Online drug rebates?

Recently, the National Health Commission issued the "Internet Diagnosis and Treatment Regulations (Draft for Solicitation of Comments)" (hereinafter referred to as the "Draft for Comments?") and publicly solicited opinions from the public
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The draft opinion stipulates that medical institutions should strictly abide by the "Prescription Management Measures" and other regulations when carrying out Internet diagnosis and treatment activities, strengthen drug management, and prohibit problems such as unified prescriptions and supplements
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The personal income of medical and health personnel shall not be linked to the income of medicines and medical examinations
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Why is this draft forbidden to supplement the party? The "statistical prescription" refers to the statistics of the hospital's information on doctors' medication use and medication receipts
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The unified prescription mentioned in the opinion draft is for commercial purposes.
It refers to the behavior of an individual or department in a hospital to provide medical marketers with information on the amount of clinical drugs used by doctors or departments within a certain period of time for them to issue drug rebates
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The purpose of banning the unification is to prevent such incidents from happening
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Earlier, some voices pointed out that some pharmaceutical companies included the online drug sales of cooperative Internet platforms in the performance assessment of medical representatives, instructing medical representatives to use offline academic visits to promote online prescriptions, including drug rebates; some Internet hospitals It also linked doctors’ service income with drug sales in an attempt to wash out drug rebates
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In the process of Internet diagnosis and treatment, it is not uncommon to prescribe drugs first and then supplement prescriptions
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Knowing the above two behaviors, it is only natural that this draft of the opinion prohibits the government from making supplements
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On the other hand, many media reported that many medicines that originally required a doctor's prescription can be purchased, even if there is no prescription on some platforms, they can be shipped as long as an order is placed, including some mental medicines
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If it is impossible to supplement prescriptions, this kind of drug purchase behavior without prescriptions is even more worrying
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Due to the great relationship between medical insurance payers, the Internet hospital platform is developing rapidly at this stage.
All provinces and cities across the country have issued Internet+ medical service prices and medical insurance payment policies.
Medical institutions in some developed regions have realized that medical insurance patients can consult at home , Online payment, home delivery of medicines
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Coupled with the promotion of the epidemic, many Internet medical platforms have been spawned, but the legal compliance of many platforms has not yet been perfected
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How to implement the new supervision of online prescriptions? For behaviors such as supplementing prescriptions, the key question is whether doctors on the online platform have actually prescribed prescriptions in a timely manner
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Domestic prescriptions are different from Western prescriptions.
Western physicians and pharmacists have the right to prescribe, while in China, only physicians have the right to prescribe
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What online medical platforms urgently need to do is to ensure that every prescription drug sold must be prescribed by a physician
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The reality is that Internet platforms have grown stronger and more profitable, and patient users have gradually increased.
However, the number of high-quality doctors in China has not increased.
It is estimated that the number of doctors distributed on the Internet diagnosis and treatment platform will not increase at the same time
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Put an end to supplement prescriptions and prescribe them in time.
At present, this work can only be undertaken by doctors, which will inevitably increase the workload of doctors and prolong the working hours of doctors.
Doctors can only spare more energy to face online patients
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However, at present, almost all domestic high-quality doctors are gathered in large tertiary hospitals, and the daily workload of these doctors is only increasing
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According to survey data, before the epidemic, each doctor took an average of 1 day off a week
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With the recurrence of the epidemic, many doctors have almost lost their only day off.
More than half of the doctors in the clinic are on the frontline of the epidemic.
For these doctors directly involved in epidemic-related work, their workload has increased significantly during the epidemic.
This is an increase of 2-3 hours from the average daily working hours before the epidemic
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In 24 hours a day, where can doctors compress the time to write prescriptions online? In fact, the penetration rate of online diagnosis and treatment in China is not high.
The recent blowout of Internet hospitals is closely related to the epidemic, but the tide has receded and whether online diagnosis and treatment is prosperous is yet to be known.

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Online diagnosis and treatment are basically based on the doctor’s title and the hospital they belong to.
At present, most of the doctors registered to practice on major online platforms come from tertiary hospitals.
Patients will also give priority to high-level doctors when registering and consulting, and high-level doctors There is almost no shortage of patients offline, and it is difficult to allocate some energy to face patients online
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Regardless of time and energy constraints, doctors working on the Internet medical platform are multi-point practice
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Although the resources of domestic doctors are very tight, doctors should be encouraged to practice more, improve the utilization rate of doctors, expand the scope of work of doctors, and provide doctors with flexible employment
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But the actual situation is that in the general environment, only a very small number of doctors can practice more, and the places where these doctors practice more are not offline large private hospitals, primary medical institutions and other places, but online platforms.
The form still cannot solve the current situation of uneven domestic medical resources and the backward medical level of primary hospitals
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How do doctors base themselves on the Internet diagnosis and treatment platform? At present, China's Internet diagnosis and treatment activities provide patients with follow-up services for some common and chronic diseases
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Common diseases are easier to understand.
Take a cold as an example.
Going to the hospital to see a cold, blood tests and chest X-rays seem to be essential.
After the results of the tests come out, you can take the medicine and go home
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When it comes online, can these checks be omitted? If the examination cannot be omitted, do you still have to go to the hospital for examination? If the source of the call is a doctor from a Beijing tertiary hospital, and the chest X-ray examination result comes from the hometown hospital, does the Beijing doctor approve it? Does online treatment of common diseases only require a prescription and everything will be fine? Is the inspection and testing procedures omitted in the middle important? No conclusion has been reached yet
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Another disease for which prescriptions for diagnosis and treatment on the Internet are directed is follow-up visits for chronic diseases
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In fact, before the opinion draft was released, this was just a "moat" within a large hospital
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Previously, in order to avoid risks to the greatest extent, online follow-up services that allowed prescriptions were only available to patients who had been treated in this hospital
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For many Internet hospitals dominated by public hospitals, this draft of the opinion clarifies the materials that patients need to prepare for follow-up consultations.
If the doctors can receive the follow-up patients in other hospitals after the patients have issued the certification materials, then, for this type of Internet hospitals It is to relax the scope of services
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Although the opinion draft can limit the occurrence of supplementary and unified prescriptions to a certain extent, this task will eventually be completed by high-level domestic doctors, and such doctors have been in a state of shortage, and multiple medical measures have not been synchronized.
The number of high-level doctors has not increased, but the workload and responsibilities of doctors have increased simultaneously
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With the rapid development of science and technology, doctors must devote more time to clinical research and research, and at the same time improve their own teaching and research capabilities, liberate high-level doctors, and strive to train more excellent doctors
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The purpose of doctors' online platform for diagnosis and treatment activities is to solve the problem of difficulty for ordinary people to see a doctor.
At present, domestic diagnosis and treatment activities are basically offline, and online Internet medical platforms only occupy the tip of the iceberg
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When the number of users on the platform increases, patients and doctors seem to be far away and close in front of you.
The communication between doctors and patients will always be separated by the distance of the Internet.
Will the doctor's voice and decision-making power weaken at that time , These are the future that doctors need to think about when practicing on the Internet
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