Orderless competition, forcing pharmaceutical companies to send kickbacks
China's pharmaceutical market is too much porridge. According to reports, the country has more than 6,000 drug manufacturers, tens of thousands of pharmaceutical distribution and sales companies, as well as a huge team of pharmaceutical representatives throughout the region. Excessive and indiscriminate production, operators, resulting in the pharmaceutical market disorder, deformed competition. Pharmaceutical companies are seeking trading opportunities, access or loss of trading opportunities, undoubtedly related to the survival of the pharmaceutical enterprises, this life and death choices, forcing pharmaceutical companies to find ways, and even at all costs to mine to grab space for development. As a businessman, pharmaceutical companies are bound to maximize profits, to a doctor kickbacks, you can let the doctor to help more sales of the company's products, to many doctors kickbacks, may bring the unprecedented benefits of all the firewood high. Pharmaceutical industry high "kickback" promotion can bring high profits, high earnings, and pharmaceutical companies bribery behavior in fact rarely be investigated and dealt with low-cost, low-risk, resulting in a number of black hearted pharmaceutical industry dares to hand out large sums of money to pay kickbacks, bringing a more serious consequence is that some of this reluctance to participate in this kind of black trade in the drugstore worried about the legitimate transaction will be "Kickback" means deprivation, and thus also have to offer "kickback" killer, resulting in the entire pharmaceutical industry are in the "kickback" in the fight. In the pharmaceutical enterprises and hospitals, doctors, pharmaceutical representatives play the role of the needle. Pharmaceutical representatives and pharmaceutical companies are employees and employers of the relationship between each other to profit as a bond and combined, favorable is together, no profit is scattered, a little error, pharmaceutical companies will never recognize the account. Such as Guangdong and Jiangsu two large pharmaceutical companies, when their medical representatives were investigated and dealt with by us to learn about the situation, they are the medical representative has long been dismissed on the grounds of non-cooperation. Pharmaceutical representatives represent the interests of pharmaceutical companies and profit from them themselves. Since the American company Schweppes brought the concept of "pharmaceutical representative" into the Chinese medical industry, pharmaceutical representatives have rapidly become a major protagonist in the pharmaceutical industry. At first, the pharmaceutical representatives to the doctors to send leaflets, explain the performance of drugs and equipment, organizing medical experts to meet and discuss, and actively promote the agent's products, and then gradually joined the tourism, entertainment projects, gifts printed with the company's product mark souvenirs, and finally to the subject of the last straight to the kickbacks, to give commission, for the naked power and money transactions.
Inflated drug prices, leaving enough room for kickbacks
In the cases investigated, the doctor's rebate amount of drugs and equipment in the retail price of 10% to 30%, the pharmaceutical representatives draw 5% or so, the pharmaceutical companies left 20% of the net profit. In other words, the drugs from the factory to the patient to buy and use, which has about 50% of the profits by doctors, drug companies, pharmaceutical representatives to divide. In some cases, the difference between the cost of a drug and its selling price is far beyond people's psychological expectations. For example, we investigated the case of orthopedic kickbacks, a piece of orthopedic upper limb ordinary steel plate, the cost of only 20 yuan, but the price of nearly 1,000 yuan sold to patients. Encountered some patients with better economic conditions, orthopedic surgeons also recommended the use of titanium alloy plate, and even the so-called "imported" titanium alloy plate, titanium alloy plate cost about 200 yuan, sold to the patient is tens of thousands of dollars, if the crown of the name of the world, often tens of thousands of dollars. The reasons for the inflated prices of medicines are manifold, and the most fundamental problem lies in the existence of serious loopholes in the market access and pricing mechanism. On the one hand, the pharmaceutical market access system loopholes. The previous section of the State Drug Administration, the Director of the Department of Pharmaceuticals and Devices, Hao Heping, the Director of the Department of Drug Registration, Cao Wenzhuang, as well as other cases of bribery of officials, are related to the power of these high-ranking officials to authorize the entry of medicines and devices into the market. This is called the "medicine door" of the management body, but not for the people to keep a good door, the so-called new drugs in new bottles, old wine, crude medical equipment, medical materials, a batch of out of the virtual R & D fee will be counted in the cost, in order to engage in the approval of bribery fee, the cost of tossing even more to be counted in the cost. On the other hand, the pricing mechanism of drugs and equipment is not perfect. China accounted for 90% of the number of drugs non-medical insurance catalog drugs, the implementation of independent pricing and market regulation, however, due to the market regulation of its own loopholes, vested interests in the pharmaceutical industry to find ways to maintain high prices. For example, we investigated the case of orthopedic kickbacks, due to the centralized procurement bidding of drugs and equipment, those low-cost orthopedic internal fixation materials ghostly high prices to win the bidding, the seller to maintain their own high profits, while at the same time, the ease of the doctor to give a high kickbacks. Accounting for 10% of the number of drugs in the medical insurance catalog of drugs, by the price department based on the average cost of society, market supply and demand conditions to set and adjust prices, but the price department is limited to the conditions, it is difficult to obtain accurate pricing information, and ultimately by the vested interests of the pharmaceutical industry to lead by the nose. For example, we investigated the case of Chinese medicine kickbacks, individual varieties of Chinese medicine prices are overpriced, the drugstore was able to give doctors a generous 10% kickback. The centralized purchasing system for medicines and devices, which is not yet sound, has also failed to effectively plug the loophole of kickbacks. In order to ensure the quality of medicines and equipment and to prevent corruption, the state requires hospitals to implement a centralized procurement and bidding system, just as administrative agencies do. Hospitals only have the right to declare and pay for large quantities of medicines and equipment, and the right to make decisions rests with the government's specialized purchasing departments. According to hospital leaders, government purchases are more expensive than previous hospital purchases, and the prices of centrally purchased medicines are even 10% to 30% higher than the prices of the original purchases. Pharmaceutical representatives with the centralized government procurement price list, and doctors in the second negotiation more comfortable - I can give you extremely generous rebates!
Pharmaceuticals for doctors, catering to medical kickbacks
A hospital administrator helplessly blunt: your Procuratorate a case, doctors prescribe medicines on the shrinkage, the hospital drug sales have plummeted, resulting in the entire hospital are operating at a loss. In the past, state-owned hospitals were invested by the state to keep running. Now that state-owned hospitals have been pushed into the market with little state input, hospitals basically rely on drug sales to survive and develop. The profit input from the sale of drugs by the hospitals maintains the operation of the whole hospital. Those medicines and devices with high rebates bring high profits to hospitals to a certain extent. Thus, the system of supporting doctors with medicines caters to medical kickbacks at a certain level of interest.
Lack of supervision, the wind of kickbacks is flourishing
In the administrative field, the health administrative departments, drug regulators on medical kickbacks from top to bottom "line supervision" is difficult to see the effect. Health, drug supervision departments to carry out a strong anti-commercial bribery activities, the health sector requires hospitals to carry out self-examination and self-correction, many hospitals in order to implement the work of anti-commercial bribery, at any cost, to take "everyone passes" approach, urging each doctor to fill in the form of self-reporting of the issue of receiving kickbacks. Even so, until now, there is not a doctor consciously state which representative, what kind of drugs received kickbacks on the substantive issues. A person in charge of a health bureau frankly: not caught, said no kickbacks, do more ideological work will not help, only the Procuratorate investigated and dealt with, only to recognize the receipt of kickbacks. In the judicial field, the implementation of amendments to the Criminal Law (VI), to combat the crime of medical kickbacks and bribery to provide a strong legal weapon. However, the provisions of our criminal law on bribery crimes are not perfect enough, especially the definition of the subject of the crime is too narrow, the content of the bribe is limited to property, and seeking undue advantage as the constitutive element of the crime of bribery, etc., which is not conducive to the fight against medical kickbacks and other bribery crimes. Moreover, like many bribery cases, medical kickbacks are given and received by both parties, which makes it difficult to investigate and deal with. In addition, the judicial supervision after the fact, and can not from the source to solve the problem of medical kickbacks at all.
Greed, resulting in doctors receiving kickbacks
Some of the doctors investigated and punished complained about their bad luck, saying that many industries have kickbacks, most people in the medical industry to take kickbacks, medical representatives sent kickbacks do not receive for nothing, do not receive will not be given to the hospital, given to the patient, just their own bad luck to be investigated and punished. From this reflects the serious errors in the subjective understanding of some doctors: one is a fluke. I prescribe more kickbacks, you more sales more profit, both sides are profitable, take kickbacks and is one-on-one, I do not confess, you do not report, you can not be investigated; Second, the heart is at ease. I sell drugs for you, collect your commission to me, kickbacks, it is only natural, in addition, the price of drugs and devices have been approved, sold is the price, I do not receive kickbacks, you will not lower the price, the benefits can not let you get the drugstore alone; Third, the law is not to blame. Everyone is receiving kickbacks, this is the medical industry and even the general rules of society, a person receiving kickbacks is wrong, everyone is receiving kickbacks is wrong to become right, at least, the judiciary will not catch all the doctors; Fourth, the crime is not in oneself. These medical representatives are pervasive around, every day, pulling corrosion, not I want to become bad, is the country did not control these medical representatives, hard to make me be dragged down by them, I am also a victim. In fact, "flies do not pick the seamless egg", the receipt of kickbacks should first be attributed to personal greed. The Department of Health and the hospital management have formulated a series of management and supervision systems to tackle the problem of kickbacks, but they still cannot control the secret collusion between medical staff and pharmaceutical representatives, and they even regard the system as nothing, and accept drug kickbacks with impunity. Therefore, those who were investigated and penalized medical personnel, need to y reflect on their own endless greed of the scourge.