| The previous studies showed that the chaos of the drug distribution system was just driven by high margin and profit. Although the Chinese central government has brought forward a series of policies to reduce drug price, rectify and normalize drug market, the effects are not obvious. The social discontentment is still very strong. The drug price is still high so that the people do not feel the declining of charges due to drug price reduction. The competition status that includes 8000 drug manufacturers in a low production level and over 6000 drug wholesale enterprises does not improve, so there is no expected effect on down size the enterprises and let the super one existing in the market. The reasons are as follows: firstly, there is no thorough reform and innovation of drug price and drug distribution system, secondly, there is no radical reformation of hospital reimbursement mechanism relying on drug revenues, thirdly, the mechanism of self-management and self-development of hospital, drug manufacturer and seller is not established, so that drug manufacturer, seller and hospital distort their behaviors without considering the whole social benefit. A study showed that in Chinese drug market there were 85% of drug volume selling to consumer (patient) through hospital and only 15% through community drugstore. Therefore, the exploration of reforming hospital drug procurement is very important to the whole drug distribution system.ObjectivesTo explore the target pattern of reforming hospital drug procurement in China and to realize the related policy, the ideal pattern is to decline the social cost of drugcirculation. So as finally to raise the people health status by means of reforming the system of drug manufacturing and circulating and the health service system.MethodsTheoretical analysis combines with the positive study, which is a bold try of our studying paradigm.ResultsIn planning economy, the government was being taken full responsibility on the input and management of medical care and public health. It has gained a great accomplishment indeed, on the other hand, there are much issues existing, such as low efficiency, short of supply and excessive utilization. After reforming and opening door to the world, the function of market increases gradually so as to becoming the leading role in medical care and pharmaceuticals field. In the past 50 years, the main accomplishments and problems of health cause in China are as follows.1. The gross resource of medical care and public health has increased in a large-scale. The total health expenditure has increased steadily and exceeded 5%GNP recommended by WHO in 1999. The health outcomes are better too, such as the life expectancy at birth has risen obviously in recent. But the input of government has decreased obviously while the private are increased. The distribution of health industry and health resources are irrational and the extent of whole health industry management is still low. The utilization rate of medical resource is rather low. The number of the opened beds is 2.32 times to the number of the beds approved by health authority, which shows that the government supervising medical service is of no effect. The debt of health sector is higher and the yield of health service is too low.2. The coverage of the medical insurance is rather low and the whole social fund has been difficulty to raise.3. The administrative effect of the medical care and public health is not good. The whole health service system, including medical service and medicines, the administrative effect is worse and worse.4. The size of the pharmaceutical industry built duplica is not big. Though the profit rate of industry cost and expenditure of pharmaceutical industry ranks at the thirdin all industries, the sell rate is the lowest in all industries. The debt rate is highand lacking of capacity to repay it in the short-term.The comparative study of separation of dispensing and prescribing (SD&P) shows that the SD&P results from the history and tradit... |
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