With the attempt to launch telemedicine in many places, getting prescriptions from remote terminals seems to bring a breakthrough in retail drugstores and pharmaceutical e-commerce to prescription drug vendors. For example, recently obtained a good pharmacist Wuhan Central Hospital outpatient pharmacy distribution business distance selling some drugs, but not long ago Ali Health Central Hospital of Wuhan recently announced Check Lynx medicine museum provide telemedicine services. However, as the number of visits at the remote end increases, prescription outflows mean two problems for the retail side and the regulator.
First of all, it is a question mark whether the prescription flows out to the retail side to reduce the cost of medicines. From the perspective of telemedicine trials in the United States, the proportion of antibiotic use has not decreased, but is higher than offline. This is caused by two factors. First, doctors are in a lack of grasp of the disease to increase the use of broad-spectrum antibiotics. Second, the patient volunteered to ask the doctor to prescribe medicine. Both of these points have pushed up medical spending.
China also has such problems. The patient may lead the doctor to prescribe too many prescriptions, and although the doctor may not be able to directly obtain the economic benefits of the outflow prescription, but for a more conservative estimate, it is possible to prescribe a prescription that is not necessarily required by itself, resulting in an increase in costs.
The second question is whether some prescription outflows brought by telemedicine can mean that prescriptions can be decoupled from the doctor's economic interests, thus driving market-based prescription drug sales, saving patients money, and helping medical insurance control fees. This logical chain Whether it can be established is also uncertain.
From the current outflow of prescriptions, prescriptions are still developing in a point-by-point manner. This is because the market is still in the early stages, and hospitals are required to provide telemedicine services. The pilot is an institution that is expanding. For the redemption of prescriptions, retail-side sellers, they must seize the opportunity to cooperate with these points. At present, there are fewer points, more sellers, and the outflow of hospital prescriptions will inevitably consume some of the doctor’s economic interests, and the scarcity of points Sexuality means that product sellers are willing to sacrifice some of their profits first, and there may be similar interests in the way that medical institutions receive subsidies from retail pharmacies.
If the retail side cooperates with the telehealth service through the collaborative mode, giving the medical institution a certain share at the retail end of the service while obtaining the prescription outflow means that the prescription is still tied to the medical institution, but this The bundle of interests has shifted from the hospital to the outside of the hospital. For the retail side, it means that the channel cost of the prescription will not be conducive to the retailer to adjust the price of the drug to a competitive range, can not directly benefit the patient, and can not reduce the cost for medical insurance.
The solution to these two problems depends to a large extent on the strength of regulation and the possibility of third-party prescription management in the future, becoming a regulator between prescriptions (doctors) and product sellers (pharmacies). For regulators, prescription outflows mean that more sophisticated regulatory tools are needed to rigorously review the need for prescriptions and whether they are consistent with the patient's medical history and disease symptoms through an independent drug regulatory agency, PBM. This will help solve the problem of abuse of antibiotics and over-pharmaceutics in the first issue. For the second problem, PBM can cut off the interest chain by blocking the prescription source and making it impossible for the retail side to directly trace the prescription to a medical institution. This will help the price of prescription drugs to return to the market at the retail end, which will benefit the patients and also help the medical insurance to control the expenses.
However, it is not easy to establish a prescription management system. The first condition is to open up medical data and bundle electronic medical records with individuals, rather than being confined to isolated islands of hospital institutions. This condition alone is time consuming and challenging. The second condition is to establish a refined prescription management model, using automatic screening and manual review to filter unreasonable prescriptions or incorrect prescriptions. The establishment of this system requires a lot of experience in drug data, and it is currently lacking in China.
In summary, the outflow of prescriptions is good for the retail side, and it takes time to operate slowly. However, in the long run, if there is no independent third-party prescription management agency, it will be difficult to monitor the abuse of drugs and cut off the service providers and The interests of the retail side involve.
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