Hospital pharmacy operations and issues that need to be corrected
The operations of hospital pharmacies still have many shortcomings and limitations... which need to be promptly rectified to ensure the rights of patients.
Many issues need to be addressedclarify
For a long time, in Nghe An, there have been many small and big stories related to hospital pharmacies, including: Doctors prescribe prescriptions and direct patients to the pharmacy (with a specific address) to buy medicine; hospitals do not have medical supplies and medicines covered by health insurance, but hospital pharmacies do, and in order to be treated, patients have to pay out of pocket; medicines and medical supplies at hospital pharmacies are more expensive than pharmacies outside the hospital; some hospital pharmacies do not accept payment by bank transfer, only cash, giving rise to money exchange services, making it even more difficult for already struggling patients...
“I went for treatment, and when I had a minor surgery, the doctor asked my family to go to the hospital pharmacy to buy every little thing from bandages to medical sutures and IV fluids. When I asked, the doctor said that the hospital was short of things. However, the hospital pharmacy did not lack anything. What is worth mentioning is that the prices of medicines and supplies at the hospital pharmacy are higher than outside. It is very inappropriate... Recently, I heard that the authorities are investigating and clarifying some hospital pharmacies. I welcome and request that the authorities promptly correct the current deviations.”
Mrs. NTL (69 years old, in Vinh city)
According to sources of Nghe An Newspaper, currently, the authorities are focusing on clarifying a number of issues of hospital pharmacies such as "illegally selling" drugs and medical supplies without hospital approval; selling drugs and medical supplies without recording them in books; dividing "commissions" between suppliers, pharmacies and prescribing doctors...
According to the Nghe An Department of Health, currently, hospital pharmacies have two problems and limitations. Firstly, units have not yet organized bidding for purchasing drug retail establishments within the hospital premises according to the provisions of Circular 07/2024/TT-BYT dated May 17, 2024 of the Ministry of Health (effective from May 17, 2024). Secondly, through inspections and checks, it is shown that most hospital pharmacies strictly comply with regulations on drug price management and professional regulations. However, there are some drugs sold at hospital pharmacies that are more expensive than some other drug retail establishments even though they do not violate regulations on drug price management.
Strengthening management
According to the Nghe An Department of Health, the reason for the above problems is that the regulation that drugs sold at pharmacies must go through bidding is a new regulation. Medical facilities are still confused in the process of organizing bidding for drugs for hospital pharmacies. With the current pharmaceutical human resources system being quite thin, the volume of pharmaceutical work and bidding for drugs used in hospitals is quite large. Many units are not yet able to organize bidding for procurement at the unit.
In addition, the price competitiveness of hospital pharmacies is limited compared to some other pharmacies in the area, especially large pharmacy chains... Due to the advantage of large purchasing volume, large pharmacy chains often buy at lower prices than hospital pharmacies, so the selling price is also more competitive.
To ensure that hospital pharmacies operate healthily, on June 21, 2024, the Department of Health issued Official Dispatch No. 1967/SYT-NVD on strengthening the management of drug retail establishments within the premises of public health facilities to public health facilities in Nghe An province.
Accordingly, the Department of Health recommends that public health facilities organize the selection of drug suppliers at drug retail establishments within the premises of public health facilities. For drugs in the list of drugs covered by health insurance participants according to the provisions of the law on health insurance, public health facilities can make purchases by combining the quantity of drugs needed to be purchased for retail sale into the quantity of drugs needed to be purchased and bid by the health facility. Or the health facility can separate the quantity of drugs needed to be purchased for retail sale into one or several bidding packages and make a plan to select contractors and organize the selection of contractors according to regulations.
However, the winning bid price for drugs purchased for retail sale must not be higher than the winning bid price of drugs with the same active ingredient, concentration, content, dosage form, and trade name as the drug that won the bid and was supplied at that medical facility (including centrally purchased drugs and price negotiations).
For drugs not on the drug list, the scope of benefits for health insurance participants, public health facilities decide on their own purchases on the basis of ensuring publicity, transparency, economic efficiency and accountability.
Public health facilities and drug retail establishments within the premises of public health facilities must strictly comply with regulations on drug price management; selling prices must comply with regulations on drug retail margin in Article 136 of Decree No. 54/2017/ND-CP dated May 8, 2017 of the Government detailing a number of articles and measures to implement the Law on Pharmacy; fully and properly post prices, selling prices must not be higher than the posted prices; closely monitor the origin, expiry date, quality and circulation conditions, ensuring that all drugs sold at pharmacies in hospitals have clear origins, expiry dates, quality assurance and are licensed for circulation according to regulations.
Pharmacist Tran Minh Tue - Deputy Director of Nghe An Department of Health
In the coming time, the Department of Health will actively direct medical examination and treatment facilities to urgently organize bidding for drugs sold at hospital pharmacies; direct hospital pharmacies to strictly implement regulations on drug retail establishments; regularly organize periodic and surprise inspections of drug retail establishments within the premises of medical examination and treatment facilities; ensure that all drugs sold at hospital pharmacies must be listed, publicly priced, and comply with regulations on retail price surplus at hospital pharmacies; promptly handle and discipline units with violations.
To ensure the healthy operation of hospital pharmacies and ensure the rights of patients, the Department of Health will also promote the application of information technology to control electronic prescriptions to ensure the safe, reasonable and effective use of drugs and gradually manage the prescription and sale of drugs according to prescriptions; connect drug supply facilities, ensure that all drug retail facilities must connect data to the National Pharmaceutical Database System; strengthen propaganda and dissemination of knowledge to people in looking up drug prices published on the website of the Ministry of Health...
In particular, direct medical facilities to thoroughly inform medical staff that they absolutely do not require patients to buy medicine at hospital pharmacies; encourage hospitals to consider and research solutions to reduce prices at hospital pharmacies./.
