我国与部分国家及地区零售药店监管与药学服务模式的对比分析

Comparison of Retail Pharmacies Supervision and Pharmaceutical Care Mode between China and Some Countries and Regions

目的:为完善我国零售药店监管与药学服务模式提供参考。方法:以"药店""零售药店""社会药房""药学服务""Drug store""Retail pharmacy""Community pharmacy""Pharmaceutical care"等为关键词,在中国知网、Medline、ISI Web of Knowledge和Scopus等数据库中,对2005-2014年有关"药店管理和药学服务"的文献进行查询,分别从零售药店的发展情况、运行模式、管理制度等方面总结部分国家和地区药店管理及开展药学服务的经验和做法。结果:共纳入统计分析文献256篇,包括国内文献234篇、国外文献22篇。部分国家和地区一半以上的零售药店为连锁药店;其对药学服务内容都有具体要求,且大多设有药事服务补偿机制;对药店所有者身份、开办位置、开办数量、人口分布状况及员工组成等方面均需进行严格审查。而我国连锁药店占全部零售药店的比例不足20%;执业药师数量严重不足,相关法律法规尚不健全,导致药学服务仍处于初级阶段;对每个零售药店需要服务人口的数量、地域分布等未作出具体规定,大多数情况下其可操作性较差。结论:建议借鉴欧美等国家和地区药店管理与药学服务模式,采取多种措施提高我国零售药店的连锁经营水平,包括明确药店的开办条件和区域分布;由政府监管部门适度控制药品零售市场,完善药品零售市场监督管理机制,对药品生产、流通、销售各个环节进行质量控制;建立完善的处方药违规销售追责机制,加大对零售药店违规销售处方药的处罚力度;完善药学服务和执业药师相关法律法规,提高零售药店的药学服务质量。

OBJECTIVE：To provide reference for perfecting retail pharmacies supervision and pharmaceutical care mode in China. METHODS：Using＂drug store＂＂retail pharmacy＂＂community pharmacy＂＂pharmaceutical care＂as keywords,the literatures about pharmacy management and pharmaceutical care during 2005-2014 were retrieved from CNKI,Medline,ISI Web of Knowledge,Scopus and other database. The experience and method of pharmacies management and pharmaceutical care in some countries and regions were summarized in respects of the development of retail pharmacies,operation mode and management system,etc.RESULTS：There were 256 literatures in total,including 234 domestic literatures and 22 foreign literatures. More than half of retail pharmacies were chain pharmacies in some foreign countries and regions,and there were specific requirements and clear compensation mechanism for pharmaceutical care;owner＇s identity,position,quantity,population distribution,staff composition and other aspects were checked strictly. The chain pharmacies accounted for less than 20% of total pharmacies in China. However,the pharmaceutical care was still in early stages in China,which resulted from the serious shortage of licensed pharmacists and incomplete relevant laws or regulations;there was no clear requirement for the number of population served by one pharmacy and geographic distribution in China;they all showed poor operability in most cases. CONCLUSIONS：Learning from the pharmacy managementand pharmaceutical care models of Europe and the United States and other developed countries and regions,government should take measures to improve the chain operation level of pharmacies and should clear the set-up requirements and the regional distribution of pharmacies. What＇s more,government should control retail drug market appropriately,improve theregulation of the drug market and control the quality of the drugs in the process of drug production,circulation and sale;perfect prosecution mechanism of prescription drug sale violation,and increase penalties;improve the quality of pharmaceutical care through completing the relevant laws and regulations of pharmaceutical care and licensed pharmacists.