs of other patients, patients with patients, patients It will become the ultimate victim of corruption.

Although most medical/medicine corruption is micro -corruption, it is related to the medical reform goal of "difficult to see a doctor, expensive to see a doctor". Therefore, the country has always attached importance to the construction of the wind. Nowadays, my country's correction work has developed into the health department and the disciplinary inspection department and the public security department jointly handling cases, and conducting circulation law enforcement with the commercial department and the market supervision department, and the "three medical linkage" with the medical insurance department and the pharmaceutical regulatory department. It is worth mentioning that since the establishment of the State Medical Insurance Bureau in 2018, the "second front front" of anti -corruption of medicines, especially the establishment of a medical evaluation system for drug recruitment, will be serious. /Especially serious dishonestyor of the behavior of the dishonesty, which makes it lose a province or even the national bidding market, thereby forming a strong deterrent to corrupt elements.

Mastering the stick, but aiming for the yard. As anti -corruption has gradually strengthened, different from doctors' individual and explicit behaviors such as red envelopes from patients, medical/medical corruption develops in a systematic and concealed direction. Take the "rebate" paid by the hospital/doctor as an example. In the bribery, some pharmaceutical companies do not directly take bribes. Instead, they include the sales fee to the sales outsourcing institution (CSO). , Fight the "guerrilla war" as the "white gloves" and money laundering agencies of the double parties of the bribery; in the bribery, some medical managers divide the "rebate" to indoor medical staff, or converted into the unit's "small vault" , Even "storage" in a pharmaceutical company, trying to avoid the investigation of party discipline and state law through "eating people short" and "not blame the public".

In the past two years, as the sales outsourcing institutions have been rectified and the drug circulation links are jumped out, a new type of corruption in a drug R & D and production link has emerged. Therefore, the above -mentioned documents of the nine ministries and commissions emphasized that the setting of "rebate" funds was transferred from circulation to production. For example: The real profit model of some so -called "doctors' scientific research platform" is to help pharmaceutical companies send illegal benefits to scientific research doctors, that is, by linked to the number of drug prescriptions for patient management survey, the doctor's project labor fee is linked to the amount of survey questionnaires. Indirectly paying high -deduction fees. For another example, the real profit model of some so -called "patent service institutions" is to help pharmaceutical companies send illegal interests to the hospital's research team and their managers, that is, by promoting pharmaceutical companies to buy new drug patents from large hospitals, indirectly pays high service fees ,Royalties.

In order to continuously and efficiently rectify medical/medicine corruption, the author recommends that at the level of cure, the "three -out -and -one" model of information flow, capital flow, and data flow can be implemented. In the cash flow of the entire industrial chain such as R & D-production-sales-use, it has conducted penetrating supervision, and screened high-risk institutions, high-risk positions, and high-risk personnel to conduct key supervision and flight inspections through big data means. At the level of control, we must benefit the law -abiding and punish illegal persons. By improving the reform of the "Cage for Birds" by increasing service income and reducing drug income, it is necessary to solve the long -term deformed prices of most medical service projects and to the medical staff. Institutions and individuals who do not pay "rebate" or rectification within the time limit for a sufficient inspiration will be strictly punished.

(The author is Secretary -General of the Value Medical Consultant and Expert Committee, editor -in -chief of the "Health National Policy 2050" academic platform)

("Well -off" · China Well -off Exclusive Draft)

This article was published in "Well -off" in early July 2022

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