There is zero price difference for hospital drugs, only from the purchase price to the retail price. The purchase price is determined by government bidding, not the market.

Take a certain infusion solution as an example. The national price is 19.50 yuan, the market purchase price is 4.50 yuan, and the dealer’s bidding price is 15.00 yuan. After government bidding, 20% of the bid was reduced, which is 12.00 yuan. In medical institutions, drugs are sold to patients at a zero markup rate of 12.00 yuan. But the purchase price at the drugstore is 4.50 yuan, and the 100% profit is 9.00 yuan, which is 3.00 yuan cheaper than the zero-margin drug in the hospital.

Of course, according to the government’s crude price-lowering method, there are also drugs whose bid prices are lower than the market price. There is an old saying in China: there is only a wrong purchase, not a wrong sale. The drug manufacturer that wins the bid will use the shortage as an excuse to cut off supply or substitute other drugs with high profits. Therefore, the shortage of medicines is basically caused by the bidding price being lower than the market price.

In short, bidding outside the market cannot reduce drug prices.

What is the difference between medicines in hospitals and medicines in pharmacies?

Thanks for the invitation. Seeing this problem, both doctors and ordinary people have their own opinions on it. Perhaps everyone only sees the surface of the matter and ignores the essence of the matter.

Here, Dr. Huang will give you a little analysis. After reading this, I hope it will be helpful to you when purchasing medicines in the future.

First of all, medicines in hospitals and medicines in pharmacies are essentially medicines, but they have different focuses. At present, the drugs we purchase mainly come from three places: the hospital’s medical insurance pharmacy, the hospital’s self-paid pharmacy, and the self-employed pharmacy outside the hospital. Let’s analyze the current domestic special medical system in detail from these three places.

(1) Medical insurance pharmacy in the hospital

Generally speaking, the drugs sold in the hospital mainly come from the medical insurance pharmacy. The pharmacy only contains drugs on the medical insurance list. The range of drugs is complete, covering drugs used in almost all clinical departments. Since there are not many types of medicines of the same type in the medical insurance catalog, the medicines provided by the medical insurance pharmacies in almost every hospital are similar.

The formation of the drug catalog in the hospital’s medical insurance pharmacy mainly depends on the pharmacists’ association of the pharmacy department and the hospital leaders in charge. At the same time, the monthly purchase volume of each drug is regulated by the logistics administration and medical insurance departments. In short, hospitals will not allow a certain kind of drug to become popular, but will allow multiple categories to be affected equally. This may involve various checks and balances of interests.

At the same time, the monthly purchase volume of medical insurance pharmacies far exceeds that of self-employed pharmacies in society. Therefore, the purchase price of medicines in hospitals is relatively low. Moreover, within the entire medical system, all medical insurance drugs are priced uniformly by the Price Bureau, and there are no drug price differences in each place. Therefore, fundamentally speaking, the medical insurance pharmacy in the hospital is a public welfare institution with unified pricing and volume-based purchasing to avoid monopoly.

In terms of purchasing channels, if you want to buy medicines from the medical insurance pharmacy in the hospital, you must be diagnosed and prescribed by a doctor in the hospital. Each patient can only purchase a certain amount of medicines, and cannot purchase in large quantities. It is somewhat similar to a planned economy system. Generally, doctors select more targeted drugs based on the patient's disease diagnosis and the disease treatment cycle.

Medical insurance pharmacies mainly belong to public hospitals. They are mainly public welfare and cover almost all basic drugs. However, they often lack new drugs, imported drugs, and expensive special effects drugs.

(2) Self-funded pharmacies in hospitals

Although my country’s medical insurance catalog covers most clinically useful drugs, there are still quite a lot of new drugs, imported drugs, scarce and expensive Medicines are not included. As a supplement to the medical insurance pharmacies in hospitals, almost all public hospitals in the country have set up self-pay pharmacies. This self-funded pharmacy is generally operated by a third party, and is controlled by the hospital leaders. It is both private and public.

In the outpatient and inpatient departments of hospitals, doctors sometimes use some expensive domestic or imported drugs to treat diseases. These drugs may even act as "life-saving drugs" in many cases. role, but due to price and usage reasons, it will not be admitted to medical insurance. Some of these drugs are very familiar to everyone, such as human albumin, imported antibiotics, imported anti-tumor drugs, etc.

In terms of purchasing channels, drugs in the hospital’s self-funded pharmacies and drugs that require intravenous medication must be purchased according to a doctor’s prescription. Many oral drugs must be purchased according to the prescription of the hospital’s doctor, and a small number of them must be purchased according to the prescription of the hospital’s doctor. Medicines can be purchased according to patients’ needs.

Private pharmacies are mainly public-private mixed systems and are highly professional. Their main function is to supplement relevant drugs that are lacking in medical insurance pharmacies in hospital diagnosis and treatment activities. The drugs they sell are generally more expensive, but they are relatively The medicinal effect is strong.

(3) Self-employed pharmacies outside hospitals

Usually, the self-employed pharmacies that people have the most contact with are actually the self-employed pharmacies that are all over the streets. In fact, the entry threshold for this type of pharmacy is not too high. As long as you have a registered pharmacist certificate, you can open and operate. Because the original intention of opening a self-employed pharmacy is to make a profit, all its business activities can actually be understood as profit-seeking behaviors.

Autonomous pricing power

Due to their scale, the price of medicines purchased by self-employed pharmacies is slightly higher than that of public hospitals. They also have independent pricing power. Each locality has different policies. I remember It seems that the sales price of the same medicine in pharmacies can be 30%-50% higher than that in public hospitals. In addition to the same drugs in hospitals, pharmacies will mainly choose drugs or health products with higher profit margins. They will not consider the efficacy of the drugs, but mainly consider the gross profit margin. Due to drug efficacy and price, the drugs of many small and medium-sized pharmaceutical companies cannot enter large public hospitals. If they need to survive, they can only sell them from pharmacies. In essence, pharmacies are not much different from supermarkets. They are both terminals for sales.

This also leads to the fact that we can often buy some medicines in pharmacies with unusual packaging and dosages. Regardless of the efficacy, the prices are surprisingly expensive.

Select drug categories independently

Generally speaking, self-employed pharmacies will not choose to purchase highly professional drugs, but will try to choose some commonly used drugs and health care products. On the one hand, drugs with strong medical properties often require a clear diagnosis. At the same time, such drugs may have some side effects. Pharmacies cannot diagnose the disease or control possible side effects, so they will not choose to sell them. of these medicines. On the other hand, drugs with strong medical properties have basically been monopolized by large pharmaceutical companies. All standardized drugs circulating in society are transparent in price, and pharmacies cannot make large profits from them.