关于公立医院药房托管的法律反思

A Discussion on thelegal issues involving the pharmacy trusteeship in public hospitals

以2001年广西柳州中医院与"三九"医药集团签订协议为起点,公立医院药房托管与"医药分开"改革同步展开并不断发展演变,直至全面取消公立医院"药品加成"和药品流通实行"两票制"政策的当下,被卫健委联合发文明令禁止。作为相当数量的公立医院近二十年来的一种选择,有必要对药房托管做一法律反思,以鉴往知今。在简要回顾药房托管发展历史的基础上,从权利义务的角度归纳其既有模式,明确药房托管是一种以药品买卖关系为基础并结合了委托、服务等法律关系的综合性社会关系,其根本目的在于向医院输送经济性利益,实践中已形成诸多法律风险,对此除明令禁止之外,还应从源头上进一步完善取消药品加成的配套改革措施。

In 2001,Guangxi Liuzhou Traditional Chinese Medical Hospital signed an agreement with Sanjiu Pharmaceutical Group.Since then,the pharmacy trusteeship and the reform on"separation of pharmacy and hospital"in public hospitals have developed and evolved.Up till now,the"cost-plus pricing"of drugs in public hospitals is generally abolished and the "two-vote system" policy is implemented in the distribution of drugs,which is jointly banned by the National Health Commission.As an option for a considerable number of public hospitals in the past two decades,it is necessary to make a legal reflection on pharmacy trusteeship in order to learn from the past.Based on a brief review of the history of pharmacy trusteeship,the article summarized its existing model from the perspective of rights and obligations.It is clear that pharmacy trusteeship is a comprehensive social web based on the relationship of drug sales and the legal relationship between commission and service.Its fundamental purpose is to transfer economic benefits to the hospitals,and many legal risks have been formed in practice.In addition to the prohibition,it is necessary to further improve the supporting reform measures to eliminate the"cost-plus pricing"of drugs from the source.