How to strengthen the management of rural pharmaceutical market envisioned and countermeasures

At present, the main problems exist in the rural pharmaceutical market drug management in Yucheng District (a) poor hardware facilities for drug management. In addition to township medical units and pharmacies, the vast majority of village health clinics, individual clinics, drugs placed randomly, not in accordance with the provisions of the safekeeping of drugs, the refrigerated is not refrigerated, the light preservation is not protected from the light, and even drugs for external use and internal medicine mixed. There are no "four zones" (pending inspection area, qualified products area, unqualified products area, return area) set up according to the requirements; and the "five prevention" (insect-proof, rodent-proof, dust-proof, moisture-proof, humidity-proof) measures are not in place. Some village health centers and individual clinics mix diagnosis, treatment and dispensing places with accommodation, meals and other living facilities, with poor sanitary conditions. Due to the deep-rooted ideology of "emphasizing medicine over drugs", primary healthcare institutions have not invested enough in pharmacies, and the working conditions of pharmacies are rudimentary; some primary healthcare institutions have not met the standards for drug storage and other hardware construction. Houses are simple, dark and damp, with outdated facilities, lack of shelves, cabinets and low-temperature refrigeration facilities, some of which are stored together with food and miscellaneous items, resulting in the unstable quality of medicines. (ii) Drug management is difficult to put in place, and the system is virtually non-existent. Drug procurement channels are disorganized, village health offices and clinics purchase small quantities of drugs, and do not use the wholesale department of medicine as the main channel in purchasing, but only pursue cheaper prices. Some are purchased on credit from drug dealers, some are purchased from private individuals, individuals and other operators without a "drug license" in the hands of the village doctors generally do not have the ability to identify the real and fake drugs, ignoring the quality of drugs, resulting in the purchase and use of fake and shoddy medicines occur from time to time. Especially individual clinics (clinics), the purchase of drugs lack of supplier-related information, not to the supplier for the relevant licenses, no purchase and sales contracts, quality agreements, purchase invoices, some did not do the drugs into the warehouse acceptance records and other relevant information, did not establish the appropriate drug management system. (iii) The phenomenon of irrational use of drugs exists. Many primary medical institutions, medical personnel, medical level is low, in the pharmacological effects of drugs, metabolic processes in the body, drug contraindications and side effects of toxicity is relatively lack of, there is irrational use of medication phenomenon. In the use of medicines, there is a phenomenon of "four combinations" of traditional Chinese medicine, western medicine, proprietary Chinese medicine and Chinese herbal medicine, as well as the phenomenon of antibiotic abuse. For example, the simultaneous use of multiple antibiotics for patients with colds and inflammation leads to the production of antibodies and the reduction of antibacterial and anti-inflammatory effects of the drugs; some infants and young children use hormones and other prohibited drugs. Analyzed, the main reasons for irrational use of drugs are: lack of training of prescribers and dispensers, lack of pharmacy knowledge, resulting in irrational prescription and dispensing; profit-driven, doctors' choice of drugs starting point is too high, and there are too many applications of new, special and expensive drugs. (d) Lack of pharmacy professionals and poor professional quality of practitioners. From most of the village health offices, individual clinics, not equipped with pharmacy professionals, dispensing drugs mostly by the doctors themselves, some even temporary personnel, not at all related to the training of professional knowledge of pharmacy, they are relatively lack of basic knowledge of drug dispensing, storage, etc., the dispensing of medicines there is the phenomenon of distributing drugs directly by hand and packaging drugs in unhygienic paper. (e) Some itinerant drug vendors ignore the law and try to exaggerate the functions of medicines, and illegally sell medicines in rural areas and marketplaces. Second, the reasons for the problems in the rural drug market (a) There is a blind spot in the management of medicines. The current Regulations on the Administration of Medical Institutions only deals with the management of medicines in Article 36: Medical institutions must strengthen the management of medicines in accordance with the laws and regulations on the management of medicines. According to this regulation, as long as a medical institution can dispense drugs, as to whether the medical institution meets the conditions of dispensing drugs, the drug supervision and management department can not monitor the situation beforehand, and can only penalize the illegal procurement and use of drugs by these medical institutions after the fact. The lack of supervision links weakens the awareness of drug management in these medical institutions, and objectively increases the difficulty of combating illegal crimes. (ii) Weak legal and safety awareness among rural personnel involved in medicines, negligence of study by personnel involved in medicines, and lack of responsibility for the safe use of medicines by farmers. On how to safe, effective and rational use of drugs did not pay attention to, not strictly in accordance with the prescribed usage, dosage of drugs. Consumers go to the hospital to prescribe medicines by name or go to the pharmacy to buy their own medicines without knowing their own conditions, while medical institutions and pharmacies do not give any guidance to such consumers, and many even think that it does not matter how much or how little they take. (iii) Medical drug advertisements over-exaggerate curative effects and mislead patients. Some patients are affected by the media propaganda, blindly requesting medical institutions or pharmacies to change their prescription drugs or non-prescription drugs, requiring the use of products advertised on the advertisements, which indirectly increase the toxic side effects of drugs on the human body, affecting the safety of patients' lives and causing unnecessary losses to patients. Therefore, to increase drug publicity and supervision to guide patients to the correct direction of the use of drugs, is the current strengthening of the rural drug market supervision of the focus of the work. (D) scattered outlets, supervision is inconvenient. Our region's rural area is vast, townships and administrative villages, village health clinics, private clinics throughout the countryside, become the main supplier of rural medicine, and village health clinics, private clinics due to the quality of personnel and business income gap, the use of medication and into the drug channel is very complex, part of the geographically remote, inconvenient transportation places, the number of frequent inspections are limited, there are places where the information is not in place for a long time, and has become a drug management Some mobile drug vendors ignore the law. Some itinerant drug dealers ignore the law and sell drugs illegally in rural areas and marketplaces, making it difficult to guarantee the quality of drugs. Countermeasures to Strengthen Rural Drug Market Supervision (1) Strengthen the infrastructure of rural medicine and health. Governments at all levels should increase their investment in and support for rural medical and healthcare hardware facilities. According to the requirements of the Party Central Committee and the State Council's "Decision on Further Strengthening Rural Health Work", combined with the current situation of the rural drug market in our region, it is suggested to improve the civilization of the farmers through various channels, increase the equipment of rural health service facilities, enrich the medical professionals and technicians in the rural areas, and improve the supply channels of rural drugs. The development program for primary health care should be fully implemented to meet the different levels of medical and health care needs of farmers and to improve their health and quality of life as a whole. Comprehensively implement the new rural cooperative system, focusing on the purpose of "increasing subsidies, comprehensive coverage, consolidating and improving", scientifically adjusting the compensation scheme, appropriately lowering the starting line for hospitalization compensation, raising the ceiling line and the compensation ratio, strengthening the supervision of medical institutions, perfecting the system of the same price for medicines in the same network, further improving the management of service charges of medical institutions in townships, and constantly standardizing the public announcement of service charges of township health centers. Further improve the management of fees and charges for services in township medical institutions, and continuously standardize the work of publicizing fees and charges for services in township health centers to increase transparency. (ii) Continuing to strengthen the training of rural personnel in the use of medicines and publicizing the safe use of medicines. All relevant departments should take various forms and channels to strengthen the training of "Drug Administration Law", "Regulations for the Implementation of the Drug Administration Law", "Regulations for the Supervision and Administration of Medical Devices", "Supervision and Administration of Disposable Sterile Medical Devices", "Supervision and Administration of the Circulation of Drugs" and other laws and regulations and professional knowledge of pharmacy for the persons in charge of the county and the following county's drug business and use units, so as to make the persons from the drugs To make the drug personnel know the law, understand the law, abide by the law, and consciously act in accordance with the law. Rural publicity rely solely on television, newspapers and other media coverage is not large, some villages can not see the local news, farmers and drug distributors almost do not subscribe to newspapers and magazines. Therefore, targeted publicity activities. First, in the rural law enforcement at the same time, can be concentrated in the village, face-to-face to the general public to teach drug management policies and regulations and general knowledge; second is to print some easy to understand pamphlets issued to the hands of the farmers, through the propaganda, so that farmers understand the "Drug Administration Law", so that rural doctors to enhance the awareness of the rule of law, so that the masses to develop a look at the validity of the purchase of medicines, medicines, medicines, found that the quality of medication problems to report habits, thereby strengthening self-protection. Reporting habits, thereby strengthening the awareness of self-protection, consciously safeguard their legitimate rights and interests, consciously resist and report the flow of counterfeit and shoddy drugs in rural areas, the formation of rural drug supervision of the group prevention and control network. (C) play the "three big roles" to improve the effectiveness of rural drug safety supervision. 1, play the role of the competent departments, proactive supervision. The establishment of a collaborative supervision network. Due to the grass-roots drug supervision departments are mostly faced with fewer law enforcement officers, heavy workload, in the supervision of rural areas often lose sight of the other, it is difficult to take into account. To realize the comprehensive supervision of the rural drug market, should obtain the attention and support of the local government, the establishment of drug supervision and industry and commerce, health, quality supervision and other relevant law enforcement departments of the cooperation mechanism, exchange of information, *** with the cooperation, to carry out joint law enforcement, to strengthen the power of supervision. In general, to establish an effective internal and external supervision mechanism. Medical institutions should really play a good role in the internal drug management organization, and regularly carry out effective tracking and supervision of all aspects of the management of medical drug use; in terms of external supervision, the drug regulatory authorities should take the initiative to communicate and coordinate with the health sector, and jointly carry out the supervision of the standardized management of the pharmacy of medical institutions. 2, continue to improve the role of rural drug supervision network and supply network (hereinafter referred to as "two networks"), so that rural drug supervision is further strengthened. So far I **** have rural drug supervision network coverage rate of 100%, rural drug supply network coverage rate of 81%. Rural drug supervision network tends to improve. This year, I Bureau to further improve and refine the drug coordinator appointment, education and training, assessment, reward system and mechanism, formulated the assessment methods, clear its specific duties, strict appointment conditions, the original drug coordinator screening, those who are really enthusiastic about the work of the masses, active and willing to work, have a certain level of policy and theory of the people to fill the coordinator team. Taking multiple forms and ways to organize and carry out rural drug wardens to assist in the management and investigation of activities to carry out activities as a carrier, give full play to the "wardens" in publicity and education, information feedback, law enforcement assistance and other aspects of the role, and to further enhance the "two networks" quality of operation. 3, play a new type of rural cooperative medical system (hereinafter referred to as the "new rural cooperative medical system"), the "new rural cooperative medical system". (hereinafter referred to as "New Rural Cooperative Medical System") and rural drug "two networks" role in the construction, integration of resources to grasp the supervision. Rural drug "two networks" construction and, is to solve the farmers to eat assured, inexpensive drugs and difficult to see the doctor's two major initiatives. Rural drug "two networks" construction and "new rural cooperative" organic combination, unified research, unified deployment, to promote each other. The first is to make full use of the existing health resources in the countryside, to establish and improve the drug supply network, to renovate the rural medical institutions, to improve the conditions of drug storage and facilities and environment, to train the personnel, to strengthen the law and professional knowledge, to better serve the public, so as to effectively save resources, short, flat, fast to improve the quality of rural medical personnel from medicine, from the root to improve the level of security of the rural drug safety and security. Secondly, the eligible retail chain pharmacies are gradually included in the "New Rural Cooperative" designated insurance units, the effective use of market competition, suppressing the price of medicines, benefiting the people. Yucheng District, medical institutions, "standardized management of the pharmacy" after two years of construction, at present, has completed all county-level medical institutions and township hospitals standardized management of the pharmacy, is to the village health office and individual clinics to promote. As an important part of the "two networks", township health centers should give full play to their guiding role. In summary, we believe that strengthening the standardization of management and supervision and management as the main content of the rural drug regulatory capacity building, and constantly explore ways to regulate and innovate the supervision mechanism, to promote the standardization of the order of the pharmaceutical market in Yucheng District, the healthy development of the pharmaceutical economy and the construction of a harmonious Yucheng leapfrog development of the economy plays an important role in changing the status quo of the rural Yucheng medication, to ensure that the majority of the people with effective medication and the safety of life and property is very important. Life and property safety is of great practical significance. Strengthening rural drug management is an imperative work, but also according to the law, the management of medicines, medicines according to the law for the benefit of the people of a major event, we must effectively grasp, grasp, grasp, in order to ensure that the rural masses of safe and effective medication