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OBJECTIVE To explore the influential factors for “Internet +” prescription circulation and construction specifications of prescription circulation platform， so as to provide reference for the government to formulate relevant policies and standardized construction of prescription circulation platform. METHODS Stakeholders in the process of prescription circulation service in medical institutions in Sichuan province were selected to conduct key insider interviews， and grounded theory was used to analyze the data. RESULTS The influential factors of prescription circulation could be divided into three aspects： participant factor， administrative decision factor and information technology factor. The influential factors of prescription circulation mainly lay in pharmacy admission and withdrawal mechanism， medical insurance reimbursement service， supporting policies and pharmaceutical care ability. In terms of pharmacy admission and withdrawal mechanism， pharmacy qualification， pharmaceutical service personnel， drug allocation and distribution should be considered to unify pharmacy admission standards； in terms of medical insurance reimbursement service， it should actively connect with social pharmacies to realize the transfer of prescription medical insurance reimbursement from designated pharmacies； in terms of supporting policies， it should pay attention to the construction of the top-level design of prescription circulation； in terms of pharmaceutical care ability， regular training and assessment of licensed pharmacists should be performed in drug consultation， prescription review and other pharmaceutical care. CONCLUSIONS Participants have more influence on prescription circulation， and pharmacy admission and withdrawal mechanism and pharmaceutical care ability need to be improved. There are various types of prescription circulation platform construction， but each has its own advantages and disadvantages. It is suggested that relevant government departments should improve the access threshold of pharmacies， follow up medical insurance reimbursement services and supporting policies， and explore ways to improve pharmaceutical care capacity， leading and issuing relevant policies and measures to promote the prescription circulation service and make the “Internet +” prescription circulation develop in an orderly manner.
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OBJECTIVE To provide reference for the access to medical insurance for rare diseases in China based on the existing access pathway and framework by analyzing the access policy of medical insurance for rare diseases in the United Kingdom （UK）. METHODS After collecting relevant guidelines and policy documents related to drug use for rare diseases in the UK， content analysis method was used to analyze the evaluation mechanism of drug use for rare diseases， reimbursement decision- making standards， stakeholder participation， coping strategies for dealing with uncertainties and risks， and policy implementation effects， and extract the key points of medical insurance access for drug use for rare diseases in the UK， to provide some suggestions for the establishment of medical insurance access system for rare diseases in China. RESULTS & CONCLUSIONS From the perspective of access， the UK had adopted a separate approach and clear criteria to assess and reimburse drugs for rare diseases. From the perspective of evaluation mechanism， multi-stakeholders such as doctors， patients and applicants participated in the decision-making process in the UK. The UK addressed uncertainty and risk by gathering better clinical evidence and using the patient access programme. After the implementation of the policy related to drug use for rare diseases， the UK had achieved remarkable results in terms of funding for drug use for rare diseases， the reimbursement rate of drug application， and the number of funded patients. It is suggested that in the process of establishing and improving the evaluation and reimbursement system for rare diseases drugs in China， the availability of rare diseases drugs should be improved by establishing a separate access assessment path for rare diseases drugs and involving more stakeholders.
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OBJECTIVE To provide reference for perfecting prescription circulation service and related platforms construction and improving online medical service level. METHODS A questionnaire was designed after literature review and consulting expert opinions. Patients who had received prescription circulation service in the prescription circulation platform of a Grade-A third-class hospital in Sichuan Province from November 22， 2019 to May 2022 were randomly selected， and the knowledge， attitude and practice of prescription circulation service were investigated by questionnaires， which were sent through telephone contact and short message. RESULTS A total of 285 patients were investigated， and the number of effective responses was 200. Most of the surveyed patients in prescription circulation service for 1-5 times in the past year （129 cases， 64.50%）； 77.0% of the patients had a “general understanding” or “no understanding” of prescription circulation services， and the main prescription circulation services they received were online consultation service （169 cases， 84.50%） and drug delivery service （106 cases， 53.00%）. The average waiting time and expected waiting time were 1-5 min. The services with the largest number of demand （145 cases， 72.50%） and the highest demand （3.585 points） were drug delivery services. Most of the respondents’ willingness to pay was “general willingness” （83 cases， 41.50%）， and most of the patients were willing to pay less than or equal to 5 yuan per time （92 cases， 46.00%）. Totally 73.0% of the surveyed patients were “satisfied” or “relatively satisfied” with the prescription transfer service. The results of univariate analysis showed that the main factors influencing patients’ satisfaction with prescription circulation service were service awareness， service waiting time， patients’ demand satisfaction and patients’ willingness to pay. CONCLUSIONS The surveyed patients are generally satisfied with prescription circulation service， and the service content with high satisfaction is drug distribution service， and patients are willing to pay a lower price for prescription circulation service. It is suggested that relevant departments should strengthen the publicity of prescription circulation service， improve the content of prescription circulation service and reduce the payment price of prescription circulation service， so as to improve the operation efficiency of Chinese medical system while facilitating patients.
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OBJECTIVE：To provide ideas for the development of electronic prescription （e-prescription）service mode under the background of “Internet+”. METHODS ：Retrieving official websites and related online resources of the national and provincial governments，health committees ，medical products administration ，and medical security bureaus （up to Jun. 2020），relevant policies，supporting documents and implementation status of e-prescription service mode were sorted out and analyzed ，and the suggestions were put forward. RESULTS ：Current e-prescription service modes included four modes ，such as pharmaceutical retail enterprise e-prescription service mode ，medical institution e-prescription information sharing service mode ，internet hospital e-prescription service mode ，and medical e-commerce e-prescription service mode. The pilot of e-prescription service mode of drug retail enterprises covered the widest range of provinces and cities ，but the participation of health departments and medical institutions was insufficient ，and the pattern of comprehensive power had not been formed. The medical institutions e-prescription information sharing service mode was mainly composed of three typical examples ，namely“Wuzhou mode ”，“Fuzhou mode ”and “Gansu mode ”. However ，it had not been unified in terms of technical standards ，access conditions ，exit mechanism and execution process，etc. At present ，this model was still in a small scope of exploration and pilot stage. The internet hospital e-prescription service mode was limited by the popularization of internet hospital medical insurance payment and the improvement of corresponding rules and regulations ，which was still at the stage of cautious pilot exploration. Medical e-commerce e-prescription service model was limited by the types of drugs within the legal service scope. Meanwhile ，the industry standards and regulations of e-prescription service were in the absence at present. CONCLUSIONS ：As an innovative service mode ，the e-prescription service mode meets the real needs of the pharmaceutical retail industries ，medical institutions and patients. Each pilot mode conforms to the development trend of “Internet+”and shows a strong development momentum ，but overall it is still in the early stage of active exploration. It is urgent to further explore and research around the leading departments ，stakeholders and prescription transfer procedures.