我国药品回扣治理的反思和对策

Introspection and Countermeasure of Precluding Drug Rebate in China

本文通过对当前药品回扣现象与成因的分析、反思,指出药品回扣现象形式多样,治理难度大,具有很强的隐蔽性、普遍性和反复性。除了医务人员职业精神失落,存在从众心理、侥幸心理等个体因素外,还存在市场管理失控、药品流通领域不规范、医疗卫生体制改革滞后、医院内部管理存在漏洞等诸多体制上、管理上的原因。为了有效遏制药品回扣的不正之风,必须重视廉政文化建设,倡导廉洁行医的优良文化氛围;建立健全管理制度,以查处典型案件为突破口,对医务人员起到震慑作用,克服侥幸心理。同时还要进一步加强政府对药品价格的监督、管理,改革药品生产流通环节,规范购销行为;完善公立医院补偿机制,改变以药养医的现状;推行临床路径,规范诊疗流程,防范过度用药等诊疗行为。并进一步探索完善药品招标采购管理机制,一切从实际出发,以阳光公开的方式,允许医疗单位在本地区中标药品目录范围内选择药品生产企业直接采购或通过某一药品经销企业打包采购,挤掉虚高药价水分,其经济收益严格专帐管理、使用和接受社会监督,最大限度地保护医务人员,克服药品回扣顽症。

Through analyzing and introspecting of the current drug rebate,this article points out that the drug rebate phenomenon has various forms and it＇s very difficult to administer due to its concealment,universality and repetition.There are not only some medical staff＇s individual factors such as lost psychology,group psychology,fluky psychology,but also some drug circulation market administer problems as mismanagement,non-standardization,lag of medical and health system reform,loopholes of hospital internal management and so on.In order to effectively restrain these immoral tendencies,we must attach great importance to the cultural construction by advocating honest practice atmosphere,establishing a sound administer system,investigating typical case as a breakthrough point to keep the medical staff from fluky psychology.Meanwhile,we should strengthen supervision and management on drug price,reform the medicine production and circulation field,perfect the compensation mechanism of public hospitals to change the drug-maintaining-medicine status;we should also promote the clinical pathway,standardize diagnosis and treatment process to prevent drug abuse.To protect medical staff from drug rebate,it＇s necessary to perfect the drug bidding and purchasing management mechanism by allowing the medical units to purchase directly from drug production enterprises or drug distribution enterprises to reduce the artificial drug price,strictly administer the economic benefit and accept social supervision.