有的短缺、有的涨价、有的停产?廉价常用药去哪了

2019-03-16 覃星星 半月谈

不少基层医疗机构和群众反映,时下部分呵护群众健康的廉价常用药短缺,有的临床常用药一药难求,价格飞涨,甚至涨了50多倍。更换名称包装,价格从几元变几十元廉价常用药在基层医疗机构和群众中颇有口碑,近年来却呈消失之势。“遇到小孩发烧、拉肚子,村卫生室都说没有药,只能跑到很远的地方去买。”西部某村村民杨翠金说。华南大瑶山腹地某卫生院院长反映,对于高血压病人,硝苯地平缓释片一盒仅几元钱,效果好又便宜,很受山

不少基层医疗机构和群众反映,时下部分呵护群众健康的廉价常用药短缺,有的临床常用药一药难求,价格飞涨,甚至涨了50多倍。

更换名称包装,价格从几元变几十元

廉价常用药在基层医疗机构和群众中颇有口碑,近年来却呈消失之势。“遇到小孩发烧、拉肚子,村卫生室都说没有药,只能跑到很远的地方去买。”西部某村村民杨翠金说。

华南大瑶山腹地某卫生院院长反映,对于高血压病人,硝苯地平缓释片一盒仅几元钱,效果好又便宜,很受山区群众欢迎,但医院就是没药。又如治疗腰痛的复方氯唑沙宗胶囊、治疗痛风的别嘌醇胶囊、治疗糖尿病的胰岛素注射液、用于外伤止血的云南白药粉等,在不少基层医疗机构或短缺,或断货。

廉价应急常用药缺乏,更令人心忧。西部一家乡镇卫生院院长对半月谈记者说,作为心衰急救临床常用药,西地兰不贵又实用。现在,这种药消失了,给上面多次打报告,却一直采购不到,心衰病人送来都不知道怎么办。无独有偶,在中越边境某乡,由于柴胡注射液缺货,卫生院有时只能“借药应急”。

在廉价常用药消失的同时,一些临床常用药涨价迅猛,群众直呼用不起。

碘解磷定注射液是农药中毒的解毒药,在西部某县,该药原进货价13.2元/盒,现进货价涨至720元/盒,现价是原价的54.5倍;治疗破伤风的破伤风抗毒素,每盒价格从36元涨到76.5元;妇产科常用药缩宫素注射液原进货价26元/盒,现在货价40元/盒……西

部某县卫计局干部直言,一个普遍现象是,一些药品更换名称和包装后,价格便从几元变成几十元。

一些便宜常用药越生产越亏本

目前,短缺的廉价常用药大都是治疗妇儿专科、急救、慢性病的药品。这几类药品的生产扶持政策不完善,致使企业利润空间得不到有效保障。一些药品越生产越亏本,企业积极性不高。

药品配送企业是保障基层用药的重要一环,但由于基层药品利润低,药品配送企业往往“择贵而送”或者不配送。西部一名向基层配送药品的医药销售经理对半月谈记者说,随着原材料价格上涨,一些药品价格出现倒挂(成本价高于中标价),药企将部分药品停产。

西部某自治区卫健委一名处长认为,“两票制”(指药品从药厂卖到经销商开一次发票,经销商卖到医院再开一次发票,以减少流通环节的层层盘剥)推行后,多个流通环节缩短为两个环节,制药企业和药品经销商尚处在调整生产经营策略的过渡期,利益重新调整容易导致一些药品短缺。

投机垄断的因素也不容忽视。西部某自治区卫健委的药政处负责人说,随着药品政府定价机制取消,药品价格由市场决定,部分药品市场竞争不充分,价格出现上涨。对一些市场上生产厂家少、临床不可替代的药品品种,一些药品经销商或控制原料,囤货不卖,造成市场供应紧张,或囤积后随意涨价出售。

促生产畅流通,保障基层药品供应

多名基层医疗机构负责人反映,廉价常用药短缺,使得基层患者对医院意见很大,不少病人不愿意到缺医少药的基层医疗机构就诊,而宁愿去拥挤的上级大医院看病,这严重影响医改“强基层”的效果。

基层医疗机构负责人呼吁,在国家层面建立短缺药品及原料药停产备案制度,医疗机构合理确定储备规模。对临床必需、用量少、市场供应短缺的药品,国家应进一步扩大定点生产品种和规模。

针对一些常用药无法进入采购平台的问题,多名卫计局局长建议,采购平台不应指定具体生产厂家,同时补助利润薄的廉价药,保证企业利润,弥补市场机制的不足,提高药品生产积极性。

此外,要对医药市场一些不法行为加大打击力度。业内人士建议,制定药品集中采购价格联动方案,合理控制短缺药品价格上涨幅度,实施各地采购价格偏高药品与全国最低采购价格联动机制,进一步降低药品采购价格,提升供应保障能力。

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    2019-05-27 wxl882001

    了解一下

    0

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    2019-04-10 wxl882001

    了解一下

    0

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    2019-03-18 tamgche
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    2019-03-18 liuxiaona