Application practice of drug clinical comprehensive evaluation thinking in management of temporary drug purchase in hospital / 中国药房

OBJECTIVE To explore the construction of a new scientific management model for temporary drug purchase，and to provide a reference for hospitals to improve the level of rational drug use. METHODS Guided by clinical diagnosis and treatment needs and patient medication safety， our hospital carried out the whole process management practice of temporarily purchased drugs by optimizing the review process， creating a review team， formulating pre-audit and post follow-up evaluation standards based on comprehensive drug evaluation， and evaluated the practice effect through the number of temporary purchase applications， implementation rate， drug structure optimization and other indicators. RESULTS Since January 2021， our hospital had implemented a new mode of temporary drug purchase management. By December 2022， clinical pharmacists had reviewed 111 temporary drug procurement applications， effectively intercepted 13 irrational drug use applications （11.71%）， reduced the overall implementation rate of temporary drug procurement by 8.36%，and proposed five batches of drug structure optimization suggestions； 24 drugs were successively introduced such as camrelizumab，sorafenib，busulfan. After optimizing the management mode，the number of temporary drug procurement applications decreased by more than half from 133 in 2019 and 138 in 2020 to 66 in 2021 and 45 in 2022. CONCLUSIONS The model is helpful to optimize the hospital drug catalog， strengthen rational drug use，ensure the safety of patients’ drug use， and fully reflects the professional value of clinical pharmacists in hospital pharmacy management and rational drug use.

Study on the Purchase Management of Priority Reviewed Drugs in China / 中国药房

OBJECTIVE： To provide reference for improving the purchase management policy of priority reviewed drugs in China. METHODS： Based on the purchase management policy of priority reviewed drugs in China， priority reviewed drugs approved for market by the end of 2017 were sorted out； the priority reviewed drugs that had been purchased in a clear way were selected and classified according to the reasons for their inclusion in the priority review. The procurement methods of different categories of priority reviewed drugs in different provinces were compared in order to find out the shortcomings of priority reviewed drug procurement management and put forward related suggestions. RESULTS & CONCLUSIONS： By the end of 2017， 56 priority reviewed drugs achieved marketing authorization， 16 of which were purchased through provincial drug procurement platforms. Among the 16 drugs mentioned above， there were 13 priority reviewed drugs of which purchase methods were specific， including direct online purchase， price-limited online purchase， bidding purchase， price-negotiated purchase， bidding purchase and record purchase. And the direct online purchase was used the most frequently. According to the reasons included in the priority review， above 13 drugs with specific purchase methods were divided into 5 categories such as new drugs with obvious clinical value， urgent medical needed drugs， pediatric drugs， first generic drugs， the drugs which had passed investigational new drug application. China’s purchase management policy of priority reviewed drugs still had shortcomings through three aspects， including the system design， purchase method and management procedure. There is no sufficient connection between the registration review policy and the procurement policy. In addition to the clinical badly-needed priority reviewed drugs， the procurement methods of priority reviewed drugs in the remaining categories was not uniform， and the regional difference was large. And the utilization degree of pharmacoeconomic evaluation during the drug purchasing process needed to be improved. It is suggested to make the category of drug purchase more detailed combining with the classification of drug registration， unify the method of drug purchase to make the purchase way of each kind of priority reviewed drugs explicit， standardize the management of drug purchase and improve the attention and utilization of pharmacoeconomic evaluation， so as to improve the accessibility of priority reviewed drugs in China.

Keypoint Analysis of Monitoring Plan for Centralized Drug Purchase and Use Project Pilot Launched Organized by State / 中国药房

OBJECTIVE： To provide reference for further evaluating， improving and ensuring the smooth implementation of centralized drug purchase and use pilot organized by the state. METHODS： By using the methods of literature research and investigation， monitoring purpose， monitoring contents （including supply guarantee， use guarantee， quality guarantee and cost control） and monitoring methods of Monitoring Programme for Centralized Drug Purchase and Use Pilot Projects Organized by the State were sorted， summarized and analyzed so as to put forward the suggestions.  RESULTS & CONCLUSIONS： The monitoring purpose was to control the procurement phase from two aspects： policy guidance and information monitoring. In the contents of monitoring， monitoring indicators were set up for supply gurantee from two aspects of production and circulation. The former included seven indicators of production inventory， stop and resume production， source and supply and price of core raw materials and accessories， and the latter included two indicators of channel inventory and days of repayment. For use gurantee， selected drugs， original drugs in the item of generic name， other drugs in the terms of generic name and substitutable drugs of the same kind were monitored in respects of monthly purchase price， purchase quantity， purchase amount， accumulative purchase quantity， accumulative purchase amount， prescription quantity. Quality gurantee indexes included drug stability （batches and projects of unqualified drugs）， safety （ADR， severe ADR， public complaints and reporting incidents） and effectiveness （number of drug-change patients and number of secondary drug-change patients）. For cost control， the monthly drug quantity and cost of selected drugs， original drugs in the item of generic name， other drugs in the terms of generic name and substitutable drugs of the same kind were monitored； original drug cost （for original drugs in the term of same generic name）， the cost of other drugs and the reimbursement ratio of last year’s medical insurance （for other drugs in the term of generic name） were compared with the same period of the previous year， in which the drug quantity was calculated by DDDs. The monitoring methods included three-level monitoring by the national organization office for the contralized procurement and useage of pharmaceuticals， “4+7” city joint procurement office and pilot area， and regular monthly reporting and timely feedback of monitoring information. Monitoring information submission was mainly in the form of standardized report format （filling by manual in monthly， e-mail submission） and automatic system submission （every day， other pilot cities and Shanghai Joint Purchasing Data Exchange Platform established data interface for automatic submission）. According to the fact， author put forward the suggestions to improve the monitoring contents， such as adjusting the measurement standard of inventory turnover days， defining the statistical caliber of purchasing quantity and price monitoring， distinguishing the specifications of pharmaceutical preparations and packaging， defining the every drug DDD value in monitoring range， and so on. At the same time， the author suggests optimizing the reporting mode of monitoring information， interworking the purchasing platform with medical insurance information， and integrating drug supply chain information from manufacturing enterprises， distribution enterprises， medical institutions to patients， providing cross-provincial trading services， etc.， make them play a greater role in drug procurement management of the National Healthcare Security Administration， rational use management of drug by the Nation Health Commission of the People’s Republic of China， and drug traceability management of the National Medical Products Administration.

Improvement Effects of SPD System on the Implementation of “Two-invoice System ”in Drug Procurement in Our Hospital / 中国药房

OBJECTIVE： To provide reference for promoting the implementation of “two-invoice system” for drug purchase in medical institutions. METHODS： The function of confirmation， enquiry， statistics for “two-invoice system” of drug purchase order were added into relevant module of SPD （supply processing distribution） system to realize the management of “two-invoice system” data by means of information technology. By analyzing the data of the “two-invoice system” of Shanxi dayi hospital （our hospital） from Aug. 2017 to Jun. 2018， the effects of SPD system on “two-invoice system” of drug purchase in our hospital were introduced after the application of SPD system. The effects of SPD system were evaluated in respects of work efficiency， accuracy rate and resource saving， etc. RESULTS： SPD system was used for the management of “two-invoice system” to realize the information management of invoices. The time for checking “two-invoice system” information was shortened from 1.5 min/sheet to 0.1 min/sheet； the accuracy rate was increased from 95％ to 100％， and about 40 000 sheets of paper were saved each year. CONCLUSIONS： The application of SPD system in “two-invoice system” of drug purchase can improve the work efficiency， reduce the labor cost and reduce the waste of resources， it effectively improves the level of management in our hospital.

Application and Practice of Drug Quantitative Scoring Table in the Temporary Drug Purchase of Our Hospital / 中国药房

OBJECTIVE： To standardize the management of temporary drug purchase， and to provide reference for drug selection in Hospital Pharmaceutical Administration and Drug Treatment Committee （Pharmaceutical Association）. METHODS： Clinical pharmacists set up drug quantitative scoring table according to the 10 attributes of drugs as effectiveness， safety， economy， etc. 15 temporary purchased drugs submitted by departments in Oct. 2018 were graded according to the rules of the scoring table， and the evaluation results were fed back to Pharmaceutical Association. A retrospective evaluation of 20 temporary purchased drugs which were discussed at the Pharmaceutical Association from Jul. to Sept. 2018 was made according to previous approval model without using drug quantitative scoring table. The effect of pre-intervention was evaluated after using drug quantitative scoring table. RESULTS： Among 15 temporary purchased drugs， 2 of them scored below 60， and the unqualified rate was 13.3％. It suggested that 2 drugs could not be discussed at the meeting. Among 20 temporary purchased drugs that have been discussed at the meeting， 9 of them scored below 60， with the unqualified rate of 45.0％， suggesting that 9 drugs may have wasted the workload of the Pharmaceutical Association. CONCLUSIONS： Drug quantitative scoring table can play a pre-intervention role in the scoring of temporary purchased drugs to a certain extent. At the same time， the table can also be used as a relevant reference for hospital drug evaluation. It is helpful to optimize hospital drug use list and improve the level of rational drug use in clinic.

Development Research of City-level Drug Quantity Purchasing Mode and Analysis of Drug Purchase Mode in Cities of Fujian Province / 中国药房

OBJECTIVE:To provide reference for the further improvement of centralized drug procurement in China. METHODS:By retrieving Suggestions on Improving the Drug Centralized Purchase of Public Hospitals issued by State Council in 2015 and drug centralized purchase policy document issued by provinces (regions,cities),the development of drug quantity purchasing mode was investigated. The mode of drug purchase in cities of representative Fujian province was analyzed. RESULTS& CONCLUSIONS:As of Aug. 31st,2017,city-level quantity purchasing mode was implemented in 12 provinces (regions, cities). Specific mode included taking the form of medical partnerships as the main body [taking cities as unit,taking cities as unit+hospital,only one medical partnership in the region or city] and taking the form of the types of negotiated drugs as main body [negotiated price for network drugs in provinces (regions,cities),negotiated price for the whole variety]. 7 cities of Fujian province announced procurement programs,quotation and bargaining rules were formulated and entered the procurement stage. Relative departments should actively promote drug quantity purchasing mode in regions or cities and also pay attention to the relationship of drug price with the quality of drugs,the purchase amount of drugs and the payment of purchase loans,the"second bargaining""third bargaining"and so on.

Investigation and Research on Influential Factors and Behavioral Characteristics of Online Drug Purchase: Taking Ningbo as an Example / 中国药房

OBJECTIVE: To provide evidence and reference for online pharmacy business and government policy adjustment. METHODS: Taking Ningbo as an example, intercepting questionnaires survey was conducted in major drugstores and major commercial centers. The influential factors of online drug purchase, specific reasons of not purchasing drugs online, online drug purchase "5W1H" behavior characteristics and influential factors of purchase decision were investigated. The data processing was conducted by using EpiDate 3. 1 and SPSS 19. 0 software. RESULTS: A total of 700 questionnaires were issued, and 660 valid questionnaires were collected with effective recovery of 94. 29％. Educational degree of the respondents, internet frequency and online shopping frequency had significant impact on whether purchased drugs on the internet (P＜0. 05), while gender, age, place of residence and type of medical insurance had no significant impact on it (P＞0. 05). Among specific reasons for not purchasing drugs online, score decended by the order of worrying about the safety of purchasing drugs online, worrying about the logistics and after-sales service, can not get professional medical and pharmaceutical care. Among the characteristics of network drug purchase behavior, 50. 2％ of respondents purchased drugs online out of the cheapness; 41. 2％ buying goods that were not available locally; Tmall and Jingdong mall were the main way to buy, accounted for 78. 9％ and 44. 2％, respectively. Within the last 6 months, online purchasing less than 5 times accounted for 72. 4％, and the amount less than 300 yuan accounted for 57. 3％. Most respondents expected to pay by Alipay and medical insurance card, each accounted for 53. 8％. Among decision-making influential factors, score decended by the order of commodity factor, after-sales service and logistics, shop and business qualification, professional service; price factor scored the lowest. CONCLUSIONS: The higher educational degree, internet frequency and online shopping frequency, the more inclined to online drug purchase. Low trust, logistics and customer service difficult to guarantee and inability to get professional service are main reasons for not purchasing drugs online. The characteristics of online drug purchase manifest as low amount, low frequency and single way. Great attention is paid to the nature of drug properties, the business qualification, after-sale rights protection and logistics efficiency, when the consumer decides to buy. It is suggested to improve online pharmacy business and related policy adjustment by forming differential marketing model, strengthening consumer confidence, cultivating consumption habits, strengthening after-sales guarantee and logistics construction, choosing suitable sale platform and professional development, avoiding vicious price-cutting competition.

Reflections on the Reform of "Two-vote System" for Drug Purchase Based on Financial Perspective / 中国药房

OBJECTIVE: To provide reference for China to comprehensively promote and perfect the "two-vote system" for drug purchase. METHODS: The effects of "two-vote system" on interested parties, the existing problems of drug purchase and its financial reasons were analyzed; the finance strategies were put forward to deal with the existing problems of drug purchase. RESULTS & CONCLUSIONS: "Two-vote system" has certain impact on drug production enterprises, drug circulation enterprises, public medical institutions and government drug supervision departments. At present, the existing problems of drug purchase mainly include that the mechanism of "drug to support hospital" has promoted the virtual-high price of drugs; drug enterprises pull drug sales by the way of rebate; hidden rules disrupt the circulation of drugs as "be subordinate to" "amateur performance". Financial reasons mainly include that the mode of "drug to support hospital" pursuit the maximization of its own interests unilaterally and ignore the drug cost burden of patients; some enterprises have poor investment, lack of R&D investment, have weak internal financial control measures, lack of social responsibility consciousness, rely on "be subordinate to" "amateur performance" profit, underestimate financial risk, etc. The drug production enterprises should adjust marketing model and reduce cost; drug circulation enterprises should predict positioning scientifically and expand profit space; public medical institutions should reform financial supply and reduce drug cost; government drug supervision departments should reduce the supervision cost and improve the comprehensive efficiency. Only by deepening the reform of the medical and health care system, improving the supporting measures for the "two-vote system" in drug purchase can the problems existing in the circulation of drugs be solved gradually.

Application Practice of Establishing Temporary Drug Purchase Approval Function of Hospital in Office Au-tomation System / 中国药房

OBJECTIVE:To improve the hospital workflow and efficiency in temporary drug purchase approval process. METHODS:The approval function for temporary drug purchase was introduced into office automation(OA)system in our hospi-tal,and the effects were evaluated. RESULTS:According to ensuring the administrative approval process,system function permis-sion assignment and approval process design in temporary drug purchase in our hospital,functions for approving temporary drug purchase were established in OA system. It achieved convenient,efficient,timely,networking and paperless approval work,as well as standardized record,checking out at any time and automatic statistics for drug purchase. CONCLUSIONS:Introducing tem-porary drug purchase approval function into hospital OA system can simplify workflow,provide better service for clinic,and pro-mote development of hospital pharmacy management.

Influencing factors and the drug purchase behaviors of outpatients in Beijing, Zhengzhou and Guangzhou / 中国卫生政策研究

Objective:To understand the drug purchase behaviors and prescription flows of outpatients and their influencing factors. Methods: After selecting and investigating tertiary hospitals, secondary hospitals, community health service centers ( one per each level) in Beijing, Zhengzhou, Guangzhou, this paper uses structured question-naire method to analyze 3,155 valid questionnaires. A logistic regression analysis is performed to understand the fac-tors influencing the drug purchase behaviors. Results:The factors influencing the drug purchase behaviors of outpa-tients mainly include the region where the patient is, level of the hospital, type of health insurance that the patient has, frequency of drug purchase, etc. Conclusions: This paper suggests hospital administrators to take measures to improve prescription flows, such as reforming the health care insurance to make payment system more suitable for pharmacies standardizing supply channels in order to make varieties consistent between hospitals and pharmacies, strengthening education and publicity to raise the outpatients’ awareness for drug purchase outside of hospitals, etc.

Status Quo and Trend of Centralized Drug Purchase in Medical Instiution / 中国药房

OBJECTIVE: To provide reference for the formulation of national centralized drug purchase policy. METHODS: Five stages of drug purchase were reviewed to analyze target of centralized drug purchase policy, purchase mode, suitable range of centralized purchase and its ways and rules, etc. Problems about centralized drug purchase were summarized, and trend of standardizing national drug centralized purchase was put forward. RESULTS & CONCLUSION: Centralized drug purchase should be further standardized and improved.

Practice of the First Time Online Bidding for Drug Purchase in a Large-scale Hospital in Anhui Province:Investigation and Analysis / 中国药房

OBJECTIVE:To investigate the implementation and the outcome of the first time online bidding for drug purchase so as to provide reference of further standardizing the online bidding for drug purchase.METHODS:The data of the first time online bidding for drug purchase of a large grade three class A comprehensive hospital were subjected to a retrospective statistical analysis with the use of Shanghai Jinshida Weining THIS4.0 system and Excel software.RESULTS:86.06% of the drug varieties in this hospital underwent online bidding for drug purchase.The mean drug cost,per capita drug cost of outpatients and inpatients were reduced by 6.95%,10.61%,and 1.10%,respectively.CONCLUSION:The online bidding for drug purchase contributes to the standardization of hospital drug purchase behavior and relieving of the problem of "high cost in medication".However,which is far from perfect and thus remains to be improved further.

Application of Moving Average Method in Formation of Hospital Drug Purchase Plan / 中国药房

OBJECTIVE:To provide a method for a scientific and rational formation of hospital drug purchase plan.METHODS:Based on the major factors influencing the drug purchase plans,a moving-average method(mathematical principle)was used to establish computational formula for hospital drug purchase plan model,which was then put into practice.RESULTS:The predicted amount calculated using the computation model could be used to track the actual consumption quantity rapidly;this model could auto-adjust the inventory and dynamically forecast the drug purchase amount.CONCLUSION:The computation model contributes to the scientific and reasonable formation of hospital drug purchase plan thus meeting the needs of majority clinical drugs.

Drug Purchase Management and Drug Use Monitoring in Our Hospital / 中国药房

OBJECTIVE: To introduce the methods of drug purchase management and drug use monitoring in our hospital,and to provide reference for drug management in hospitals.METHODS: Sunshine Project of New Drug Purchase and scientific selection methods for contract drugs were carried out in order to control the quality of drugs and monitor the whole process of new drugs.RESULTS: 82 kinds of new drugs were purchased in our hospital since 2005 and 1 500 kings of drugs were voted by randomly selected experts to apply in the clinic.The consumption sum of drugs in our hospital were controlled within 500 million yuan,and the drug use was basically rational.CONCLUSIONS: Methods for new drugs purchase and use in our hospital can promote rational use of drugs in the clinic.

Establish Honest Government Risk Prevention & Control Pattern to Containment the Unhealthy Tendency in Drug Purchase / 中国药房

OBJECTIVE: To containment the unhealthy tendency in drug purchase and to promote the healthy and harmonious development of heath service.METHODS: Honest government risk prevention & control pattern was established in our hospital,and the system construction was strengthened,furthermore,a scientific operation flow was formulated,and a system of rewards and disciplinary evaluation was established.RESULTS: With the honest government risk prevention & control pattern,the centralized public bidding was achieved in 100% of the hospital drug purchasing,the clinical drug use tends to be more and more rational and standard,and the drug use structure became more reasonable,the honest government risk in drug purchase and sale has been effectively avoided.CONCLUSION: This honest government risk prevention & control pattern is practical and feasible thus deserving popularized in medical institutions.

Explore How to Examine and Verify the Qualification Document of Drug Supplier on the Issue Medical Institution / 中国药房

OBJECTIVE:To guarantee that the medical institutions to purchase qualified drugs from legal suppliers of drug.METHODS:The qualification documents of the pharmaceutical manufacturers and management enterprises were collected,examined and verified,numbered and filed.RESULTS & CONCLUSIONS:Strict examination of the qualification documents of the drug suppliers contributed to scientific and normalized management of drug purchase of medical institutions so as to guarantee the drug quality.

Establishment of Control Model for Hospital Drug Purchase Plan / 中国药房

OBJECTIVE:To study the control model for hospital drug purchase plan.METHODS:On the basis of six fac?tors related to hospital medicines purchase,the control model for hospital drug purchase plan was established by using computer system.RESULTS&CONCLUSION:Purchase plan made from mathematics model under the control of computer rather than personal experience helps to improve the management in hospital and bring about rational allocation of hospital resources.

Study on the Business Data Needed in Drug Purchase and Payment in Hospital / 中国药房

OBJECTIVE:To provide accurate business data for purchase and payment of drugs in order to reduce inventory costs and improve cash circulation efficiency. METHODS:According to analysis of influence factor for required payment and actual payment,business data of drug purchase and payment were put forward and designed in respect of business process,data structure,algorithm and so on. RESULTS:Scientific payment management applied in information system resolved the problems of inaccurate basic data of drug payment and information islands. CONCLUSIONS:Funds of drug purchase achieve scientific distribution by hospital purchase and payment to minimize the cost of drug stock and improve the utilization rate of funds.

Experiences of Ningxia's "Trinity" Reform of Drug Tender Policy / 中国药房

OBJECTIVE:To summarize the experiences of Ningxia's drug tender policy reform in unifying tender operation,price,and distribution("Trinity" reform).METHODS:Review of the reform process with discussion from the perspective of extension of tender policy objective,essential medicine policy as well as existing problems and corresponding countermeasures.RESULTS & CONCLUSIONS:In addition to the functions that Ningxia's "Trinity" reform of drug tender policy solidifies the price-lowering role of drug tender policy and benefits the construction of essential medicine policy,the reform still needs to be improved with regards to some existing problems.

Experience with the Practice of ISO9001 Standards in the Public Bid of Drug Purchase of Medical Institutions / 中国药房

OBJECTIVE:To probe into the standardized administration in the public bid for drug purchase of medical institutions.METHODS:Experiences and understandings in carrying out ISO9001standards in the public bid for drug purchase of our hospital were introduced;problems involved in which were analyzed and some advices were put forward.RESULTS&CONCLUSION:The practice of ISO9001standards does good to the consummation and standardization of the public bid of drug purchase in Chinese medical institutions.