浅谈药品回扣的治理

笔者通过分析我国药品回扣产生的原因,研究我国药品回扣的治理现状,结合外国治理药品回扣的成功经验,借鉴其中的可行性做法,从规范市场管理、加强医院监管、完善补偿机制三个方面提出了对我国药品回扣的治理建议,以期从根本上解决我国药品回扣的问题,实现我国医药行业的公平、公正竞争。     

医疗回扣的治理研究综述

目前我国药品生产、流通企业数量众多,导致医药流通领域中"回扣"等不正当竞争行为盛行,所以治理药品回扣现象,解决人民群众看病贵的问题是医疗服务部门的当务之急.文章通过综述国内外医疗回扣的产生原因、表现形式、危害,并通过借鉴国际治理医疗回扣的经验,提出治理我国医疗回扣的建议,以期我国医药行业走向公平、公正竞争.     

"医药回扣"问题的刑法学审视

医药回扣是引起医疗腐败的直接也是最重要的根源之一。所以如何惩治医疗领域中“医药回扣”问题,一直是医学界和法学界争议的话题之一,本文将从刑法学的角度来进行考察。1目前我国卫生法律、法规中对“医药回扣”问题的刑法学考察对于“医药回扣”问题在我国的卫生法律中一直是采取明文禁止的态度,《药品管理法》59条第一款明文规定:禁止药品的生产企业、经营企业和医疗机构在药品购销中帐外暗中给予、收受回扣和其他利益。禁止医疗机构的负责人、药品采购人员、医师等有关人员以任何名义收受药品的生产企业或者代理人给予的财物或者其他利…     

非营利性医院卫生材料回扣不可小视

近几年，药品回扣现象成了卫生行业最大的不正之风，并引起了社会各界的广泛关注。但对卫生材料的回扣，很多人不太了解，卫生材料虽然在使用总量上比药品少，得到卫生材料回扣的人也远没有药品回扣那么多，但在腐败程度上不比药品回扣小，我们对其中存在的问题不可小视。因此，对卫生材料回扣，从业人员要从法律     

试论药品回扣产生的原因及遏制对策

近几年,在药品购销活动中出现的回扣问题,已成为社会舆论关注的焦点之一,回扣换来的是影响人民身体健康,造成国家税收大量流失和企业之间的不平等竞争,扰乱了社会经济秩序,败坏了医药卫生行业的职业道德。现就药品回扣产生的原因及遏制对策谈谈自己的看法。 一、原因 (一)国家对医疗单位的补偿机制不完善,以药养医,为药品回扣的产生和蔓延提供了条件     

试析药品回扣的危害及对策

药品销售中的回扣和让利不同,它属于商业贿赂行为,是一种不正当竞争行为。在商品大潮中,近年来,药品回扣风愈演愈烈,花样百出,应充分认识其危害,采取果断措施,坚决遏制药品回扣的违法行为。 一、药品回扣的危害 1、国家税收大量流失。药品回扣始于80年代中期,当时药品回扣率一般在2—     

浅谈药品回扣管理

加强药品回扣的管理,是提高医院经济效益的重要途径。近几年来,找院十分重视药品回扣的管理工作,采取了多种办法,努力堵塞药品回扣流失的漏洞,不断增加药品回扣的收入,提高我院的经济效益。以1992年至1994年的药品回扣收入情况     

医生收受药品回扣的行为经济学分析

药品回扣是医药市场的不和谐因素,在我国有些医院,药品回扣涉及大部分医生,本文运用现代经济学中关于行为经济学理论,分析医生收受药品提成的行为心理,为医生过度用药的治理提供参考。     

加强药品回扣的管理

回扣在医药市场领域中的危害性很大,一是回扣可以使一些单位或个人见利忘义,购进假冒伪劣药品;二是大部分采取现金回扣,回扣透明度差,使一些药品采购人员有可乘之机,回扣不交公,据为己有,损公肥私;三是因为回扣而使药品销售成本增加,药价上涨,从而使医疗单位和消费者受到经济损失;四是违反财会制度,偷漏国家税款,使国家蒙受经济损失;五是有药品采购权的人员因回扣麻痹了思想而走上犯罪的道路。 鉴于回扣的种种表现,我们必须加强对药品回扣的管理。     

弗隆姆期望理论与药品回扣的激励循环

药品营销过程中的回扣已经成为一个严重的社会问题．对多个方面都产生了不良的影响。它直接导致了医疗费昂贵．使患者负担过重：它扭曲了医生正常的诊疗行为．败坏了医德医风：它导致了过度医疗以及抗生素的滥用。其长远的危害难以估量。此外．药品回扣扰乱了国家正常的经济运行秩序。据商务部提供的资料表明。在全国药品行业，作为商业贿赂的药品回扣．每年侵吞国家资产约7．72亿元．约占全国医药行业全年税收收入的16％。面对药品回扣问题．政府有关部门采取过各种措施来打击．各媒体的舆论讨伐也是一浪高过一浪，结果问题不但没有解决，甚至有愈演愈烈的趋势。要解决药品回扣问题。应该对其内在运行机制有深入的认识。     

Considerations of drug therapy in patients receiving enteral nutrition

Some basic principles to consider in giving medications to patients receiving enteral nutrition include: 1. If the patient is able to take medication by mouth, this is the preferred route. 2. Liquid medications are the preferred dosage form. 3. The use of oral medications that are not meant to be crushed for enteral tube administration should be avoided. 4. For individual doses of most medications, the tube should be flushed with at least 30 ml of water before and after administration of medications. 5. Highly concentrated solutions should be diluted with 60 ml of water. 6. When several medications are to be administered to the same patient, all medications should be delivered separately and the tube flushed with at least 5 ml of water after each dose. 7. Medications should not be added directly to the feeding formulation. 8. Drug-nutrient interactions should be considered. 9. GI side effects are the most common adverse effects that occur with enteral feedings, and treatment depends on the cause.     

Considerations regarding oral medications delivery to patients on nasoenteral tubes

Patients with healthy gastrointestinal tract but not capable to be fed orally may receive their nutrition and medications via enteral feeding tubes, patients who receive nutrition via feeding tubes are often receive medications through the same route. Not all medications are appropriate to be administrated enterally, improper dosage form selection, drug-nutrition interactions and incompatibilities, inadequate dilution, and other types of preparation and administration errors might lead to an unpleasant outcome. Appreciating the complexity of the administration of medications via feeding tube, following proper techniques could help in reducing incidents and improve patient outcomes. The present review covers the most considerations regarding the preparation and administration of oral medications to patients on nasoenteral feeding tubes.     

A commentary on the importance of controlling for medication use within trials on the effects of exercise on depression and anxiety

The aims of this commentary are to (1) identify the potential interactive effects of exercise with anxiety/depression medications, based on mechanistic or observational studies, (2) describe how studies dealt with use of antidepressant or anxiolytic participants' medications in their study design and analyses, based on a narrative review of Randomized Controlled Trials (RCTs), and (3) consider the implications for future research for assessing the use of medications within trials and using this information in analyses.     

Fluid matters in choosing antihypertensive therapy: a hypothesis that the data speak volumes

Assuming that blood pressure is lowered equivalently, diuretics are more effective than angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and alpha-adrenergic receptor blockers (alpha-blockers) at preventing heart failure, and they are more effective than ACEIs and alpha-blockers at preventing strokes. Compared with beta-adrenergic receptor blockers (beta-blockers) and ACEIs, CCBs are less effective at reducing myocardial infarcts and heart failure. There is currently no conceptual framework by which to organize data indicating that some antihypertensive medications are better than others at preventing cardiovascular diseases. The thesis of this article is that the fluid reduction or fluid retention attributable to antihypertensive medications, either alone or in combination, provides a basis for ranking these medications. Diuretics have a theoretical advantage compared with other antihypertensive medications because they reduce total body fluid more than other agents. Therefore, they are the preferred drugs for treating hypertension. The other antihypertensive agents that promote fluid reduction, ACEIs and angiotensin receptor blockers (ARBs), are next in preference, ranking a close second to diuretics. Because beta-blockers have a neutral effect on total body fluid, they rank on a third tier of preference, after ACEIs and ARBs. CCBs and alpha-blockers are the least preferred medications for treating hypertension because they promote fluid retention.     

Veterinarian Perception of the Intentional Misuse of Veterinary Medications in Humans: A Preliminary Survey of Idaho-Licensed Practitioners

The intentional administration of veterinary medications to humans is a form of medication misuse that has not been systematically studied. Veterinarians are the health practitioner group most likely to have knowledge about this problem and to be approached by the public for advice. For this preliminary study, questionnaires were mailed to 1,077 veterinarians registered with the Idaho Board of Veterinary Medicine regarding their knowledge and perceptions of this type of misuse; 392 (36.4%) completed surveys were returned. The most frequently reported veterinary medications misused in humans were analgesic, anti-inflammatory medications, anti-arthritis medications, or both; systemic antibiotics, topical anti-infectives; and topical corticosteroids. People involved with rodeo, horse racing, and health care; rural area residents; and those lacking health insurance were perceived to be the groups most likely to misuse veterinary drugs. Veterinarians rated the following as likely reasons for misuse: having an independent self-sufficient attitude, convenient availability of veterinary medications, lower cost, and belief that veterinary medications are stronger than comparable human medications. Human misuse of veterinary drugs may be more common than many health practitioners realize. Limitations of this study include the response rate, sampling of veterinarians licensed in only one rural state, and reliance on veterinarians' recall of relevant instances of misuse and their perceptions of groups most likely to misuse these drugs and why. These limitations make it difficult to determine if the problem is being under- or over-represented relative to the general population. However, regardless of the magnitude of the problem in the rural population, the general population, or both, the potential for harm is great. Patients with risk factors for this form of misuse should be questioned by their physician in a nonthreatening manner to detect use of veterinary medications and to provide an opportunity to inform them of the risks.